目的调查分析湖南省石门县某乡学校一起由埃可病毒33型肠道病毒(ECHO33)引起的流感样疫情暴发的流行病学特征及病因。方法采用现场流行病学调查方法了解病例发生情况及可疑传播途径。对采集的12份咽拭子标本进行人肠道病毒(enterovirus,EV)核酸检测以及病毒分离。采用VP1序列测定比对的方法,对分离的EV型别进行鉴定。结果本次疫情从2013年5月29日开始至6月18日结束,持续20 d,共发生病例108例,罹患率为11.26%。6月6-9日为发病高峰期,发病92例(占85.19%)。病例首发在中学,病例以中学生为主,占69.44%,男女之比为1.12:1。高年龄组(12~,≥14岁)罹患率较低年龄组(≤5、6~、8~、10~岁)差异有统计学意义(P<0.05)。病例的潜伏期为3.5 d,主要症状为发热(76.85%)、咽痛及扁桃体肿大(54.63%)、头痛、头晕(42.59%)。大多数患者病情较轻。病原学检测12份鼻咽拭子,其中10份标本EV阳性,型别鉴定证实为ECHO33型人肠道病毒。结论本次学校流感样病例暴发疫情是由ECHO33型肠道病毒引起的,今后应加强对学校流感样病例暴发疫情的病原学监测和防控工作。 Objective To investigate and analyze the epidemiological characteristics and causes of influenza outbreaks caused by ECHO33 in a township school in Shimen County, Hunan Province. Methods The method of field epidemiology was used to understand the incidence of cases and the route of suspicious transmission. 12 samples of throat swabs were collected for detection of enterovirus (EV) nucleic acids and virus isolation. VP1 sequence determination using the method of comparison, the EV type of separation were identified. Results The outbreak began from May 29, 2013 to June 18, 2013 and lasted for 20 days. A total of 108 cases were reported with an attack rate of 11.26%. June 6-9 peak incidence, the incidence of 92 cases (85.19%). The cases started in secondary schools, mainly in secondary school students, accounting for 69.44%, male to female ratio was 1.12: 1. There was significant difference in the age group with lower attack rate (≤5,6 ~, 8 ~, 10 ~) in high age group (12 ~, ≥14 years old) (P <0.05). The incubation period was 3.5 days. The main symptoms were fever (76.85%), sore throat and tonsil enlargement (54.63%), headache and dizziness (42.59%). Most patients are in a mild condition. Etiological detection of 12 nasopharyngeal swabs, of which 10 were EV positive, type identification confirmed as ECHO33 human enterovirus. Conclusion The outbreak of influenza-like illness in this school was caused by ECHO33 type enterovirus. Etiological monitoring and prevention and control of outbreaks of influenza-like illness should be strengthened in the future.