卫生部通报安徽省阜阳市发生手足口病疫情的情况
今年3月份以来，安徽省阜阳市发生了较大规模的手足口病疫情。截至5月1日24时，安徽阜阳累计报告手足口病3321例，其中22例死亡；有978例正在住院治疗，其中重症病例48人，病危10例；正在接受门诊治疗1209人；已治愈1112人。党中央、国务院领导同志高度重视，多次作出重要批示，并召开专门会议进行研究部署。当地各级政府和卫生部门积极应对，采取了各种措施，全力救治患者，努力控制病死率，取得了初步成效。手足口病是一种多年存在的传染病，在欧亚国家和地区均有发生。患者以婴幼儿为主，大多数病例症状轻微，主要表现为发热和手、足、口腔等部位的皮疹或疱疹等特征，多数患者可以自愈。少数病例可发生脑膜炎、脑炎、心肌炎和肺炎等重症，个别重症患儿病情进展快，易发生死亡。少年儿童和成人感染后大多不发病，但能够传播病毒。手足口病是由肠道病毒感染引起的临床症候群，以肠道病毒71型（EV71）和柯萨奇病毒、埃可病毒的某些血清型最为常见。
今年发生在安徽阜阳的疫情由EV71感染引起，主要经粪口途径和接触传播，传染性强，潜伏期为2-7天，病程一般为7-10天。EV71感染引起重症的比例高于其他类型肠道病毒，重症患儿病死率较高。目前尚无疫苗和特效治疗药物。
上世纪70年代以来，一些欧亚国家和地区先后发生较大规模EV71感染流行。1998年，我国台湾地区曾发生大规模EV71疫情，报告病例129106例，其中重症405例，死亡78例。
今年以来，在新加坡和我国台湾地区的手足口病疫情比去年同期明显上升。我国安徽以外部分省份的手足口病疫情较去年也有所上升。国内外资料显示，6－7月份是手足口病的发病高峰期。今后一段时间我国部分地区的手足口病疫情还可能上升。
安徽阜阳发生手足口病疫情后，当地党委和政府高度重视，广大卫生工作者积极落实各项防控措施，紧急救治重症患儿。卫生部领导率队赴阜阳指导工作，并派出临床和疾病控制专家驻在当地指导临床救治和疫情防控工作，协助开展病因调查。4月23日，中国疾病预防控制中心检测确定引发本次疫情的病源为EV71。随即卫生部向世界卫生组织、港澳台地区通报疫情，并组织临床专家完善救治方案，加强重症病例的早期筛查，指定定点医院集中救治重症病例。当地卫生部门针对疫情防治需要，扩建儿科病房，紧急购置专门设备，提高救治能力，努力降低患儿病死率。疾病预防控制机构加强疫情监测，及时掌握疫情动态；培训专业技术人员，提高防治能力；大力开展健康教育，提高公众防病意识；加强环境卫生整治和饮食饮水卫生监督；加强托幼机构的预防指导和检查；及时发布疫情和防控工作信息，全面做好疫情防控工作。
为了指导全国手足口病防控工作，卫生部已于4月底下发通知，指导各地完善防控工作方案，加大监测工作力度，加强重症病例临床救治，大力开展爱国卫生运动，强化公众健康教育，切实做好手足口病等病毒感染性疾病的防控工作，并印发了手足口病的诊疗和防控技术指南，并对儿科专家组织进行手足口病诊疗技术培训。针对当前疫情，卫生部决定把手足口病纳入丙类法定传染病管理，实行网络疫情信息直报。卫生部正在总结国内外手足口病防控和临床救治经验，组织开展流行病学、病原学等方面的深入研究。
手足口病传播途径多，婴幼儿普遍易感。做好儿童个人、家庭和托幼机构的卫生整治是预防感染的关键。对儿童要做到饭前便后洗手、不喝生水、不吃生冷食物，勤晒衣被，避免接触患儿；孩子家长和老师接触儿童前也要洗手。托幼机构和家长发现可疑患儿，要及时到医疗机构就诊，并及时向卫生和教育部门报告，及时采取控制措施。轻症患儿不必住院，可在家中治疗、休息，避免交叉感染。做好这些方面的工作，手足口病是可以得到有效预防和控制的。
卫生部新闻办公室
二〇〇八年五月三日
新华网http://politics.people.com.cn/GB/7190041.html 在流行地区幼儿园和小学暂停是否会减低疫情传播和控制感染呢??
