宜昌市1951—2015年流行性脑脊髓膜炎流行病学特征

目的全面了解宜昌市流行性脑脊髓膜炎流行规律及地域分布特征,为开展疫苗针对性疾病防控措施制订提供科学依据。方法收集1951—2004年宜昌市疫情资料汇编和2005—2015年中国传染病疫情报告系统资料,流脑监测报告信息系统数据,对1951—2015年间流行性脑脊髓膜炎发病趋势与特征进行分析。结果1951—2015年宜昌市流行性脑脊髓膜炎年发病率、死亡率总体呈现下降趋势,疫苗运用前（1951—1981年）为流行性脑脊髓膜炎自然流行阶段,共发生3次流行,且有明显规律性,流行间隔周期8~13年。疫苗运用后（1982—2015年）流行性脑脊髓膜炎发病得到较好控制,未发生流行。疫苗运用前后年均发病率之间差异有统计学意义（P<0.01）。65年间共报告流行性脑脊髓膜炎病例25 413例,年均发病率为12.75/10万,死亡2 249人,年均死亡率 1.14/10万,病死率为8.85%。流脑疫苗运用（1994—2015年）时期 ,流脑发病周期性不明显,季节性高峰突现;发病人群以小学生为主;流行菌群有变迁,维持流脑疫苗高接种率情况下,发病率呈现极低水平。结论宜昌市流行性脑脊髓膜炎发病率降到极低水平,低年龄组人群仍是发病重点人群。在提高疫苗接种率的同时,应加强流行性脑脊髓膜炎持续性、系统性监测,掌握菌群变化趋势与人群免疫水平,以防控全市城乡一体化建设过程中流行性脑脊髓膜炎的流行 。

Epidemiological characteristics of epidemic cerebrospinal meningitis in Yichang,1951-2015

ObjectiveTo comprehensively understand the epidemic regularity of epidemic meningococcal meningitis (MM) in Yichang City and its geographical distribution, so as to provide the evidence for formulating the control measures of vaccine preventable diseases in the region. MethodsThe data from the epidemic datum compilation in Yichang City, 1951-2004, the national notifiable diseases registry system in Yichang City, 2005-2015, and the case-based MM surveillance system, 1951-2015 were collected and analyzed. ResultsThe overall morbidity and mortality of epidemic cerebrospinal meningitis were on a declining trend from 1951 to 2015. From 1951 to 1981, as the natural epidemic cerebrospinal meningitis epidemic stage, when the vaccine was not used, there were 3 obvious regularity epidemics which had epidemic interval cycle of 8-13 years. Epidemic cerebrospinal meningitis was better controlled from 1982 to 2015, when the vaccine was used, and there was no epidemic. There was a statistically significant difference of the average annual incidence before and after vaccine using (P<0.01). Totally 25 413 epidemic cerebrospinal meningitis cases were reported during 65 years, with an annual incidence rate of 12.75/10⁵, 2 249 deaths, annual mortality rate of 1.14/10⁵, and case fatality rate of 8.85%. The 21 years’ analysis of epidemic meningococcal vaccines using (1994-2015) showed that the periodicity of meningococcal meningitis incidence was not obvious, the seasonal peaks were prominent, the onset people were confined mainly to pupils, there were endemic flora changes, and in the condition of maintenance of high meningococcal vaccination rates, the incidence was very low. ConclusionsThe incidence of epidemic cerebrospinal meningitis dropped to a very low level in Yichang City during the vaccine using period. The low age groups are still the key incidence population. It is necessary to increase the vaccination rate, improve the systematic surveillance of epidemic cerebrospinal meningitis, grasp the trends of flora switching and population immunity levels, and practice the prevention first, in order to prevent and control epidemic cerebrospinal meningitis epidemics in the city during the period of urban-rural integration.