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Article(id=1324077947895816288, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077716676424398, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202506201, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1749657600000, receivedDateStr=2025-06-12, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614382956, onlineDateStr=2026-11-02, pubDate=1773072000000, pubDateStr=2026-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614382956, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614382956, creator=13701087609, updateTime=1793614382956, updator=13701087609, issue=Issue{id=1324077716676424398, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='5', pageStart='769', pageEnd='960', issueExtLink='null', onlineDate='null', pubDate='1773072000000', pubDateStr='2026-03-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614327830, creator='13701087609', updateTime=1793614418028, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324078095132655884, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077716676424398, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324078095132655885, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077716676424398, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=927, endPage=934, ext={EN=ArticleExt(id=1324077949695172705, articleId=1324077947895816288, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Epidemiological characteristics of public health emergencies in schools in Zhejiang Province from 2019 to 2024, columnId=1228016573156360233, journalTitle=Modern Preventive Medicine, columnName=Disease Control and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the epidemic patterns of public health emergencies in schools in Zhejiang Province from 2019 to 2024, and to provide references for the prevention and control strategies of such events in the future.

Methods

The information of public health emergencies in schools in Zhejiang Province from 2019 to 2024 was collected from the Public Health Emergency Management Information System of China Disease Prevention and Control Information System, and the descriptive epidemiological method was used to analyze the data in terms of time, space, type of school and the effect of event control. Descriptive statistical analyses and spatial autocorrelation analyses were performed using R 4.3.1 software.

Results

A total of 2 067 public health emergencies in schools were reported in Zhejiang Province from 2019 to 2024, with a total number of 66 441 reported cases, and an average attack rate of 2.94%. There were no deaths during the period. The largest number of reported events was 651 in 2023, accounting for 31.49% of the total number of events. The peak time of incidence was from November to December and from March to April. The global spatial autocorrelation analysis showed that there was no significant spatial aggregation in the spatial distribution of public health emergencies in schools (P values were all >0.05). The main locations where public health emergencies occurred in schools were in primary schools (1 088 cases), accounting for 52.64%. The second was in kindergartens (488 cases), accounting for 23.61%. The attack rate was the highest in kindergartens(5.79%), and the lowest in colleges and universities (0.67%). There was a significant difference in the attack rate among different schools (χ2=7 938.143, P<0.001). The attack rate in rural schools was significantly higher than that in county, town and urban schools (P<0.001). The intervention time of school public health emergencies was positively correlated with the duration (r1=0.830, P1<0.001), and the duration of the event was positively correlated with the number of cases (r2=0.607, P2<0.001).

Conclusion

Public health emergencies in schools in Zhejiang Province are mainly intestinal and respiratory infectious diseases, with a peak period in winter and spring. Prevention and control should be focused on young children. Communication and collaboration between family, schools and health departments should be strengthened. Early intervention and handling could shorten the duration of the events and reduce the scale of the outbreak.

, authors=Qi-feng ZHAO1, 2, Tao ZHANG3, Chen WU3, authorsList=Qi-feng ZHAO, Tao ZHANG, Chen WU, authorCompany=null, correspAuthors=Chen WU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324077950974435434, articleId=1324077947895816288, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=2019—2024年浙江省学校突发公共卫生事件流行特征分析, columnId=1228016573844226129, journalTitle=现代预防医学, columnName=疾病预防控制, runingTitle=null, highlight=null, articleAbstract=
目的

分析浙江省2019—2024年学校突发公共卫生事件的流行规律，为今后学校事件的防控对策提供参考。

方法

收集中国疾病预防控制信息系统《突发公共卫生事件管理信息系统》中浙江省2019—2024年学校突发公共卫生事件信息，利用描述流行病学方法从时间、空间、学校类型及事件控制效果等方面进行分析。使用R 4.3.1软件完成描述性统计分析和空间自相关分析。

