广州市越秀区2011——2015年学校聚集性疫情流行特征分析

Epidemiological characteristics of school clustered cases in Yuexiu District of Guangzhou,2011-2015

目的分析越秀区2011—2015年学校各类聚集性疫情的流行特征和处理情况,为应对学校聚集性疫情提供依据。方法采用SPSS20.0统计软件包对收集到的聚集性疫情率、比、中位数进行描述性统计分析,多样本率比较采用Kruskal-Wallis秩和检验,不同变量间相关性采用Pearson秩相关分析。结果共报告聚集性疫情538起,病例数2 910例,种类有手足口病、流感样病例、水痘和诺如病毒感染性腹泻。流感样病例疫情和水痘疫情在幼儿园罹患率最高,流感样病例为2.41%,水痘为1.36%(P=0.003;P=0.000)。夏秋季是手足口病高发季节,高发场所在托幼机构,其中2015年手足口病聚集疫情由EV71病毒引起占采样起数的61.54%,3—6月是流感样病例暴发疫情的高发季节,水痘发病的高峰集中在4—6月及12月—次年1月,诺如病毒感染性腹泻高峰于9—12月及次年1月、3月。手足口病和水痘疫情,首发病例至报告处理的时间间隔(天)和首发病例至末例病例出现时间间隔(天)呈正相关(r=0.969,P=0.000;r=0.869,P=0.000)。结论幼儿园是聚集性疫情防控的重点单位,学校聚集性疫情要做到早发现、早报告、早处理,并通过广泛的宣传教育提高水痘、流感、EV71手足口病疫苗接种率来提升人群免疫水平。

Objective To analyze the characteristics and epidemic situation and control status of clustered cases of various aggregation epidemics at schools in Yuexiu District, Guangzhou City, so as to provide the evidence for improving the control work of the potential clustered cases in the future. Methods The data of various aggregation epidemics at schools were collected and statistically analyzed to describe the rate, ratio, and median of the clustered cases by using the SPSS20.0software. The multiple rates were compared by using Kruskal-Wallis rank test and the variable correlation was analyzed by using Pearson rank analysis. Results Totally 538 clustered cases were reported, with the case number of 2 910, including hand-foot-mouth disease（HFMD）, influenza-like illness（ILI）, chickenpox and norovirus gastroenteritis. ILI and chickenpox had the leading prevalence among kindergarten children, and the prevalence of influenza-like illness was 2.41%, and the prevalence of chickenpox was 1.36%（P=0.003;P=0.000）. The clustered HFMD peaked during summer and autumn in the child care settings, of which EV71 virus accounted for 61.54% in 2015. ILI cases peaked during the period of March to June.The chickenpox cases peaked during the period of April to June and of December to the next January. The duration time between the firstly reported case and the report processing time was positively associated with the duration time between the first case and the last case for HFMD and chickenpox clustered cases（r=0.969, P=0.000; r=0.869, P=0.000）. Conclusions The kindergarten is the key unit of prevention and control of aggregation epidemics. We should respond to school outbreaks through early detection, early reporting and early treatment. We also need to enhance the health education to increase the chickenpox, influenza and EV71 vaccination rates to elevate the population immunity level.