珠海市托幼机构手足口病流行病学特征分析

Analysis of epidemiological features of hand foot and mouth disease(HFMD) in nurseries of Zhuhai City

目的分析珠海市2012年托幼机构手足口病聚集性疫情的流行病学特征,为预防托幼机构的手足口病流行提供依据。方法收集珠海市2012年113家托幼机构内手足口病聚集性疫情的数据与资料,采用观察性流行病学方法进行描述及分析。结果 2012年珠海市共发现并调查托幼机构手足口病聚集性疫情148起,每起聚集性发病2-14例,平均8.1例/起。1年内曾发生2次或以上手足口病聚集性疫情的有24家,占21.2%（24/113）,其中1家发生4次聚集性疫情。农村地区托幼机构的手足口病聚集性疫情发生率明显低于城镇地区（χ^2=11.95,P〈0.05）。病例年龄最小的1岁,最大的6岁,其中3岁或以下年龄组的儿童发病最多,占总数的57.4%（691/1 203）。EV71的检出率最高（39.3%）。疫情持续时间与首例病例发病时间—首次介入调查时间间隔之间差异有统计学相关性（r=0.580,P〈0.05）。不同病原学型别引起的手足口病聚集性疫情的持续时间之间差异无统计学意义（F=0.523,P=0.595）。配置消毒水的浓度和课室紫外线灯管离地的高度在与疫情的持续时间在病例组和对照组之间差异有统计学意义（P〈0.05）。结论珠海市2012年托幼机构手足口病主要病原是EV71和CoxA16,消毒措施是否符合消毒技术规范是影响手足口聚集性疫情发生和持续时间的可能因素。

Objective To understand the epidemiological features of hand foot and mouth disease（ HFMD） in nurseriesof Zhuhai city in 2012. Methods The data of HFMD in nurseries of Zhuhai city in 2012 were collected andepidemiologically analyzed. Results Total 148 cluster infections of HFMD were reported in nurseries averagely with 2 to 14cases in each events and averagely the infection occurred for every 8.1 days. The incidence of cluster infection of HFMD inurban nurseries was significant higher than that of nurseries rural area（χ^2=11.95, P〈0.05）. Age of the HFMD cases was from 1years to 6 years, most of them were 3 years old or below, accounting for 57.4%（691/1203） of total cases. The detection rate ofEV71（39.3%） was the highest. Statistically significant difference was observed between the duration of disease, the onset of thefirst case, and the time interval of first survey（r=0.580, P〈0.05）. No statistical significance was found between the duration ofdisease epidemic in HFMD caused by different pathogenic types（F=0.523, P=0.595）. The concentration of disinfection waterand the height of classroom UV lamp above ground showed statistically significant difference between the observation groupand control group（P〈0.05）.Conclusion The principal pathogen of HFMD in Zhuhai in 2012 was EV71 and CoxA16（61.9%）. The disinfection quality in nurseries and the strictly abide by the technical criteria for disinfection might be possiblefactor influencing cluster infection and duration of HFMD.