摘要
目的调查贵州省3起手足口病疫情的环境危险因素。方法通过对手足口病疫情区病例的看护人和其他关键人物访谈,对病例可能的感染来源进行追踪调查,检测病例标本以及流行病学关联的环境标本,分析疫情的环境危险因素。检测病原并分析公共场所、看护人及农村用水的病原与疾病流行的相关性。结果病前接触手足口病病例发病风险最高(OR=6.10,95%CI:1.91～20.02)、其次为到医疗机构就诊(OR=3.91,95%CI:1.43～11.24)、预防接种活动(OR=2.86,95%CI:1.32～9.56)、吸吮手指(OR=2.72,95%CI:1.36～5.86)是本次疫情的危险因素。EV71为环境及调查人群中的主要病原(χ2=7.76～10.45;χ2=3.91～9.94,P<0.05),所调查的环境项目均可以作为病原传播的危险因素(χ2=8.66,P>0.05);病例及与看护人病原类型吻合率高于对照组,对照组病原隐性感染率也较高(χ2=1.02,P>0.05),环境与调查人群的各病原阳性率吻合率较高(P>0.05);农村用自来水部分检出EV及CA16;环境与调查人群的病原同源性≥96.88%。结论EV71在疫情流行中起主要作用;手足口病的疫情与高危人群及高危环境接触史有密切关系;疫情期应做好生活环境及水源的消毒。
Objective To investigate the environmental risk factors of 3 epidemics of hand,foot and mouth disease(HFMD) in Guizhou province. Methods Interviewing the relatives of the HFMD case and other key persons,thoroughly investigating the infection source.Later,epidemiological and environmental data of the case were conducted.Detecting pathogen and analyzing the relativity of the epidemic and pathogen in public places,guarders and rural water. Results Contacwith the HFMD patients before attack(OR=6.10,95% CI: 1.91 20.02).Seen a doctor betore attack(OR=3.91,95% CI: 1.43 11.24),was the other tactors,sucsess,vely tactors were,vaccinated(OR=2.86,95% CI: 1.32 9.56),sucked fingers(OR=2.72,95% CI: 1.36 5.86),played in amusement park(OR=1.53,95% CI: 0.66 4.03) sometimes.The EV71 was the main pathogen in environment and crowds in this survey(χ2= 7.76 ~ 10.45;χ2= 3.91 ~ 9.94,P<0.05).The environmental cases were all the risk factors of the disease epidemic in the investigation(χ2= 8.66,P>0.05).The consistency of the pathogenic types in cases and guarders was higher than control group.The recessive infected pathogenic rate in control group was higher(χ2 = 1.02,P>0.05).The consistency of each pathogenic types in environments and investigated crowds was higher(P > 0.05).EV and CA16 have been detected in the rural tap water.The pathogenic amino acid homologies were more than 96.88% in the environments and crowds. Conclusion The EV71 has played the main role in this HFMD epidemic.The close relationship of the HFMD epidemic was that exposed in the high-risk groups and high-risk environmental factors.During the epidemic period,we should do a better disinfect of living environment and water source.
出处
《贵州医药》
CAS
2012年第3期214-218,共5页
Guizhou Medical Journal
基金
贵州省卫生厅科学技术基金[gzwkj2009-1-037]
贵州省科学技术基金[黔科合J字(2011)2280号]
中国CDC现场流行病学培训资助项目
关键词
手足口病
疫情
危险因素
环境
贵州
Havd foot and mouth disease Epidemic situation Risk factor Environment Guizhou
