First, disease overview: hand, foot and mouth disease (HFMD) is an infectious disease caused by enterovirus, which mostly occurs in infants and can cause herpes in hands, feet and mouth, and some patients can cause complications such as myocarditis, pulmonary edema and aseptic meningoencephalitis. There are more than 20 kinds of enteroviruses that cause hand, foot and mouth disease. Coxsackievirus A (16, 4, 5, 9 and 10), Coxsackievirus B (2 and 5) and enterovirus 7 1 are the common pathogens of hand, foot and mouth disease, among which Coxsackievirus A (16) is the most common. The incubation period of the disease is 2 ~ 7 days, and the sources of infection include patients and recessive infected people. During the epidemic, patients are the main source of infection. Patients with acute onset can excrete virus from pharynx; Herpes fluid contains a large number of viruses and overflows when it breaks; After several weeks of illness, patients can still excrete virus from feces. The spread of this disease is varied, mainly through close contact with people. The virus can be spread indirectly through hands, towels, handkerchiefs, tooth cups, toys, tableware, milk utensils, bedding and underwear contaminated by saliva, herpes fluid and feces. The virus in patients' throat secretions and saliva can be spread by droplets; If you come into contact with water contaminated by virus, you may also be infected by water; Cross-infection in outpatient department and unqualified disinfection of oral instruments are also one of the reasons for the spread. People are generally susceptible to the enterovirus that causes hand, foot and mouth disease, and they can gain immunity after infection. Due to the lack of cross-protection of antibodies after infection of different disease types, people can be infected repeatedly. Most adults acquire corresponding antibodies through recessive infection. Therefore, the patients with hand, foot and mouth disease are mainly preschool children, especially those aged ≤3 years. According to foreign literature, it can be popular among people every 2 ~ 3 years. Hand, foot and mouth disease is widely distributed, and there is no obvious regional; It can occur in all seasons, with high incidence in summer and autumn. The disease usually occurs sporadically after an outbreak; During the epidemic, kindergartens and nurseries are prone to collective infection, and families can also gather. The disease is highly contagious and has complicated transmission routes, which can cause a large-scale epidemic in a short time. Two. Epidemic situation and trend forecast (I) International epidemic situation. Hand, foot and mouth disease is a global infectious disease, which has been reported in most parts of the world. 1957 The disease was first reported in New Zealand. 1958 isolated coxsackie virus, and 1959 put forward the name "hand, foot and mouth disease". Hand-foot-mouth disease (HFMD) caused by Coxsackie, echovirus and EV 7 1 often occurs in the United States, Australia, Italy, France, Netherlands, Spain, Romania, Brazil, Canada and Germany. Japan is a country with many hand, foot and mouth diseases, and there have been many large-scale epidemics in history. 1969 ~ 1970 was dominated by Cox A 16, and 1973 and 1978 were caused by EV7 1 and 1978. At the end of 1990s, EV 7 1 began to wreak havoc in East Asia. 1997, an outbreak of hand, foot and mouth disease mainly caused by EV 7 1 occurred in Malaysia. There were 2628 cases from April to August, and only 29 cases died from April to June, with an average age of 1.5 years. 1998, hand, foot and mouth disease and herpetic angina broke out in Taiwan Province province, China. June and June 10, * * monitoring 129 106 cases, 405 cases were severe and 78 cases died, most of them were children under 5 years old. (2) The epidemic situation in China. The disease was found in Shanghai from China 198 1, and has been reported in ten Yu Sheng cities, including Beijing, Hebei, Tianjin, Fujian, Jilin, Shandong, Hubei and Guangdong. An outbreak of hand, foot and mouth disease caused by Cox A 16 occurred in Tianjin in 1983, and more than 7 000 cases occurred in 5 ~ 10 years. Two years after the epidemic, 1986 broke out in nurseries. 1In 995, Wuhan Virus Research Institute isolated EV 7 1 virus from hand-foot-mouth patients, and in 998, Shenzhen Health and Epidemic Prevention Station isolated two strains of EV 7 1 virus from patients. From May to August, 2000, an epidemic of hand, foot and mouth disease in children occurred in Zhaoyuan City, Shandong Province. The Municipal People's Hospital admitted 1.698 children, including 1.025 males and 673 females, ranging from 5 months to 0/.4 years old. 3 cases died of fulminant myocarditis. In 2006, hand-foot-mouth disease 13637 cases were reported nationwide (8460 cases were male, accounting for 62.04%; 5 177 women, accounting for 37.96%, and 6 cases (4 men and 2 women) died. Except Xizang Autonomous Region, 3 1 provinces, autonomous regions and municipalities have reported cases. The top ten provinces with reported cases are Shandong (3030 cases), Shanghai (2883 cases), Beijing (22 10 