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目的分析上海市杨浦区2012年手足口病聚集性疫情流行特征,为制定手足口病防控措施提供科学依据。方法应用描述性流行病学方法,对杨浦区2012年手足口病聚集性疫情进行分析,计数资料用χ2检验,计量资料用方差分析,P<0.05为差异有统计学意义。结果 2012年杨浦区共报告手足口病聚集性疫情80起,波及18 384人,涉及病例337例,平均患病率1.83%,无重症、死亡病例。发生在中小学3起,占3.75%,为不同的3家学校,发生率为2.94%;发生在托幼机构77起,占96.25%,涉及托幼机构56家,发生率为52.83%。报告高峰在4~6月份。疫情的持续时间与疫情非及时处理(首发病例发病时间-停课时间间隔)(r=0.352,P=0.002)及发病人数(r=0.458,P<0.001)之间呈显著正相关,在控制发病人数影响后,疫情持续时间与疫情非及时处理的统计学相关性增强(r=0.385,P=0.001)。在因素不变的情况下,聚集性疫情每延迟处理2d,或发病人数每增加1人,疫情时间均会延长1d,即:y=0.09+0.81x1+0.51x2。采样的34起疫情中,由EV71、Cox A16、其他肠道病毒引起的疫情数分别为10(29.41%)、6(17.65%)和9起(26.47%)。结论防控的重点仍是托幼机构,加强全年监测,深入研究病原变异,督促学校做好晨检和及时上报工作,规范处置能很好的控制疫情的发展。
Objective To analyze the epidemic characteristics of HFMD in Yangpu District of Shanghai in 2012 and provide a scientific basis for the prevention and control measures of HFMD. Methods Descriptive epidemiological methods were used to analyze the HFMD epidemic in Yangpu District in 2012. Chi-square test was used to count data, and the measurement data were analyzed by ANOVA. P <0.05 was considered as statistically significant. Results In 2012, a total of 80 HFMD outbreaks were reported in Yangpu District, affecting 18,384 people. There were 337 cases involved, with an average prevalence rate of 1.83%. There were no severe cases or deaths. Occurred in 3 primary and secondary schools, accounting for 3.75%, for three different schools, the incidence was 2.94%; occurred in 77 kindergartens, accounting for 96.25%, involving kindergartens 56, the incidence was 52.83%. The report peaked from April to June. There was a significant positive correlation between the duration of the outbreak and the non-timely treatment of the outbreak (the onset time of the first case-time between closure) (r = 0.352, P = 0.002) and the number of patients (r = 0.458, P <0.001) After the impact of population, the statistical correlation between the duration of the outbreak and the non-timely treatment of epidemic situation was enhanced (r = 0.385, P = 0.001). Under the same factors, the epidemic situation will be prolonged by 1d every 2 days of delayed or 2-hour increase in the number of outbreaks, ie: y = 0.09 + 0.81x1 + 0.51x2. Of the 34 outbreaks sampled, the number of outbreaks caused by EV71, Cox A16 and other enteroviruses were 10 (29.41%), 6 (17.65%) and 9 (26.47%) respectively. Conclusion The focus of prevention and control is still nurseries and kindergartens, to strengthen the annual monitoring, in-depth study of pathogenic variation, and urge the school to do a good job of morning inspection and timely reporting, standardize the disposal can well control the development of the epidemic.