据报道新加坡和香港已经让手足口病发病地区停课两周了. 目前尚无疫苗和特效治疗药物。在"手足口病传播途径多，婴幼儿普遍易感。"下,做好
1、针对当前疫情，卫生部决定把手足口病纳入丙类法定传染病管理，实行网络疫情信息直报。
2、爆发和流行地区及时通报疫情，及时发现和治疗患者。
3、做好儿童个人、家庭和托幼机构的卫生整治是预防感染的关键。（建议严重的应隔离停课？）
4、儿童要做到饭前便后洗手、不喝生水、不吃生冷食物，勤晒衣被，避免接触患儿！！
5、孩子家长和老师接触儿童前也要洗手。
6、手足口病是可以得到有效预防和控制的。
7、轻症患儿不必住院，可在家中治疗、休息，避免交叉感染。
8、卫生部正在总结国内外手足口病防控和临床救治经验，组织开展流行病学、病原学等方面的深入研究。 手足口病传播途径多，婴幼儿普遍易感。单做好粪便消毒是误区？手足口病毒通过空气飞沫/消化道/分泌物接触等传播途径。从隔离消毒传染源，切断传染途径和保护易感人群出发，采取综合措施。甚至及时通报信息，提高公众健康知识都很关键。流行病学面对人群预防干预传染病，使传染病危害性降低到最小程度？:L 是的，我们也收到手足口病紧急防控通知，看了fangfh老师讲了关于EV71病毒感染的表现及防控注意事项，非常详细，我还想请问：作为我们院感工作者除了做好手卫生、近距离接触戴口罩等措施之外应该还做哪方面的消毒工作呢？比如EV71病毒是何种病毒，物表需要何种级别消毒液擦拭，粪便需如何处理等？ 这类病毒疣一显著特点：对乙醚有抵抗力、经20%乙醚于4℃作用18h，仍保留感染性，表明病毒结构中不含脂质；耐酸试验是区别肠道病毒与鼻病毒、口蹄疫病毒的方法之一。肠道病毒在PH3.5仍然稳定，而口蹄疫病毒、鼻病毒不稳定；对阳离子稳定性，加入1克分子量的氯化镁或其他二价阳离子时，肠道病毒在50℃作用1h不被灭活。
肠道病毒除了上述特性外，对已知菌素及化学治疗药物具有抗性，实验室消毒剂为75%酒精，5%来苏对肠道病毒没有作用，同时对乙醚，去氯胆酸盐等不敏感。但对紫外线及干燥敏感，各种氧化剂(高锰酸钾、漂白粉等)、甲醛、碘酒都能灭活。这些特性为我们消毒提供了依据。
因此，建议按照河南省手口足病防治技术方案进行相关消毒吧！
附：
《河南省手足口病防治技术方案（试行）》对预防手足口病常用的１０种消毒方法作出介绍。
蚊蝇：可用５％氯氰菊酯（奋斗呐）、２．５％溴氰菊酯或其他杀虫剂，按说明书使用。
饮用水：用每升１毫克—３毫克有效氯含氯消毒剂，如漂白粉、优氯净等作用３０分钟。
垃圾：用每升１０００毫克有效氯含氯消毒剂溶液喷雾作用１２０分钟。
生活用具、书籍、玩具、交通工具：用有效氯含氯消毒剂溶液擦拭消毒，作用时间３０分钟，或用０．３％过氧乙酸作用６０分钟，或用紫外线灯直接照射３０分钟。
食具、饮具：用每升２５０毫克有效氯含氯消毒剂溶液作用３０分钟。
生活污水：用每升５０毫克有效氯含氯消毒剂作用１２０分钟。
人畜粪便：可用生石灰以１∶１的比例与其搅拌均匀消毒。
盛放排泄物的容器：用每升５００毫克有效氯含氯消毒剂作用１２０分钟。
患者衣、被单：煮沸２０分钟或用每升５００毫克有效氯含氯消毒剂作用３０分钟。
厕所或其他污染地面、墙：用每升５００毫克有效氯含氯消毒剂消毒。用量每平方米２００毫升。旱厕也可用生石灰覆盖。
[ 本帖最后由 一枝梅 于 2008-5-3 17:33 编辑 ]
回复 #6 一枝梅 的帖子
谢谢提供,严格按要求执行。:handshake 提供2006年9月美国CDC关于HFMD资料What is hand, foot, and mouth disease?
