重庆市一起学校麻疹爆发疫情的调查分析

目的调查重庆市潼南县一所小学的麻疹爆发疫情,进行爆发流行病学和疾病传播模式描述,研究爆发危险因素和控制措施。方法对所有疑似病例开展流行病学调查和采集血、咽拭子标本进行实验室检测,同时隔离治疗病例和采取应急接种措施控制疫情蔓延。对收集的数据进行爆发流行病学描述。结果此次爆发中该小学共28名学生罹患麻疹,罹患率为1．7％,病例分布于新校区10个班级,首发病例所在班级幼儿园大三班发病数最多,罹患率10．26％。所有病例均住院隔离治疗,无重症和死亡病例。16名病例无麻疹类疫苗免疫史,首个病例发病后未及时诊断和隔离,导致疫情在学校内蔓延。该小学完成校区全部应急接种,实种2734人,接种率97．79％。塘坝镇与相邻乡镇目标儿童摸底共计12005人,实种11867人,接种率98．85％,无接种异常反应报告。结论降低麻疹发病率和防止学校等集体单位麻疹爆发疫情需保证儿童高质量2剂次含麻疹类疫苗接种率和严格执行入托、入学查验接种证制度,同时应加强疫情预警和提高对爆发疫情的应对能力。

Investigation and epidemiologic analysis of a measles outbreak in an elementary school of Chongqing

Objective To investigated a measles outbreak in an elementary school in a county of Chongqing in order to describe the epidemiologic features of the outbreak and disease transmission pattern, examine risk factors of outbreak and discuss control measures. Methods All the suspected measles cases during the outbreak were investigated and specimens were collected for laboratory test.Cases were quarantined for cure and appropriate range of emergent immunization was implemented immediately.Data were collected for epidemiological description. Results 28 students acquired measles with the overall attack rate of 1.7%. Cases distributed in 10 classes,the class of the first measles case had the highest attack rate of 10.26%. 16（57.14%） of the 28 cases had no measles vaccine history. Disease spread out in the school because of delayed clinical identification of first measles case.All the cases were quarantined in hospitals for cure, there is no severe nor death case. Emergent immunization were carried out immediately in the school, 2 734 students were vaccinated with a rate of 97.79%.12 005 children in Tangba county and adjacent areas were investigate for enlarged emergent immunization.ll 867 children were vaccinated with a rate of 98.85%, no AEFI were reported. Conclusions Enhancing 2-dose routine vaccine coverage and mandating and implementing school entry immunization checks can effectively avert epidemic.Early warning of measles outbreak should also be strengthened and aggressive plus effective control measures should be implemented immediately confronted an outbreak.