北京市某幼儿园手足口病聚集疫情流行病学调查

Epidemiological investigation on an outbreak of hand foot and mouth disease in a kindergarten in Beijing

目的 了解2014年北京市某幼儿园手足口病聚集疫情的流行病学特征,为完善手足口病防治措施提供科学依据.方法 应用描述性流行病学方法进行调查,并采集患儿及密切接触者的咽拭子进行荧光定量RT-PCR方法检测.结果 该幼儿园短时间内手足口病共发病12例,主要集中在4～5周岁儿童,罹患率为7.89％,流行期15 d.首发病例发病前接触过确诊的手足口病患儿,其余患儿发病前和潜伏期的首发病例有密切接触.12例患儿中发热5例,占41.7％,11例患儿均有口腔疱疹、手足出现红疹的临床表现.实验室检测出CoxA16病毒株样品7件,EV71病毒株样品1件,肠道未分型病毒株样品1件.结论 流行病学调查结合实验室检测结果可推测此起疫情是由CoxA16病毒株引起.该疫情提示疫情流调过程中,在建立整体疫情框架的同时应系统分析该疫情中的每一例个案,找寻个案之间的关联,从而为疫情的定性提供依据.在手足口病防控工作中,应着重加强手足口病的健康教育,提高家长对手足口病的认识程度.

Objective To understand the epidemiologieal characters of an outbreak of hand foot and mouth disease in a kindergarten in Beijing in 2014, and to provide scientific evidence for disease control and prevention. Methods Descriptive epidemiologieal method was adopted in investigation. Throat swabs from cases and their close contacts were collected and detected by fluorescence quantitative RT-PCR. Results Total 12 cases were reported during the short term outbreak and most of them were 4 to 5 years old. The attack rate was 7.89% and the interval of epidemic was 15 days. The index case had exposed to confirmed patient before the onset of illness. Other cases contacted with the index patient closely. Among 12 cases, 5 had the symptom of fever （accounted for 41.7% ）, 11 had oral herpes and hands and feet rash. CoxA16 strain was detected from 7 samples. EV71 and other enterovirus were also found out from one sample. Conclusion This study showed the outbreak of hand foot and mouth disease was caused by CoxA16. The outbreak also suggested that we should analyze each case carefully and find the link between cases during the epidemiological investigation. Health education and disease knowledge should be strengthened in disease control and prevention strategies.