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目的探讨散居儿童手足口病发病与托幼机构手足口病暴发之间的联系,为控制散居儿童手足口病发病提供参考。方法采用病例对照方法对某县两所幼儿园手足口病暴发期间,该幼儿园儿童居住地感染手足口病和未感染手足口病的散居儿童进行问卷调查,了解其感染手足口病的危险因素。对两所托幼机构手足口病病人和健康儿童分别采集咽拭子标本,用实时荧光定量反转录聚合酶链反应法进行病毒核酸检测。结果单因素分析显示:儿童发病前10 d内接触过手足口病病人、发病前10 d内接触过幼托儿童、家中有其他在托幼机构的儿童、所接触的幼托儿童所在班级有手足口病病人均为散居儿童发病的危险因素,饮食前给儿童洗手和有单独使用的毛巾是保护因素。多因素分析显示:儿童发病前10 d内接触过手足口病病人、发病前10 d内接触过幼托儿童、家中有其他在托幼机构的儿童和所接触的幼托儿童所在班级有手足口病病人均为散居儿童发病的危险因素。发生手足口病暴发的班级,其隐性感染病毒型别为Cox A16和其他肠道病毒,隐性感染率为38.46%。结论托幼机构手足口病暴发期间幼托儿童有较高的隐性感染率,减少幼托儿童与当地散居儿童的接触,重视传染源的妥善管理和隔离,加强幼托和散居儿童的家庭教育,促使其养成良好的卫生习惯,是降低散居儿童手足口病发病率的有效手段。
Objective To explore the relationship between the incidence of hand-foot-mouth disease in children and the outbreak of hand-foot-mouth disease in nurseries, and to provide reference for controlling the incidence of hand-foot-mouth disease in the scattered children. Methods A case-control study was conducted to investigate the risk factors of hand-foot-mouth disease (HFMD) in hand-foot-mouth disease among two kindergartens in a county during the outbreak of HFMD. Throat swab specimens were collected from both hand-foot-mouth disease patients and healthy children in kindergartens and nurseries, respectively. Real-time fluorescent quantitative reverse transcription polymerase chain reaction (RT-PCR) was used to detect the viral nucleic acid. Results Univariate analysis showed that children who had been exposed to hand-foot-mouth disease during the first 10 days before onset had contact with kindergarten children within 10 days prior to the onset of disease. Other children in kindergartens at home had contact with kindergarten children Stomatopathy patients are scattered risk factors for diaspora, pre-diet children wash their hands and have a separate towel is a protective factor. Multivariate analysis showed that children who had been exposed to hand-foot-mouth disease during the first 10 days before onset had contact with kindergarten children within 10 days before the onset of disease. Other children in the kindergarten and the kindergarten they were exposed had hand-foot-mouth Sick patients are scattered risk factors for children. In the class of hand, foot and mouth disease outbreak, the latent virus type was Cox A16 and other enteroviruses, and the latent infection rate was 38.46%. Conclusions Kindergarten children have higher latent infection rate during the outbreak of hand-foot-mouth disease, and reduce the contact between preschool children and local scattered children, pay attention to the proper management and isolation of infection sources and strengthen the family education of preschool children and diaspora. , To promote their development of good health habits, is to reduce the incidence of hand-foot-mouth disease in children living scattered effective means.