甘肃省一起学校手足口病暴发疫情调查

An outbreak of hand-foot-mouth disease at a school in Gansu

目的对甘肃省LT县发生的一起学校手足口病暴发疫情开展流行病学调查,为本地手足口病暴发疫情的防控提供参考。方法制定病例定义后,开展病例搜索、调查病例发生情况和可疑传播途径;采集病例鼻咽拭子标本以RTPCR方法检测肠道病毒核酸;采用描述和分析流行病学相结合的方法分析病例的流行病学特征、学生日常生活相互接触情况和卫生习惯。结果共搜索到19例病例,其中幼儿园15例、小学4例,罹患率幼儿园儿童(7.69%,15/195)高于小学生(1.32%,4/302),临床表现以手、足和口部疱疹或皮疹症状为主,流行曲线提示疫情基本符合“人传人”的发病特点;抠鼻子、揉眼睛、手部和指甲不干净是手足口病发病的危险因素,4例病例鼻咽拭子标本中检出EV71阳性。结论本次疫情为一起学校发生的EV71病毒感染引起的手足口病暴发疫情,未及时对首发病例和第二三例病例采取隔离措施是导致疫情由中班传播至小班、大班等其他班级的根本原因;应及早做好学生健康教育工作,促使幼儿养成良好的卫生习惯,减少疾病的感染风险。

Objective To investigate an outbreak of hand-foot-mouth disease(HFMD)at a school in LT county of Gansu province,and provide references for the prevention and control of local outbreak of HFMD.Methods The case definition was clearly made for case search,investigation on situation of cases onset and suspicious transmission way.The nasopharyngeal swab was collected for detection for enterovirus nucleic acid with RT-PCR.The epidemiological characteristics,daily contact and hygienic habit of students were analyzed with descriptive and analytical epidemiology methods.Results Totally 19 cases were found,including 15 cases of children in a kindergarten and 4 cases of students at an elementary school.The prevalence rate of kindergarten children(7.69%,15/195)was higher than that of primary school students(1.32%,4/302).The herpes of hand,foot and mouth or skin rash were the main clinical symptoms.The epidemic curve indicated that the outbreak basically met the characteristics of human-to-human transmission.Picking noses,rubbing eyes,and unclean hands and nails were the risk factors of HFMD infection.The nasopharyngeal swabs of 4 cases were detected EV71 positive.Conclusions This outbreak of HFMD is caused by EV71 virus at a school.The failure to timely isolation of the first,second and third cases is the primary reason for HFMD spreading from middle class to small and large class.The health education should be conducted as early as possible at the school,and good hygiene habits of children should be trained to reduce the risk of infection.