结果

2019—2024年浙江省累积报告了2 067起学校突发公共卫生事件，报告发病总数66 441例，平均罹患率为2.94%，期间无死亡病例。2023年报送事件最多，为651起，占事件总数的31.49%。发病高峰时间为11—12月及3—4月。空间自相关分析结果显示，各年度学校突发公共卫生事件无空间聚集性（P值均>0.05）。学校突发公共卫生事件发生场所主要在小学（1 088起），占52.64%；其次为幼儿园（488起），占23.61%。幼儿园罹患率最高，为5.79%，高校罹患率最低，为0.67%，不同学校罹患率存在统计学差异（χ2=7 938.143，P<0.001）。农村地区学校罹患率明显高于县、镇和城市学校（P<0.001）。学校突发公共卫生事件的介入处置时间、持续时间两者呈正相关关系（r1=0.830，P1<0.001），事件的持续时间、发病数两者呈正相关关系（r2=0.607，P2<0.001）。

结论

浙江省学校突发公共卫生事件主要以肠道、呼吸道传染病为主，其中冬春季为高峰期，低龄儿童应作为防控重点，需加强家校和卫生部门之间沟通协作，早期介入处置可缩短事件持续时间，减小发病规模。

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赵棋锋（1991—），男，硕士，主管医师，研究方向：疾病控制

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吴晨，E-mail:
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赵棋锋（1991—），男，硕士，主管医师，研究方向：疾病控制

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注：审图号为浙S（2021）41号。

, figureFileSmall=mnr4LNUw3l/twnCPCfraAA==, figureFileBig=EgqVbozsjk5aDBODy+QZ9w==, tableContent=null), ArticleFig(id=1324077954849972364, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077947895816288, language=EN, label=Figure 3, caption=Spatial clustering analysis of public health emergencies in schools in Zhejiang Province from 2019 to 2024, figureFileSmall=2Y08GD0y9NPTRIqQ5GvgxA==, figureFileBig=EmJ2KezBg7MM/qY4gHFUDQ==, tableContent=null), ArticleFig(id=1324077954912886925, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077947895816288, language=CN, label=图3, caption=2019—2024年浙江省学校突发公共卫生事件空间聚集性分析

注：审图号为浙S（2021）41号。

, figureFileSmall=2Y08GD0y9NPTRIqQ5GvgxA==, figureFileBig=EmJ2KezBg7MM/qY4gHFUDQ==, tableContent=null), ArticleFig(id=1324077954988384398, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077947895816288, language=EN, label=Figure 4, caption=Analysis of control effectiveness for school public health emergencies in Zhejiang Province from 2019 to 2024, figureFileSmall=fnkfBTGSuyMQ4ws4mSRWfg==, figureFileBig=IhEf8O08J+g/VZz93sLd9A==, tableContent=null), ArticleFig(id=1324077955055493263, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077947895816288, language=CN, label=图4, caption=2019—2024年浙江省学校突发公共卫生事件控制效果相关分析

注：A为事件介入处置时间与持续时间散点图；B为事件持续时间与发病数散点图。

, figureFileSmall=fnkfBTGSuyMQ4ws4mSRWfg==, figureFileBig=IhEf8O08J+g/VZz93sLd9A==, tableContent=null), ArticleFig(id=1324077955126796432, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077947895816288, language=EN, label=Table 1, caption=

The composition of public health emergencies in different types of schools in Zhejiang Province from 2019 to 2024

, figureFileSmall=null, figureFileBig=null, tableContent=
事件类型事件发病波及人数罹患率（%）
数量（起）构成比（%）数量构成比（%）
乙类传染病200.973540.5333 0281.07
百日咳100.482130.3211 9671.78
新型冠状病毒感染90.441290.1921 0430.61
副伤寒10.05120.021866.67
丙类传染病1 76185.2058 88588.631 831 3803.22
其他感染性腹泻病1 03450.0217 97327.05857 2432.10
诺如病毒感染98747.7516 70125.14800 7272.09
札如病毒感染211.023070.4614 6802.09
其他261.269651.4541 8362.31
流行性感冒61129.5638 66058.19915 4204.22
手足口病1075.181 9452.9343 9684.42
流行性腮腺炎50.241840.2811 2231.64
急性出血性结膜炎40.191230.193 5263.49
其他类传染病28113.597 05010.61391 3781.80
水痘25612.396 5229.82371 4951.76
腺病毒感染130.632290.3411 8821.93
疱疹性咽峡炎60.291150.171 4827.76
支原体肺炎50.241240.194 7412.62
鼻病毒感染10.05600.091 7783.37
食物中毒50.241520.234 1603.65
合计2 067100.0066 441100.002 259 9462.94
), ArticleFig(id=1324077955202293905, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077947895816288, language=CN, label=表1, caption=