cases), Hebei (1 133 cases), Zhejiang (793 cases), Guangdong (670 cases) and Heilongjiang (670 cases). By May of February1year, 5,459 cases of hand-foot-mouth disease were reported nationwide in 2007, with 2 deaths. Compared with the same period last year (2488 cases), the number of reported cases increased by 1 19.38+0%. (3) Forecast of fashion trends. Because hand, foot and mouth disease has not been included in the management of legal infectious diseases in China, most of the epidemic data come from monitoring or epidemic investigation data, so it is difficult to make an accurate and comprehensive judgment on the epidemic situation. According to the epidemic data reported in recent years, the annual peak of hand, foot and mouth disease is around July. As the national temperature rose earlier in 2007, experts predicted that the peak incidence of hand, foot and mouth disease might be advanced, and the reported cases of hand, foot and mouth disease would further increase in 2007. Three. Prevention and control measures (1) Strengthen the work of infectious diseases departments in medical institutions and do a good job in pre-detection, triage and diagnosis and treatment of infectious diseases. 1. According to the clinical features and epidemiological history, the hand-foot-mouth disease cases were clinically diagnosed. Clinical features: acute onset, fever; Oral mucosa appears scattered herpes, the size of rice grain, and the pain is obvious; Herpes the size of a grain of rice appear on the palm or sole of your hand, occasionally involving your hips or knees. There is an inflammatory blush around the herpes, and there is less liquid in the blister. Some children may be accompanied by cough, runny nose, loss of appetite, nausea, vomiting, headache and other symptoms. The disease is a self-limited disease, most of which have a good prognosis and no sequelae. Very few children can cause serious complications such as meningitis, encephalitis, myocarditis, flaccid paralysis and pulmonary edema. Understanding the epidemiological contact history is helpful for the diagnosis of cases, including: local kindergartens or schools have similar epidemics, or cases have contact history with similar patients. The disease targets mainly preschool children. 2. Mild symptoms are mainly treated by outpatient symptomatic treatment. For severe cases (nervous system symptoms or cardiovascular symptoms, etc. ), should be hospitalized for key treatment. 3. Strengthen hospital infection control to avoid cross-infection in hospital. Hospitals should implement the pre-diagnosis system and set up special consultation rooms for fever and herpes cases; Focus on strengthening the disinfection of hospital delivery rooms and pediatric wards to prevent serious consequences caused by nosocomial infection of newborns and infants. (two) to carry out epidemic monitoring and epidemiological investigation, to grasp the epidemic situation. 1. Strengthen epidemic monitoring and management in key areas and people such as kindergartens and schools; Go deep into medical institutions to understand the epidemic situation in time and encourage medical institutions to report the epidemic situation on their own initiative. 2. Pay attention to the difference between hand, foot and mouth disease and viral encephalitis, and carry out monitoring and investigation of related diseases such as viral encephalitis to ensure the accuracy of epidemiological investigation. 3. Hand, foot and mouth disease epidemic areas should strengthen morning check-ups in kindergartens and primary schools to find cases in time. If children with herpes are found, parents should be immediately mobilized for family isolation treatment until they are cured. 4. Nursery institutions should clean and disinfect toys and utensils every day to reduce indirect contact and spread. 5. Strengthen food and environmental sanitation supervision to reduce the spread of hand, foot and mouth disease through food and public places. 6. For new patients, samples should be collected in time for etiological diagnosis. (three) to carry out publicity and education and health promotion. In kindergartens, primary and secondary schools, hospitals and other places, carry out health education such as washing hands before and after meals and promoting indoor ventilation; Print relevant publicity materials, popularize health knowledge among the masses, and advocate the establishment of good personal hygiene habits; Parents are advised to let their children go to crowded public places as little as possible to reduce the chance of being infected. In case of fever, rash and other symptoms, see a doctor in time and isolate in time. (4) Do a good job in professional training and assessment. All localities should provide hand, foot and mouth disease prevention and control technical training for professionals in medical institutions and disease prevention and control institutions. Disease prevention and control institutions shall guide and evaluate the prevention and treatment of hand, foot and mouth disease in medical institutions within their jurisdiction according to law.