Hand, foot, and mouth disease (HFMD) is a common illness of infants and children. It is characterized by fever, sores in the mouth, and a rash with blisters. HFMD begins with a mild fever, poor appetite, malaise ("feeling sick"), and frequently a sore throat. One or 2 days after the fever begins, painful sores develop in the mouth. They begin as small red spots that blister and then often become ulcers. They are usually located on the tongue, gums, and inside of the cheeks. The skin rash develops over 1 to 2 days with flat or raised red spots, some with blisters. The rash does not itch, and it is usually located on the palms of the hands and soles of the feet. It may also appear on the buttocks. A person with HFMD may have only the rash or the mouth ulcers.
Is HFMD the same as foot-and-mouth disease?
No. HFMD is often confused with foot-and-mouth disease of cattle, sheep, and swine. Although the names are similar, the two diseases are not related at all and are caused by different viruses. For information on foot-and-mouth disease, please visit the web site of the US Department of Agriculture.
What causes HFMD?
Viruses from the group called enteroviruses cause HFMD. The most common cause is coxsackievirus A16; sometimes, HFMD is caused by enterovirus 71 or other enteroviruses. The enterovirus group includes polioviruses, coxsackieviruses, echoviruses and other enteroviruses.
Is HFMD serious?
Usually not. HFMD caused by coxsackievirus A16 infection is a mild disease and nearly all patients recover without medical treatment in 7 to 10 days. Complications are uncommon. Rarely, the patient with coxsackievirus A16 infection may also develop "aseptic" or viral meningitis, in which the person has fever, headache, stiff neck, or back pain, and may need to be hospitalized for a few days. Another cause of HFMD, EV71 may also cause viral meningitis and, rarely, more serious diseases, such as encephalitis, or a poliomyelitis-like paralysis. EV71 encephalitis may be fatal. Cases of fatal encephalitis occurred during outbreaks of HFMD in Malaysia in 1997 and in Taiwan in 1998.
Is HFMD contagious?
Yes, HFMD is moderately contagious. Infection is spread from person to person by direct contact with nose and throat discharges, saliva, fluid from blisters, or the stool of infected persons. A person is most contagious during the first week of the illness. HFMD is not transmitted to or from pets or other animals.
How soon will someone become ill after getting infected?
The usual period from infection to onset of symptoms ("incubation period") is 3 to 7 days. Fever is often the first symptom of HFMD.
Who is at risk for HFMD?
HFMD occurs mainly in children under 10 years old, but may also occur in adults too. Everyone is at risk of infection, but not everyone who is infected becomes ill. Infants, children, and adolescents are more likely to be susceptible to infection and illness from these viruses, because they are less likely than adults to have antibodies and be immune from previous exposures to them. Infection results in immunity to the specific virus, but a second episode may occur following infection with a different member of the enterovirus group.
What are the risks to pregnant women exposed to children with HFMD?
Because enteroviruses, including those causing HFMD, are very common, pregnant women are frequently exposed to them, especially during summer and fall months. As for any other adults, the risk of infection is higher for pregnant women who do not have antibodies from earlier exposures to these viruses, and who are exposed to young children - the primary spreaders of enteroviruses.