2019—2024年浙江省不同类型学校突发公共卫生事件构成情况

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事件类型事件发病波及人数罹患率（%）
数量（起）构成比（%）数量构成比（%）
乙类传染病200.973540.5333 0281.07
百日咳100.482130.3211 9671.78
新型冠状病毒感染90.441290.1921 0430.61
副伤寒10.05120.021866.67
丙类传染病1 76185.2058 88588.631 831 3803.22
其他感染性腹泻病1 03450.0217 97327.05857 2432.10
诺如病毒感染98747.7516 70125.14800 7272.09
札如病毒感染211.023070.4614 6802.09
其他261.269651.4541 8362.31
流行性感冒61129.5638 66058.19915 4204.22
手足口病1075.181 9452.9343 9684.42
流行性腮腺炎50.241840.2811 2231.64
急性出血性结膜炎40.191230.193 5263.49
其他类传染病28113.597 05010.61391 3781.80
水痘25612.396 5229.82371 4951.76
腺病毒感染130.632290.3411 8821.93
疱疹性咽峡炎60.291150.171 4827.76
支原体肺炎50.241240.194 7412.62
鼻病毒感染10.05600.091 7783.37
食物中毒50.241520.234 1603.65
合计2 067100.0066 441100.002 259 9462.94
), ArticleFig(id=1324077955290374290, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077947895816288, language=EN, label=Table 2, caption=

Annual reporting situation of school public health emergencies in Zhejiang Province from 2019 to 2024

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年份（年）事件数（起）构成比（%）发病数波及人数罹患率（%）
201945421.9619 395495 0513.92
202026913.015 591272 7922.05
202128813.935 113250 1392.04
20221889.103 883217 2341.79
202365131.4926 828823 4273.26
202421710.505 631201 3032.80
合计2 067100.0066 4412 259 9462.94
), ArticleFig(id=1324077955412009107, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077947895816288, language=CN, label=表2, caption=

2019—2024年浙江省学校突发公共卫生事件各年度报告情况

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年份（年）事件数（起）构成比（%）发病数波及人数罹患率（%）
201945421.9619 395495 0513.92
202026913.015 591272 7922.05
202128813.935 113250 1392.04
20221889.103 883217 2341.79
202365131.4926 828823 4273.26
202421710.505 631201 3032.80
合计2 067100.0066 4412 259 9462.94
), ArticleFig(id=1324077955483312276, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077947895816288, language=EN, label=Table 3, caption=

Global spatial autocorrelation analysis of the attack rate of public health emergencies in schools in Zhejiang Province from 2019 to 2024

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年份（年）Moran I值Z值P值
2019-0.0160.3660.714
20200.0600.6360.525
2021-0.264-0.7620.446
2022-0.0730.2480.804
2023-0.0830.1070.915
2024-0.283-0.7360.462
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2019—2024年浙江省学校突发公共卫生罹患率全局空间自相关分析

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年份（年）Moran I值Z值P值
2019-0.0160.3660.714
20200.0600.6360.525
2021-0.264-0.7620.446
2022-0.0730.2480.804
2023-0.0830.1070.915
2024-0.283-0.7360.462
), ArticleFig(id=1324077955676250262, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077947895816288, language=EN, label=Table 4, caption=

Subgroup analysis of the distribution of school types in public health emergencies in schools in Zhejiang Province

