一起幼儿园手足口病暴发疫情调查

 目的 调查分析某幼儿园手足口病暴发的流行病学特征及其影响因素,为有效控制疫情暴发提供策略。方法 通过多渠道搜索2021年6月8日—7月8日该幼儿园的手足口病病例,对病例特征进行分析,同时进行环境卫生学调查和病例对照研究,分析可能造成本次疫情传播及暴发的因素。结果 本次疫情病例集中分布在大一班、中一班、中二班,共搜索到病例25例(确诊5例),其中男性14例,女性11例,总罹患率9.12%(25/274)。临床表现以手、足和口部疱疹或皮疹症状为主,症状典型。采集5例病例鼻咽拭子标本,检测均为柯萨奇A16阳性。流行曲线提示疫情基本符合"人传人"的发病特点。病例对照研究结果显示,接触手足口病疑似患者(OR=6.50,95%CI:2.73~45.44)、在学校不洗手(OR=4.92,95%CI:1.56~22.52)、有触摸口唇/吃手指的习惯(OR=6.20,95%CI:1.74~38.33)、手和指甲不干净(OR=2.92,95%CI:1.23~6.92)是该起疫情暴发的主要危险因素。结论 该起疫情由柯萨奇A16型引起,接触手足口病患儿是导致此次事件发生的主要原因,接触未消毒的公共设施是造成本次疫情传播的最重要途径。

An outbreak of hand-foot-and-mouth disease in a kindergarten

Objective To investigate the epidemiological characteristics and influencing factors of hand-foot-and-mouth disease (HFMD) outbreak in a kindergarten, and provide strategies for effective control of epidemic. Methods HFMD cases in a kindergarten from June 8 to July 8, 2021 were searched, characteristics of cases were analyzed, environmental hygiene survey and case-control study were carried out,and factors that caused the spread and outbreak of the epidemic were analyzed. Results The epidemic cases were concentrated in the first class, the middle-first class and the second class, a total of 25 cases (5 confirmed cases) of HFMD were found, including 14 males and 11 females, the overall incidence was 9.12% (25/274). The main clinical manifestations were herpes or rash on hands, feet and mouth, symptoms were typical . Nasopharynx swab specimens from 5 cases were positive for Coxsackie A16. The epidemic curve indicates that the epidemic situation basically conformed to the characteristics of "human to human transmission". Case-control study results showed that the main risk factors for the outbreak were contacting with suspected HFMD patients (OR=6.50, 95%CI: 2.73-45.44), not washing hands at school (OR=4.92, 95%CI: 1.56-22.52), the habit of touching lips/eating fingers (OR=6.20, 95%CI: 1.74-38.33), and unclean of hands and nails (OR=2.92, 95%CI: 1.23-6.92). Conclusion This outbreak was caused by Coxsackie A16, exposure to HFMD children is the main cause of this outbreak, and contact with undisinfectant public facilities is the most important route of transmission.