Abstract:Objective To investigate the epidemiological characteristics and influencing factors of hand-foot-and-mouth disease (HFMD) outbreak in a kindergarten, and provide strategies for effective control of epidemic. Methods HFMD cases in a kindergarten from June 8 to July 8, 2021 were searched, characteristics of cases were analyzed, environmental hygiene survey and case-control study were carried out, and factors that caused the spread and outbreak of the epidemic were analyzed. Results The epidemic cases were concentrated in the first class, the middle-first class and the second class, a total of 25 cases (5 confirmed cases) of HFMD were found, including 14 males and 11 females, the overall incidence was 9.12% (25/274). The main clinical manifestations were herpes or rash on hands, feet and mouth, symptoms were typical. Nasopharynx swab specimens from 5 cases were positive for Coxsackie A16. The epidemic curve indicates that the epidemic situation basically conformed to the characteristics of "human to human transmission". Case-control study results showed that the main risk factors for the outbreak were contacting with suspected HFMD patients (OR=6.50, 95%CI: 2.73-45.44), not washing hands at school (OR=4.92, 95%CI: 1.56-22.52), the habit of touching lips/eating fingers (OR=6.20, 95%CI: 1.74-38.33), and unclean of hands and nails (OR=2.92, 95%CI: 1.23-6.92). Conclusion This outbreak was caused by Coxsackie A16, exposure to HFMD children is the main cause of this outbreak, and contact with undisinfectant public facilities is the most important route of transmission.