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学校类型事件数构成比（%）发病数波及人数罹患率（%）χ2值P值
幼儿园48823.617 017121 1675.7946.305<0.001
城市28113.593 66267 0695.46
县镇1296.242 17236 6665.92
农村783.771 18317 4326.79
小学1 08852.6441 9521 295 4243.24292.598<0.001
城市63130.5324 794757 8093.27
县镇27813.4511 148380 5842.93
农村1798.666 010157 0313.83
中学36417.6112 876486 0592.65271.340<0.001
城市2039.827 629284 6192.68
县镇1195.763 732161 3822.31
农村422.031 51540 0583.78
高等学校311.501 153171 0490.67
中等职业学校562.712 197134 8531.63
其他学校401.941 24651 3942.42
), ArticleFig(id=1324077955806273687, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077947895816288, language=CN, label=表4, caption=

浙江省学校突发公共卫生事件学校类型分布的亚组分析

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学校类型事件数构成比（%）发病数波及人数罹患率（%）χ2值P值
幼儿园48823.617 017121 1675.7946.305<0.001
城市28113.593 66267 0695.46
县镇1296.242 17236 6665.92
农村783.771 18317 4326.79
小学1 08852.6441 9521 295 4243.24292.598<0.001
城市63130.5324 794757 8093.27
县镇27813.4511 148380 5842.93
农村1798.666 010157 0313.83
中学36417.6112 876486 0592.65271.340<0.001
城市2039.827 629284 6192.68
县镇1195.763 732161 3822.31
农村422.031 51540 0583.78
高等学校311.501 153171 0490.67
中等职业学校562.712 197134 8531.63
其他学校401.941 24651 3942.42
), ArticleFig(id=1324077955936297112, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077947895816288, language=EN, label=Table 5, caption=

Correlation analysis of control effectiveness for major types of infectious disease public health emergencies [M（Q1，Q3）]

, figureFileSmall=null, figureFileBig=null, tableContent=
疾病名称介入处置时间（d）持续时间（d）发病数r1P1值r2P2值
其他感染性腹泻病2.35（1.44，3.56）2.50（1.36，4.71）13（9，20）0.583<0.0010.346<0.001
流行性感冒7.30（5.96，9.99）13.00（7.92，21.07）49（35，75）0.618<0.0010.750<0.001
水痘18.73（13.21，23.71）35.01（21.04，52.39）21（16，31）0.600<0.0010.704<0.001
手足口病8.22（6.23，11.04）12.04（7.08，19.04）16（13，22）0.516<0.0010.733<0.001
), ArticleFig(id=1324077955999211673, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077947895816288, language=CN, label=表5, caption=

主要构成的传染病突发公共卫生事件控制效果相关分析[M（Q1，Q3）]

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疾病名称介入处置时间（d）持续时间（d）发病数r1P1值r2P2值
其他感染性腹泻病2.35（1.44，3.56）2.50（1.36，4.71）13（9，20）0.583<0.0010.346<0.001
流行性感冒7.30（5.96，9.99）13.00（7.92，21.07）49（35，75）0.618<0.0010.750<0.001
水痘18.73（13.21，23.71）35.01（21.04，52.39）21（16，31）0.600<0.0010.704<0.001
手足口病8.22（6.23，11.04）12.04（7.08，19.04）16（13，22）0.516<0.0010.733<0.001
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2019—2024年浙江省学校突发公共卫生事件流行特征分析
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赵棋锋 1, 2 , 章涛 3 , 吴晨 3
现代预防医学 | 疾病预防控制 2026,53(5): 927-934
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现代预防医学 |疾病预防控制 2026 , 53 (5) : 927 -934
2019—2024年浙江省学校突发公共卫生事件流行特征分析
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赵棋锋1, 2, 章涛3, 吴晨3
作者信息
  • 1.绍兴市疾病预防控制中心，浙江 绍兴 312075
  • 2.浙江省现场流行病学培训项目，浙江 杭州 310051
  • 3.浙江省疾病预防控制中心，浙江 杭州 310051
通讯作者:
吴晨，E-mail:
作者简介:

赵棋锋（1991—），男，硕士，主管医师，研究方向：疾病控制

Epidemiological characteristics of public health emergencies in schools in Zhejiang Province from 2019 to 2024
Qi-feng ZHAO1, 2, Tao ZHANG3, Chen WU3
Affiliations
  • Shaoxing Municipal Center for Disease Control and Prevention, Shaoxing, Zhejiang 312075, China
出版时间: 2026-03-10 doi: 10.20043/j.cnki.MPM.202506201
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摘要
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目的

