某幼儿园一起手足口病暴发的现场流行病学调查报告

目的了解某幼儿园手足口病暴发的流行病学特征及造成传染的主要原因,为进一步做好该园手足口病防控工作提供依据。方法按照病例定义,电话开展病例搜索,结合现场流行病学调查情况,形成假设,采用1：2匹配的病例对照研究,对照选取同班同年龄组同性别的儿童,使用统一的调查表询问儿童的日常卫生习惯。结果该幼儿园从2010年3月16日至3月23日共发生9例临床诊断病例,3例实验室确诊病例,罹患病率为7.95%。以小班病例为主,3～4岁组比例高（8/12）。3份粪便检测出病原体CoxA16。有吸吮手指、吸吮玩具、饭前不洗手、便后不洗手、挖鼻孔、揉眼睛等任一不良卫生习惯是手足口病发病的危险因素（OR=12,95%CI=1.3～114）。结论幼儿不良卫生习惯是该幼儿园手足口病传播的主要原因。建议该园加强儿童不良卫生习惯的纠正,培养良好卫生习惯,以达到控制传染的目的。

A Case Report of Epidemiological Investigation of A Hand-Foot-Mouth Disease Outbreak in A Kindergarten

Objective To understand the epidemiological features of hand-foot-and-mouth disease（HFMD） outbreaks in a kindergarten and the cause of infection,and to provide scientific basis for the further prevention and control in the kindergarten.Methods Information was obtained through telephone survey and field inspection.we came to a hypothesis and tested it by a 1：2 matched case-control study.Age and sex matched children in the same class were selected as control.The inquiry included the personal hygiene of the children.Results 9 clinic-confirmed cases and 3 lab-confirmed cases were diagnosed between 16 March and 23 March 2010,and the attack rate was 7.95%.Most of the cases were from the junior class and the proportion of 3 to 4 years old group was high.CoxA16 was detected in 3 fecal specimens.Poor health habits such as sucking fingers and toys,un-hand-washing after urinating and before meals picking noses and rubbing eyes,were the risk factors（OR=12,95%CI=1.3~114）.Conclusion Poor health habit was the major cause of HFM transmission in this kindergarten.Kindergarten should help the children to develop a good health habit for the prevention of disease outbreak.