北京市2000～2004年流行性脑脊髓膜炎流行病学分析

目的了解北京市2000~2004年流行性脑脊髓膜炎(流脑)流行病学特征,以便制定科学的免疫策略。方法对2000~2004年540例流脑病例进行描述流行病学分析。结果2000~2004年流脑发病率由0.17/10万上升到1.43/10万,死亡率为0.01/10万~0.12/10万。本市人口病例119例,占22.04%;外来人口病例421例,占77.96%。临床诊断503例,占93.15%;实验室确诊37例,占6.85%;A群11例,B群5例,C群6例,未分群15例。540例病例中,3~5月发病370例,占总病例数的68.52%;发病构成比在前3位的年龄组为:15~19岁108例,占20.00%;0~4岁组88例,占16.30%;20~24岁组64例,占11.85%。119例本市人口病例中,学生53例,占44.54%;421例外来人口病例中,学龄前儿童76例,占18.05%;民工246例,占58.43%。外来人口病例1~14岁87例。其中有免疫史的11例,占12.64%;无免疫史的76例,占87.36%。结论北京市2000~2004年流脑发病呈持续上升趋势,高度散发,冬春季为高发季节,病例主要为外来人口,存在A、B、C群脑膜炎奈瑟菌引起的病例,应关注菌群的变迁。要做好流脑病原学、血清学监测。同时加强外来儿童的管理和脑膜炎球菌多糖疫苗接种工作。

Epidemiological Analysis on Meningococcal Meningitis in Beijing During 2000 - 2004

Objective To understand the epidemiological patterns of meningococcal meningitis in Beijing during 2000-2004 and facilitate the policy making for meningococcal meningitis control.Methods 540 cases of meningococcal meningitis identified during 2000-2004 were analyzed over the demonstrated epidemiological patterns.During 2000-2004,540 cases of meningococcal meningitis were identified.The incidence of meningococcal meningitis rose from 0.17 to 1.43 per 100 000,with an average increase rate of 1.82,and the death rate fluctuated between 0.01 and 0.12 per 100 000.Results Of all 540 cases,119 cases(22.04%) were native cases in Beijing,and 421 cases(77.96%) were foreign cases.503 cases(93.15%) were clinically confirmed,and 37 cases(6.85%) were confirmed in laboratory.11 cases belonged to Group A;5 cases belonged to Group B;6 cases belonged to Group C;15 cases were un-classified.370 cases(68.52%) were with an onset during March through May.The first 3 age groups with the most cases of meningococcal meningitis were group 15-19 years,with 108(20.00%) cases,group 0-4 years,with 88(16.30%) cases,and group 20-24 years,with 64(11.85%) cases.Of the 119 native cases,53 cases(44.54%) were students.Of the 421 foreign cases,76 cases(18.05%) were pre-schooling children,and 246 cases(58.43%) were floating workers.Of the 87 foreign cases of the age group of 1-14 years,11 cases(12.6%) were with an immunization history,while 76 cases(87.4%) were without an immunization history.Conclusions The epidemic of meningococcal meningitis in Beijing was on a continual increase during 2000-2004.The epidemiological patterns were highly sporadic epidemic,the winter and spring are the highest epidemic seasons,the most cases happened in floating population,and were identified of(Group B) and Group C cases.Accordingly,the intensification of pathogenic as well as serological surveillance on meningococcal meningitis,( strengthening) of the administration on floating workers,improvement of the immunization efforts on meningococcal meningitis for the floating children,and enhanced alertness on change in the epidemic virus groups should be urgently concerned.