分析浙江省2019—2024年学校突发公共卫生事件的流行规律，为今后学校事件的防控对策提供参考。

方法

收集中国疾病预防控制信息系统《突发公共卫生事件管理信息系统》中浙江省2019—2024年学校突发公共卫生事件信息，利用描述流行病学方法从时间、空间、学校类型及事件控制效果等方面进行分析。使用R 4.3.1软件完成描述性统计分析和空间自相关分析。

结果

2019—2024年浙江省累积报告了2 067起学校突发公共卫生事件，报告发病总数66 441例，平均罹患率为2.94%，期间无死亡病例。2023年报送事件最多，为651起，占事件总数的31.49%。发病高峰时间为11—12月及3—4月。空间自相关分析结果显示，各年度学校突发公共卫生事件无空间聚集性（P值均>0.05）。学校突发公共卫生事件发生场所主要在小学（1 088起），占52.64%；其次为幼儿园（488起），占23.61%。幼儿园罹患率最高，为5.79%，高校罹患率最低，为0.67%，不同学校罹患率存在统计学差异（χ2=7 938.143，P<0.001）。农村地区学校罹患率明显高于县、镇和城市学校（P<0.001）。学校突发公共卫生事件的介入处置时间、持续时间两者呈正相关关系（r1=0.830，P1<0.001），事件的持续时间、发病数两者呈正相关关系（r2=0.607，P2<0.001）。

结论

浙江省学校突发公共卫生事件主要以肠道、呼吸道传染病为主，其中冬春季为高峰期，低龄儿童应作为防控重点，需加强家校和卫生部门之间沟通协作，早期介入处置可缩短事件持续时间，减小发病规模。

学校  /  突发公共卫生事件  /  流行特征
Objective

To analyze the epidemic patterns of public health emergencies in schools in Zhejiang Province from 2019 to 2024, and to provide references for the prevention and control strategies of such events in the future.

Methods

The information of public health emergencies in schools in Zhejiang Province from 2019 to 2024 was collected from the Public Health Emergency Management Information System of China Disease Prevention and Control Information System, and the descriptive epidemiological method was used to analyze the data in terms of time, space, type of school and the effect of event control. Descriptive statistical analyses and spatial autocorrelation analyses were performed using R 4.3.1 software.

Results

A total of 2 067 public health emergencies in schools were reported in Zhejiang Province from 2019 to 2024, with a total number of 66 441 reported cases, and an average attack rate of 2.94%. There were no deaths during the period. The largest number of reported events was 651 in 2023, accounting for 31.49% of the total number of events. The peak time of incidence was from November to December and from March to April. The global spatial autocorrelation analysis showed that there was no significant spatial aggregation in the spatial distribution of public health emergencies in schools (P values were all >0.05). The main locations where public health emergencies occurred in schools were in primary schools (1 088 cases), accounting for 52.64%. The second was in kindergartens (488 cases), accounting for 23.61%. The attack rate was the highest in kindergartens(5.79%), and the lowest in colleges and universities (0.67%). There was a significant difference in the attack rate among different schools (χ2=7 938.143, P<0.001). The attack rate in rural schools was significantly higher than that in county, town and urban schools (P<0.001). The intervention time of school public health emergencies was positively correlated with the duration (r1=0.830, P1<0.001), and the duration of the event was positively correlated with the number of cases (r2=0.607, P2<0.001).

Conclusion

Public health emergencies in schools in Zhejiang Province are mainly intestinal and respiratory infectious diseases, with a peak period in winter and spring. Prevention and control should be focused on young children. Communication and collaboration between family, schools and health departments should be strengthened. Early intervention and handling could shorten the duration of the events and reduce the scale of the outbreak.

