2023年自贡市一起柯萨奇病毒A4引起的幼儿园疱疹性咽峡炎暴发疫情  

Investigation of an outbreak of herpangina caused by coxsackievirus A4 in a kindergartens in Sichuan Province

作　　者：张洁[1] 游春芳[2] 明雪微 刘雅琼[3] 崔婷婷 王斌[1] 陈曦[1] ZHANG Jie;YOU Chunfang;MING Xuewei;LIU Yaqiong;CUI Tingting;WANG Bin;CHEN Xi(Zigong Center for Disease Control and Prevention,Zigong 643000,Sichuan Province,China;Zigong First People's Hospital,Zigong 643000,Sichuan Province,China;Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China)

机构地区：[1]自贡市疾病预防控制中心,四川自贡643000 [2]自贡市第一人民医院,四川自贡643000 [3]四川省疾病预防控制中心,四川成都610041

出　　处：《职业卫生与病伤》2024年第1期21-25,共5页Occupational Health and Damage

摘　　要：目的 了解柯萨奇病毒A4(coxsackievirus A4,CV-A4)引起的疱疹性咽峡炎暴发疫情的流行病学特征及排毒时长,为疱疹性咽峡炎暴发疫情防控提供数据支撑。方法 2023年5月对自贡市金苹果幼儿园1起疱疹性咽峡炎暴发疫情进行调查处置,采集幼儿园小2班教师2份、全体儿童咽拭子9份和环境样本10份,经RT-PCR肠道病毒核酸检测,对阳性儿童再次连续采样(间隔1周)至核酸检测阴性时终止。结果 本次疫情共发现病例14名,罹患率为53.9%(14/26)。患儿临床症状以发热(100.0%)、咽痛(78.6%)及咽峡部疱疹(71.4%)为主,咽拭子和环境样本中均检出肠道病毒核酸阳性,分型为CV-A4。排毒时长中位数为21(95%CI:14.0~28.0)d,生存分析检验显示病例与隐性感染者、男性与女性排毒时长差异无统计学意义。结论 本次疫情为一起CV-A4型引起的幼儿园疱疹性咽峡炎暴发疫情,排毒时间较长,建议幼儿园、学校在节假日后强化晨午检工作,持续对儿童进行追踪随访,卫生与教育部门协同做好流行季节肠道病原学监测。Objective To investigate the epidemiological characteristics of a herpangina outbreaks caused by coxsackievirus A4(CV-A4) and explore the duration of detoxification,so as to provide scientific basis for the prevention and control of herpangina outbreaks. Methods In May 2023, an outbreak of herpangina in Zigong Jinpingguo Kindergarten was investigated and disposed. After obtained informed consents, two samples from kindergarten teachers of Class 2, 9 throat swabs from all children and 10 environmental samples were collected, enterovirus nucleic acid detection by RT-PCR, all the confirmed herpangina cases were continuously sampled every week until two consecutive Nucleic acid test results were negative. Results A total of 14 cases were reported in the outbreak,the incidence was 53.9%(14/26). The main symptoms of the cases were predominantly fever(100.0%), sore throat(78.6%) and pharyngeal isthmus herpes(71.4%), respectively,enterovirus nucleic acid was positive in throat swabs and environmental samples of children,which were classified as coxsackie virus A4. The median length of detoxification was 21 days(95% CI:14.0-28.0 d),and the Log-rank test showed no statistically significant difference between cases and latently infected cases, and between males and females. Conclusions This outbreak of herpes pharyngitis in kindergarten caused by coxsackievirus A4 type,with a long detoxification time. It is cruicial to enhance the morning and afternoon inspections and health education in kindergartens and schools after the vacations,especially during the epidemic season of infectious disease.

关 键 词：柯萨奇病毒A4型 暴发 流行病学特征 

分 类 号：R725.1[医药卫生—儿科] R181.8[医药卫生—临床医学]