幼儿园手足口病暴发疫情特点及影响因素

Epidemiological characteristics and influencing factors of hand-footmouth disease outbreaks in kindergartens

目的：了解幼儿园手足口病暴发疫情特点及影响因素，为开展防控工作提供参考。方法通过万方数据库和中国知网（CNKI）期刊全文数据库，搜集2009—2015年发表的幼儿园手足口病暴发疫情文献资料并进行描述、分析。结果共获得幼儿园手足口病暴发疫情事件39起，其中2008—2012年发生35起，2007、2013、2014、2015年各1起。发生时间：5月份和4月份暴发疫情数较多，分别占疫情总数的33．34％和23．08％。疫情持续时间为5～52 d，中位数为11 d，30．77％的疫情持续两周以上。幼儿园全园罹患率为1．90％～39．74％，65．79％的疫情全园罹患率介于5％～15％，13．16％的疫情全园罹患率＞20％。85．71％的暴发疫情波及到全园20％以上班级，其中25．71％的暴发疫情覆盖所在幼儿园全部班级。EV71、CoxA16均可造成幼儿园手足口病暴发，部分暴发疫情中可检测到两种病毒；EV71和CoxA16组疫情全园罹患率、发病最高班罹患率、班级波及率和疫情持续时间比较，差异均无统计学意义（均P＞0．05）。结论幼儿园内一旦出现手足口病暴发，疫情强度大，EV71、CoxA16均可造成幼儿园手足口病暴发。在幼儿园手足口病暴发疫情中，班级规模与罹患率间无明显联系。

Objective To study the epidemiological characteristics and influencing factors of hand-foot-mouth dis-ease（HFMD）outbreaks in kindergartens,so as to provide reference for control and prevention of HFMD. Methods Papers published between 2009 and 2015 about HFMD outbreaks in kindergartens were retrieved from Wanfang database and China National Knowledge Infrastructure （CNKI）,then collected papers were analyzed. Results Data about 39 cases of HFMD outbreaks were obtained,35 cases occurred in 2008-2012,1 case occurred respectively in 2007,2013,2014,and 2015. 33.34% and 23.08% of outbreaks occurred in May and April. Out-breaks lasted 5-52 days,with a median of 11 days,30.77% of outbreaks lasted more than 2 weeks. The attack rates of the whole kindergartens were 1.90% -39.74% ,attack rates of whole kindergartens were 5% -15% a-mong 65.79% of outbreaks,attack rate of whole kindergartens was 〉20% among 13.16% of outbreaks. 85.71%of outbreaks involved more than 20% of classes,25.71% of which involved all classes. Both EV71 and CoxA16 caused HFMD outbreaks in kindergartens,two kinds of viruses were both detected in some outbreaks;there were no significant difference in attack rate of whole kindergartens,attack rate of classes with highest incidence,class in-volving rate,and duration of epidemic between EV71 and CoxA16 epidemic groups（all P〉0.05）.Conclusion Once an HFMD outbreak occurred in a kindergarten,epidemic intensity would be high,both EV71 and CoxA16 can cause HFMD outbreak. There is no obvious correlation between class size and attack rate.