Schools  /  Public health emergencies  /  Epidemiological characteristics
赵棋锋, 章涛, 吴晨. 2019—2024年浙江省学校突发公共卫生事件流行特征分析. 现代预防医学, 2026 , 53 (5) : 927 -934 . DOI: 10.20043/j.cnki.MPM.202506201
Qi-feng ZHAO, Tao ZHANG, Chen WU. Epidemiological characteristics of public health emergencies in schools in Zhejiang Province from 2019 to 2024[J]. Modern Preventive Medicine, 2026 , 53 (5) : 927 -934 . DOI: 10.20043/j.cnki.MPM.202506201
正文
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学校由于人群比较密集，人群之间相互接触频繁，易感人群较多，容易发生传染性疾病暴发或流行，对学生的身心健康和教学秩序产生严重的影响。在新型冠状病毒感染疫情流行期间，国家实施了非常严格的控制政策和措施，对学校采取了非药物干预措施，包括封闭式管理、错峰活动、定期消毒以及师生症状监测等，有效降低了学校肠道、呼吸道传染病的发生[1-2]。浙江省人口基数大，且有多元、稳定且庞大的教育生态，可以较好反映学校突发公共卫生事件特征，了解学校突发公共卫生事件状况有助于开展有针对性的防控工作。因此，本文对2019—2024年浙江省学校突发公共卫生事件流行特征进行了研究分析，为今后学校事件的防控对策提供参考依据。
1　资料与方法
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1.1　资料来源
数据来源于中国疾病预防控制信息系统《突发公共卫生事件管理信息系统》，收集2019年1月1日—2024年12月31日浙江省报告并最终结案的学校突发公共卫生事件相关资料，资料包括事件名称、事件分类、级别、地区、创建时间、波及人数、发病数、死亡数、传染病诊断、学校类型、接到报告时间、首例病人和末例病人发病时间。
1.2　相关定义
通过参照《国家突发公共卫生事件相关信息报告管理工作规范（试行）》《国家突发公共卫生事件应急预案》中的相关规定，将事件等级进行判定，分为特别重大、重大、较大、一般事件以及未分级事件[3-4]。介入处置时间定义为：事件第一个病人发病至接到报告的时间间隔，持续时间定义为：事件第一个病例发病与最后一个病例发病的时间间隔。
1.3　统计分析
使用Excel 2010整理数据，使用R 4.3.1软件完成描述性统计分析和空间自相关分析。采用χ2检验比较率，采用Spearman秩相关分析事件持续时间与介入处置时间、发病数之间的相关性，采用Kruskal-Wallis检验进行多个独立样本比较。计数资料用频数或构成比表示，偏态分布的数据用中位数M（Q1，Q3）表示。双侧检验，检验水准α=0.05。
2　结果
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2.1　突发公共卫生事件总体情况
2019—2024年，浙江省累积报告学校突发公共卫生事件2 067起，报告发病人数为66 441例，波及人数为2 259 946人，平均罹患率为2.94%，无死亡病例。其中未分级事件1 982起（95.89%），一般事件85起（4.11%）。
在2 067起事件中，乙类、丙类、其他类传染病事件、食物中毒事件分别有20（0.97%）、1 761（85.20%）、281（13.59%）和5起（0.24%），罹患率分别为1.07%、3.22%、1.80%和3.65%。事件数居前三的传染病是其他感染性腹泻病（1 034起）、流感（611起）和水痘（256起）。罹患率前三位的传染病分别为副伤寒（66.67%）、手足口病（4.42%）和流行性感冒（4.22%）。其他感染性腹泻病事件以诺如病毒感染为主（987起），占其他感染性腹泻病事件的95.45%（987/1 034）。见表1。
根据传播途径分，肠道传染病事件1 148起（55.54%），发病20 045例（30.17%），罹患率为2.22%；呼吸道传染病事件910起（44.03%），发病46 121例（69.42%），罹患率为3.42%；其他事件9起（0.44%），发病275例（0.41%），罹患率为3.58%。不同传播途径之间的罹患率差异有统计学意义（χ2=2 726.896，P<0.001）。
