2012—2017年上海市黄埔区托幼机构手足口病聚集性病例流行特征及影响因素
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摘要
目的了解2012—2017年上海市黄浦区托幼机构幼儿手足口病聚集性病例流行特征,分析引起手足口病聚集性疫情的相关因素。方法收集2012—2017年黄浦区托幼机构手足口病聚集性疫情及病例,对部分病例采集咽拭子标本进行病原学检测。结果 2012—2017年黄浦区共发生1 220例手足口病例,187起手足口聚集性疫情,涉及病例678例,平均每起手足口聚集性疫情中出现3.63例病例。聚集性病例缺勤至报告的加权平均时间为(2.68±2.66)天,最短为0.41天,最长为11.43天。夏季或冬季,幼儿园,私立/民办,低级别学校,小班学生,男童,缺勤日期与报告日期时间差大,是病例成为聚集性疫情病例的危险因素。6—8月肠道病毒71型(EV71)占比较高(54.5%),12—2月柯萨奇病毒A组16型(CoxA16)占比较高(77.0%)。结论 2012—2017年黄浦区手足口病聚集性疫情起数有下降趋势,但聚集性病例构成比较高,应加强对私立/民办、低级别的托幼机构手足口病聚集性疫情报告的培训,提高学校主动报告意识,增强及时性,及早进行疫情处置,防止手足口散发病例演变为聚集性病例。夏季、冬季应针对不同手足口病病原体开展有针对性的防控措施,减少手足口病聚集性疫情的发生。
[Objective]To und erstand the epidemiological characteristics of hand-foot-mouth disease(HFMD)cluster cases in kindergarten children of Huangpu District in Shanghai from 2012-2017,analyze the influencing factors of cluster epidemic.[Methods]The epidemic situation of HFMD cluster cases kindergarten children of Huangpu District in Shanghai from 2012-2017 was collected,and throat swabs were collected from some cases for etiological examination.[Results] From 2012-2017,totally HFMD cases occurred in Huangpu District,there were 187 cluster events,involving 678 cases,with an average of 3.63 cases in one HFMD cluster epidemic event. The weighted average time from absence to report was(2.68±2.66)days,the shortest was0.41 days and the longest was 11.43 days. In summer or winter,the kindergarten,private school,the lower level,junior class,the boy,the longer the time interval between the date of absence and the date of the report were the risk factor of the case became cluster cases. Enterovirus 71(EV71) accounted for a relatively high proportion(54.5%)from June to August,while coxsackievirus A16(CoxA16) accounted for a relatively high proportion(77.0%) from December to February.[Conclusion]From 2012-2017,the number of HFMD cluster epidemic events in Huangpu District has decreased,but the proportion of cluster cases has increased. It is necessary to strengthen the training of the reports of the HFMD cluster epidemic in private and lower level kindergartens,improve the awareness of initiative report,enhance the timeliness,and dealt with the epidemic situation as early as possible to prevent sporadic cases evolved into clustered cases. In summer and winter,the targeted prevention and control measures for different HFMD pathogens should be carried out to reduce the incidence of HFMD cluster epidemic.
[Objective]To und erstand the epidemiological characteristics of hand-foot-mouth disease(HFMD)cluster cases in kindergarten children of Huangpu District in Shanghai from 2012-2017,analyze the influencing factors of cluster epidemic.[Methods]The epidemic situation of HFMD cluster cases kindergarten children of Huangpu District in Shanghai from 2012-2017 was collected,and throat swabs were collected from some cases for etiological examination.[Results] From 2012-2017,totally HFMD cases occurred in Huangpu District,there were 187 cluster events,involving 678 cases,with an average of 3.63 cases in one HFMD cluster epidemic event. The weighted average time from absence to report was(2.68±2.66)days,the shortest was0.41 days and the longest was 11.43 days. In summer or winter,the kindergarten,private school,the lower level,junior class,the boy,the longer the time interval between the date of absence and the date of the report were the risk factor of the case became cluster cases. Enterovirus 71(EV71) accounted for a relatively high proportion(54.5%)from June to August,while coxsackievirus A16(CoxA16) accounted for a relatively high proportion(77.0%) from December to February.[Conclusion]From 2012-2017,the number of HFMD cluster epidemic events in Huangpu District has decreased,but the proportion of cluster cases has increased. It is necessary to strengthen the training of the reports of the HFMD cluster epidemic in private and lower level kindergartens,improve the awareness of initiative report,enhance the timeliness,and dealt with the epidemic situation as early as possible to prevent sporadic cases evolved into clustered cases. In summer and winter,the targeted prevention and control measures for different HFMD pathogens should be carried out to reduce the incidence of HFMD cluster epidemic.
