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目的分析珠海市2012年托幼机构手足口病聚集性疫情的流行病学特征,为预防托幼机构的手足口病流行提供依据。方法收集珠海市2012年113家托幼机构内手足口病聚集性疫情的数据与资料,采用观察性流行病学方法进行描述及分析。结果 2012年珠海市共发现并调查托幼机构手足口病聚集性疫情148起,每起聚集性发病2~14例,平均8.1例/起。1年内曾发生2次或以上手足口病聚集性疫情的有24家,占21.2%(24/113),其中1家发生4次聚集性疫情。农村地区托幼机构的手足口病聚集性疫情发生率明显低于城镇地区(χ2=11.95,P<0.05)。病例年龄最小的1岁,最大的6岁,其中3岁或以下年龄组的儿童发病最多,占总数的57.4%(691/1 203)。EV71的检出率最高(39.3%)。疫情持续时间与首例病例发病时间—首次介入调查时间间隔之间差异有统计学相关性(r=0.580,P<0.05)。不同病原学型别引起的手足口病聚集性疫情的持续时间之间差异无统计学意义(F=0.523,P=0.595)。配置消毒水的浓度和课室紫外线灯管离地的高度在与疫情的持续时间在病例组和对照组之间差异有统计学意义(P<0.05)。结论珠海市2012年托幼机构手足口病主要病原是EV71和CoxA16,消毒措施是否符合消毒技术规范是影响手足口聚集性疫情发生和持续时间的可能因素。
Objective To analyze the epidemiological characteristics of HFMD in Zhuhai in 2012 and to provide a basis for prevention of FMD epidemics in nurseries in Zhuhai. Methods Data and data on the aggregated outbreaks of HFMD in 113 kindergartens in Zhuhai were collected and analyzed by observational epidemiological methods. Results A total of 148 HFMD outbreaks were found and investigated in Zhuhai in 2012, with a cumulative incidence of 2 to 14 cases (average 8.1 cases / case). Twenty-four (21.2%) of them (24/113) had a cluster outbreak of HFMD twice or more in a year. Of these, one occurred in four outbreaks. The prevalence of HFMD in nurseries in rural areas was significantly lower than that in urban areas (χ2 = 11.95, P <0.05). The youngest patient was 1 year old and the oldest was 6 years old, with the highest incidence in children aged 3 years or younger, accounting for 57.4% (691/1 203) of the total. The highest detection rate of EV71 (39.3%). The difference between the duration of the outbreak and the onset time of the first case-the interval of the first intervention was statistically significant (r = 0.580, P <0.05). There was no significant difference in the duration of the aggregated outbreaks of hand-foot-mouth disease caused by different etiological types (F = 0.523, P = 0.595). The concentration of sterilizing water and the height of UV lamp in the classroom were statistically different between the case group and the control group in the duration of the epidemic (P <0.05). Conclusion The major pathogens of hand-foot-mouth disease in nurseries in Zhuhai in 2012 are EV71 and CoxA16. Whether the disinfection measures comply with the disinfection technical specifications is a possible factor that affects the occurrence and duration of hand-foot-mouth aggregation epidemic.