2.2　学校突发公共卫生事件流行病学特征
2.2.1　时间分布
2019—2024年浙江省各年均报告了学校突发公共卫生事件，事件报告数最多的是2023年，为651起，占事件总数的31.49%，主要以流感、其他感染性腹泻病及水痘事件为主；罹患率最高的为2019年，为3.92%，且不同年份间罹患率差异有统计学意义（χ2=4 437.880，P<0.001）。见表2。
事件时间分布显示，呈双峰分布，高峰时段在11—12月及3—4月，分别占报告事件总数的45.04%和19.25%，7—8月为全年事件发生数量最低时期，即暑假时期。11—12月主要事件有流行性感冒、其他感染性腹泻病和水痘，3—4月主要事件有其他感染性腹泻病、流行性感冒和手足口病。见图1。
2.2.2　空间分布
浙江省11个地市均有学校突发公共卫生事件报告，按照事件数前五位的城市依次为杭州市（占33.43%）、温州市（占10.89%）、金华市（占10.06%）、宁波市（占9.24%）和嘉兴市（占8.22%）。舟山市学校突发公共卫生事件罹患率最高，为8.07%，衢州市最低，为2.15%，各地区学校突发公共卫生事件罹患率差异有统计学意义（χ2=5 126.161，P<0.001）。全局空间自相关分析结果显示，各年度学校突发公共卫生事件罹患率无空间聚集性。见表3和图2。通过聚类和异常值对不同年份罹患率进行局部空间自相关分析，结果显示均未呈现明显高-高/低-低聚集特征。见图3。
2.2.3　学校类型分布
2019—2024年浙江省学校突发公共卫生事件主要发生在小学，为1 088起，占事件总数的52.64%，发病41 952例，罹患率为3.24%；其次是幼儿园的488起，占23.61%，发病7 017例，罹患率为5.79%。罹患率最高为幼儿园，为5.79%，最低的是高等学校，为0.67%，各类型学校罹患率差异有统计学意义（χ2=7 938.143，P<0.001）。对于学校突发公共卫生事件构成较高的幼儿园、小学和中学阶段，对不同区域（城市、县镇、农村）做进一步分析，发现幼儿园、小学和中学阶段农村地区学校罹患率均显著高于县镇与城市学校（幼儿园：χ2=46.305，P<0.001；小学：χ2=292.598，P<0.001；中学：χ2=271.340，P<0.001）。见表4。
2.3　学校突发公共卫生事件控制成效分析
浙江省学校突发公共卫生事件介入处置时间为4.86（2.27，8.55） d，持续时间为6.69（2.44，17.03） d。相关分析结果显示，事件介入处置时间与持续时间存在显著正相关关系（r1=0.830，P1<0.001），同时事件持续时间与发病数呈正相关关系（r2=0.607，P2<0.001）。见图4。四种主要构成的传染病事件介入处置时间、持续时间均呈正相关，包括其他感染性腹泻病（r1=0.583，P1<0.001）、流行性感冒（r1=0.618，P1<0.001）、水痘（r1= 0.600，P1<0.001）、手足口病（r1=0.516，P1<0.001）；事件持续时间与发病数均呈正相关，包括其他感染性腹泻病（r2=0.583，P2<0.001）、流行性感冒（r2=0.618，P2<0.001）、水痘（r2=0.600，P2<0.001）、手足口病（r2=0.516，P2<0.001）。见表5。
3　讨论
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浙江省2019—2024年累积报告学校突发公共卫生事件2 067起，其中以传染病突发事件为主，占比99.76%。病原学监测显示主要病种为其他感染性腹泻病、流感及水痘，占91.97%，表明浙江省学校传染病事件防控着重以肠道、呼吸道传染病为主。
2020—2022年，浙江省学校突发公共卫生事件年均数和罹患率均显著下降，尤其以呼吸道传染病事件降低较为明显，可能与传染病传播动态和特征改变有关[5]，考虑在新冠疫情防控期间，浙江省采取了一系列非药物干预措施，学校聚集性活动减少，采用居家网课的方式开展线上教学，学生接触机会减少，疾病传播得以阻断[6]；2023—2024年，学校突发公共卫生事件数及罹患率均上升，学校流感事件大幅增加，可能与浙江省实施校园卫生健康行动加强学校传染病监测有关，提高了学校疫情报告敏感性，另外可能与社会面疫情出现反弹有关，人群普遍感染新型冠状病毒后群体免疫力下降致易感人群积累，疾病通过社区传播给学生，造成学校疫情发生[7-8]。