Most enterovirus infections during pregnancy cause mild or no illness in the mother. Although the available information is limited, currently there is no clear evidence that maternal enteroviral infection causes adverse outcomes of pregnancy such as abortion, stillbirth, or congenital defects. However, mothers infected shortly before delivery may pass the virus to the newborn. Babies born to mothers who have symptoms of enteroviral illness around the time of delivery are more likely to be infected. Most newborns infected with an enterovirus have mild illness, but, in rare cases, they may develop an overwhelming infection of many organs, including liver and heart, and die from the infection. The risk of this severe illness in newborns is higher during the first two weeks of life.
Strict adherence to generally recommended good hygienic practices by the pregnant woman (see "Can HFMD be prevented?" below) may help to decrease the risk of infection during pregnancy and around the time of delivery.
When and where does HFMD occur?
Individual cases and outbreaks of HFMD occur worldwide, more frequently in summer and early autumn. In the recent past, major outbreaks of HFMD attributable to enterovirus 71 have been reported in some South East Asian countries (Malaysia, 1997; Taiwan, 1998).
How is HFMD diagnosed?
HFMD is one of many infections that result in mouth sores. Another common cause is oral herpesvirus infection, which produces an inflammation of the mouth and gums (sometimes called stomatitis). Usually, the physician can distinguish between HFMD and other causes of mouth sores based on the age of the patient, the pattern of symptoms reported by the patient or parent, and the appearance of the rash and sores on examination. A throat swab or stool specimen may be sent to a laboratory to determine which enterovirus caused the illness. Since the testing often takes 2 to 4 weeks to obtain a final answer, the physician usually does not order these tests.
How is HFMD treated?
No specific treatment is available for this or other enterovirus infections. Symptomatic treatment is given to provide relief from fever, aches, or pain from the mouth ulcers.
Can HFMD be prevented?
Specific prevention for HFMD or other non-polio enterovirus infections is not available, but the risk of infection can be lowered by good hygienic practices. Preventive measures include frequent handwashing, especially after diaper changes (see "Handwashing" in: An Ounce of Prevention: Keeps the Germs Away), cleaning of contaminated surfaces and soiled items first with soap and water, and then disinfecting them by diluted solution of chlorine-containing bleach (made by mixing approximately ¼ cup of bleach with 1 gallon of water. (See more about cleaning and disinfecting in general in CDC's Prevention Resources). Avoidance of close contact (kissing, hugging, sharing utensils, etc.) with children with HFMD may also help to reduce of the risk of infection to caregivers.
HMFD in the childcare setting
HFMD outbreaks in child care facilities occur most often in the summer and fall months, and usually coincide with an increased number of cases in the community.
CDC has no specific recommendations regarding the exclusion of children with HFMD from child care programs, schools, or other group settings.Children are often excluded from group settings during the first few days of the illness, which may reduce the spread of infection, but will not completely interrupt it.Exclusion of ill persons may not prevent additional cases since the virus may be excreted for weeks after the symptoms have disappeared.Also, some persons excreting the virus, including most adults, may have no symptoms.Some benefit may be gained, however, by excluding children who have blisters in their mouths and drool or who have weeping lesions on their hands.
If an outbreak occurs in the child care setting:
Make sure that all children and adults use good handwashing technique, especially after diaper changes.
Thoroughly wash and disinfect contaminated items and surfaces using diluted solution of chlorine-containing bleach.