引文
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[11]王文碧,敬琼,杨秀程.2014—2016年阿坝州手足口病病原学监测结果分析[J].预防医学情报杂志,2018,34(9):1150-1153.
[12]赖辉兵,黄海锋,王娟.云浮市5岁以下婴幼儿家长手足口病认知和肠道病毒71型灭活疫苗接种意愿调查[J].职业与健康,2018,34(14):1952-1956.
[13]黄灵,张月华,林晓,等.海口地区儿童家长手足口病认知情况与EV71疫苗接种意愿及影响因素调查[J].实用预防医学,2018,25(8):995-998.
[14]彭立昌.天津市某区2010—2016年手足口病流行特征和防控策略研究[D].天津:天津医科大学,2017:42-43.
[15]颜丙新,马利君,刘伟,等.2010—2013年济宁市手足口病聚集性疫情流行病学及病原学特征分析[J].现代预防医学,2015,42(7):1165-1167.
[16]田靓,朱仁义,范俊华,等.江宁.上海市2009年托幼机构手足口病聚集性病例流行病学分析[J].中国学校卫生,2011,32(5):596-598.
[17]赖汉佳.珠海市2015—2016年手足口病聚集性疫情流行病学和病原学特征分析[J].人人健康,2018(2):17,19.
[18]叶中文,阮峰,张雪宝,等.珠海市托幼机构手足口病流行病学特征分析[J].中国热带医学,2014,14(4):414-416,428.
[2]金丹.2009—2016年徐州市法定报告传染病流行病学分析[J].预防医学情报杂志,2018,34(9):1199-1205.
[3]于德山,张勇,陈建华,等.甘肃省2008—2012年手足口病流行特征及病原学研究[J].病毒学报,2014,30(1):25-32.
[4]仲宾山.2014—2017年广元市利州区手足口病流行病学特征分析[J].寄生虫病与感染性疾病,2018,16(2):92-96.
[5]刘建生,韦庆娟,苏兴栋.2015—2017年泰安市手足口病流行病学特征分析[J].预防医学论坛,2018,24(5):344-345,349.
[6]高杰,李春华,王领,等.2011—2015年承德市手足口病流行特征及防控体系[J].职业与健康,2016,32(18):2526-2529.
[7]葛锦荣,孙霞霞,朱彩蓉,等.2011—2017年宁波市北仑区手足口病流行特征及病原学特征分析[J].预防医学情报杂志,2018,34(9):1222-1228.
[8]王金明,路滟,许少坚,等.2013—2017年深圳市龙华区手足口病流行病学及病原学特征分析[J].华南预防医学,2018,44(3):250-253.
[9]张王剑,季振东,郭貔,等.广东省2009—2012年手足口病流行趋势分析[J].中山大学学报(医学科学版),2014,35(4):607-613.
[10]郑媛,周步宇,关路媛,等.2009—2013年陕西省手足口病流行病学及病原学特征分析[J].中华疾病控制杂志,2015,19(2):135-137.
[11]王文碧,敬琼,杨秀程.2014—2016年阿坝州手足口病病原学监测结果分析[J].预防医学情报杂志,2018,34(9):1150-1153.
[12]赖辉兵,黄海锋,王娟.云浮市5岁以下婴幼儿家长手足口病认知和肠道病毒71型灭活疫苗接种意愿调查[J].职业与健康,2018,34(14):1952-1956.
[13]黄灵,张月华,林晓,等.海口地区儿童家长手足口病认知情况与EV71疫苗接种意愿及影响因素调查[J].实用预防医学,2018,25(8):995-998.
[14]彭立昌.天津市某区2010—2016年手足口病流行特征和防控策略研究[D].天津:天津医科大学,2017:42-43.
[15]颜丙新,马利君,刘伟,等.2010—2013年济宁市手足口病聚集性疫情流行病学及病原学特征分析[J].现代预防医学,2015,42(7):1165-1167.
[16]田靓,朱仁义,范俊华,等.江宁.上海市2009年托幼机构手足口病聚集性病例流行病学分析[J].中国学校卫生,2011,32(5):596-598.
[17]赖汉佳.珠海市2015—2016年手足口病聚集性疫情流行病学和病原学特征分析[J].人人健康,2018(2):17,19.
[18]叶中文,阮峰,张雪宝,等.珠海市托幼机构手足口病流行病学特征分析[J].中国热带医学,2014,14(4):414-416,428.