从时间分布来看，11—12月以及3—4月是浙江省学校突发公共卫生事件的两个高发时段，开学后大约两个月左右内是防控重点时期[9]。主高峰（11—12月）以流感和其他感染性腹泻病事件为主，次高峰（3—4月）以其他感染性腹泻病为主伴少部分流感事件，这一特征与其他感染性腹泻病及流感在冬春季高发一致[10-11]。根据浙江省学校突发公共卫生事件的空间分布情况来看，未发现空间聚集性，杭州市的报告事件数最高，其次为温州市、金华市和宁波市，报告事件数量的差异受城市学校数量、人口密度影响，另外可能受当地疫情监测敏感性和处置及时性有关[12]。
浙江省学校发生突发公共卫生事件主要集中在小学和幼儿园，与广东省[12]情况一致。小学阶段报告事件数占比达52.64%，发病数占比达63.14%，这主要是由于小学生正处于生长发育时期，自身抵抗力较差，防病意识薄弱、个人卫生习惯较差等原因有关，加上校内学生较多，增加了疾病传染的可能性[13-14]。通过对各学段罹患率统计发现，罹患率最高的是幼儿园，学段越高罹患越低，可能与卫生意识、免疫力等方面存在年龄梯度差异有关[15]，提示需要重点低龄儿童传染病防护，加强家校健康协同管理，家长及时为孩子接种疫苗，培养良好卫生习惯，学校严格执行晨午检制度及健康监测。农村学校（幼儿园、小学和中学）突发公共卫生事件罹患率高于城市和县镇学校，可能与农村学校卫生资源投入不足和疫情监测处置能力较弱有关，在学校发生疫情时，易出现更多病例[16]。事件介入处置时间与持续时间呈正相关，持续时间越长，发病人数越多，说明处置越晚，事件的持续时间越久，疫情的规模就越大，与王苗苗等[17]研究结论一致。在工作中可以通过开展标准化处置流程培训课来提升学校早发现早处置能力，并提升突发公共卫生事件早期预警的敏感度，早期阻断疾病传播控制疫情发展态势[18]。
本研究存在一定的不足之处。没有分析探讨学校规模、疫苗接种率等因素对学校突发公共卫生事件罹患率及持续时间的影响；在实际工作中会有部分符合学校突发公共卫生事件报告标准，但未及时报告或漏报，或者已报告事件准确性存在差异，可能会出现信息偏倚。
综上，浙江省学校突发公共卫生事件监测与防控工作中，要以传染病事件为主，特别加强肠道、呼吸道传染病的健康教育和指导，更早介入可以减少学校突发公共卫生事件的持续时间，降低学校突发公共卫生事件规模。根据学校疫情特点，一方面要加强传染病宣传教育，培养学生良好卫生习惯，积极倡导家长带孩子接种流感、水痘等疫苗；另一方面学校要严格执行晨午检制度，做好学生群体症状监测，建立家庭、学校和疾控之间沟通，及时发现报告疫情苗头事件。另外，要利用好全健康这一优势理念优化应急处置流程，努力提升学校突发公共卫生事件的应急处置能力和防控总体水平[19]。
基金
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  • 浙江省医药卫生科技计划(WKJ-ZJ-2522)
文献
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参考文献 引证文献
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2026年第53卷第5期
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doi: 10.20043/j.cnki.MPM.202506201
  • 接收时间：2025-06-12
  • 首发时间：2026-11-02
  • 出版时间：2026-03-10
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  • 收稿日期：2025-06-12
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浙江省医药卫生科技计划(WKJ-ZJ-2522)
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    1.绍兴市疾病预防控制中心，浙江 绍兴 312075
    2.浙江省现场流行病学培训项目，浙江 杭州 310051
    3.浙江省疾病预防控制中心，浙江 杭州 310051

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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