See the section “Can HFMD be prevented?” to learn more about hygienic practices which may be helpful in preventing HFMD transmission. major outbreaks of HFMD attributable to enterovirus 71 have been reported in some South East Asian countries 。
解释了由科萨奇A16引起的手足口病疾病过程温和，而肠道病毒71 引起的两次暴发可以是 致命性的，合并病毒性脑炎、心肌炎。
回复 #9 泉子 的帖子
新华网合肥5月3日电 (记者 代群) 记者5月3日从安徽省卫生厅了解到，截至5月2日，阜阳累计报告手足口病3736例，其中痊愈1460例，死亡22例，重症30例，病危12例。截至5月2日24时，除池州市、铜陵市无病例报告外，安徽其他15个市从1月1日至5月2日累计报告手足口病病例4529例。报告数居前5位的分别为：阜阳、淮南、亳州、蚌埠、合肥。
5月2日，安徽全省新增报告手足口病病例766例，其中阜阳市共报告手足口病(EV71感染)患者415例。
据悉，目前，安徽省4家省级医院、7家市级医院向阜阳派出了医疗专家，连同卫生部抽调的外省专家，目前共有45名国家、省级专家在阜阳帮助防控和救治工作。
回复 #10 zhangfh 的帖子
一方有难，八方支援！是中国的传统美德！很好！:hear 中新社北京五月三日电 (记者 曾利明)记者今晚从国家卫生部获悉：为进一步加强全国手足口病防控工作，卫生部今天成立手足口病防控工作领导小组。部长陈竺任组长，副部长高强、马晓伟、刘谦任副组长。领导小组下设综合协调、疫情防控、医疗救治和新闻宣传四个工作小组。
各小组已经启动相关工作。
防控工作领导小组强调，要以对人民群众高度负责的态度，及时做好疫情信息的发布，提高疫情防控工作透明度，要将安徽阜阳市的疫情情况如实向社会通报，并积极配合媒体做好社会宣传，使群众认识到手足口病是一种可防可治的疾病，而且通过治疗一些重症患儿已经好转，从而坚定群众防治疾病的信心，避免不必要的社会恐慌。
同时切实加强信息报告制度，严格执行疫情报告制度，统一报送渠道，抓紧对实行网络直报后的疫情数据进行统计和整理，及时对疫情信息进行分析和判断，为传染病防治决策提供科学依据。
防控工作领导小组提出，加强对患病儿童特别是重症患儿的救治，组织专家对阜阳市的重症患儿进行会诊，不断优化治疗方案，把重症患儿的死亡率降下来。派出一部分专家支援阜阳市各县级医院，提高县医院的鉴别诊断和医疗救治能力，在县医院设立观察隔离病房，力争对患病儿童早发现、早诊断、早治疗，实现关口前移。
防控工作领导小组认为，当前工作的重点是要开展以家庭为核心的卫生整治工作，教育广大群众特别是农村地区群众养成良好的生活习惯，控制疾病传播；要做好医院内的消毒工作，防止由于患儿和家长大量聚集医院造成院内感染的发生。 领导重视，一定管用！:lol
回复 #12 zhangfh 的帖子
只要领导重视，什么事情都能办成办好。 阜阳市幼托机构放假时间延长以控制疫情2008年05月04日 18:10新华网新华网合肥5月4日电（记者周立民）安徽省阜阳市手足口病（EV71感染）防治工作指挥部决定延长全市幼托机构（学前班）的放假时间，从5月6日起开始延长假期，开学时间另行通知。专家认为，此举有利控制疫情、保障儿童健康。截至5月2日，阜阳市累计报告手足口病（EV71感染）3736例，其中痊愈1460例，死亡22例，重症30例，病危12例。
据专家介绍，从国内外情况看，六七月份是手足口病（EV71感染）的发病高峰期，EV71感染潜伏期为2天至7天，目前尚无疫苗和特效治疗药物，减少易感人群密切接触几率是控制疫情蔓延的重要措施。
由卫生部、安徽省和阜阳市专家组成的阜阳市手足口病防治工作指挥部专家组编写了婴幼儿（特别是5岁以下）肠道传染病预防要点。预防要点指出，婴幼儿（特别是5岁以下），如有下列情况之一，要及时送县医院就诊:发热伴手、足、口腔、肛周皮疹，病程在4天之内；发热伴精神差；疱疹性咽峡炎。
预防要点指出，婴幼儿（特别是5岁以下）预防肠道传染病必须做到勤洗手、吃熟食、喝开水、多通风、晒衣被。婴幼儿（特别是5岁以下）预防肠道传染病家庭及周边卫生环境必须做到“清理粪便和垃圾、清除杂草和污泥、厕所消毒灭蚊蝇、家禽家畜要圈养、生活用水须干净”。
专家提醒，成人也可感染EV71病毒，感染后一般不发病但可能成为隐性感染者，没有症状却具有传染性，凡是可能接触过EV71病毒感染者的成年人，也都应该及时进行清洗和消毒，避免病毒传播。
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