托幼机构手足口病暴发对周围散居儿童感染手足口病的影响  

Connections between HFMD outbreak in kindergartens and the infection of scattered children living nearby

作　　者：王春艳[1] 王磊[1] 国红娟 

机构地区：[1]保定市疾病预防控制中心,河北071000

出　　处：《医学动物防制》2017年第8期866-868,共3页Journal of Medical Pest Control

基　　金：河北省卫生计生委重点科技研究计划(20150407)

摘　　要：目的探讨散居儿童手足口病发病与托幼机构手足口病暴发之间的联系,为控制散居儿童手足口病发病提供参考。方法采用病例对照方法对某县两所幼儿园手足口病暴发期间,该幼儿园儿童居住地感染手足口病和未感染手足口病的散居儿童进行问卷调查,了解其感染手足口病的危险因素。对两所托幼机构手足口病病人和健康儿童分别采集咽拭子标本,用实时荧光定量反转录聚合酶链反应法进行病毒核酸检测。结果单因素分析显示:儿童发病前10 d内接触过手足口病病人、发病前10 d内接触过幼托儿童、家中有其他在托幼机构的儿童、所接触的幼托儿童所在班级有手足口病病人均为散居儿童发病的危险因素,饮食前给儿童洗手和有单独使用的毛巾是保护因素。多因素分析显示:儿童发病前10 d内接触过手足口病病人、发病前10 d内接触过幼托儿童、家中有其他在托幼机构的儿童和所接触的幼托儿童所在班级有手足口病病人均为散居儿童发病的危险因素。发生手足口病暴发的班级,其隐性感染病毒型别为Cox A16和其他肠道病毒,隐性感染率为38.46%。结论托幼机构手足口病暴发期间幼托儿童有较高的隐性感染率,减少幼托儿童与当地散居儿童的接触,重视传染源的妥善管理和隔离,加强幼托和散居儿童的家庭教育,促使其养成良好的卫生习惯,是降低散居儿童手足口病发病率的有效手段。Objective According to this investigation,the relationship between HFMD outbreak in kindergartens and infection of scattered children living nearby has been discussed in order to provide a reference for lowering the infection rate of scattered children. Methods During the period of HFMD outbreak in two kindergartens of a county,a case-control method has been used to investigate scattered children with or without HFMD living near the kindergartens by questionnaires and analyze their risk factors of HFMD infection. For HFMD sick children and healthy children in the kindergartens,throat swabs and stool samples were collected to detect virus nucleic acid with fluorescent PCRs. Results Single-factor analysis shows that contact HFMD sick children within 10 days before the morbidity,contact kindergarten children within 10 days before the morbidity,having other children sent to kindergartens in the family,the kindergarten children they contact have HFMD sick children in their class are risk factors for scattered children＇s infection; while washing hands before meal and having separate towel for each child are protective factors. Multiple-factor analysis shows that contact HFMD sick children within 10 days before the morbidity,contact kindergarten children within 10 days before the morbidity,having other children sent to kindergartens in the family,the kindergarten children they contact have HFMD sick children in their class are all risk factors for scattered children＇s infection. In HFMD outbreak classes,children＇s inapparent infection viruses are Cox A16 and other enterovirus,with an inapparent infection rate of 38. 46%. Conclusion Children in kindergartens tend to have a higher rate of inapparent infection. Reducing scattered children＇s exposure to kindergarten children,attaching importance to appropriate management and isolation of infection source,reinforcing the family education for both scattered children and kindergarten children to help them form healthy habits are effective methods for lowering the morbi

关 键 词：托幼机构 手足口病 暴发 隐性感染 

分 类 号：R512.5[医药卫生—内科学]