1978-2006年湖南省娄底市麻疹流行病学分析

目的了解娄底市麻疹流行特征,为有效控制麻疹提供科学依据。方法监测系统数据库收集个案资料,酶联免疫吸附试验(ELISA)法检测IgM和IgG抗体。Excel和SPSS作统计分析。结果1978-2006年共报告麻疹32642例,年均发病率30.71/10万,各时段各县市区发病率差异极显著。29年共报告麻疹死亡79例,病死率0.24%。整个发病趋势呈从高到低而后回升,分为3个时段,第I时段形成3个高峰之后,1987-2000年一路走低,至2004年再度形成一个相对高峰。1991-2006年整个发病季节集中在3～6月;但2004年回升高,发时发病高峰在2～4月。人群分布5岁以下儿童占60.47%,散居儿童占总数的55.48%。29年麻疹减毒活疫苗(MV)接种率为71.50%～99.76%,发病率与MV接种率呈明显负相关,免疫监测结果麻疹IgG总阳性率91.18%。2005-2006年病例有明确免疫史者仅为15.30%。结论娄底市麻疹发病率总体下降89.14%,近年回升较明显,上升原因主要为规划免疫滑坡,存在免疫空白人群。最近的较高流行年份,发病季节早而流行强度大,为典型的小年龄发病模式。

Epidemiological analysis of measles in Loudi City of Hunan Province from 1978 to 2006

Objective The study was conducted to explore the epidemiological characteristics of measles in Loudi City and to provide scientific bases for effective measles control.Methods Measles cases were notified through the surveillance system;serum samples were collected and tested by ELISA to detect measles IgM and IgG antibodies.Analyses were conducted using Excel and SPSS.Results 32 642 measles cases were reported from 1978 to 2006,the average annual incidence being 30.71/lakh.Significant differences were observed in incidence rates of different districts/counties and of different time periods.The epidemic trend went ascending,then declining and finally returned,and could be divided into 3 periods.After the three major peaks in period I,the epidemic continuously declined from 1987 to 2000 until a minor peak recurred in 2004.79 deaths with a fatality rate of 0.24% were reported in the 29 years.Cases were mostly reported in March to June from 1991 to 2006,while in 2004 when the incidence rate re-ascended,peaks were seen during February to April.60.47% of the cases occurred in children under 5 years old and dispersed children accounted for 55.48% of all the cases.Measles vaccination coverage rates ranged from 71.50% to 99.76% in the 29 years,which were negatively correlated with the annual incidences.The total antibody positive rate was 91.18% in serologic surveillance.Among the cases reported from 2005 to 2006,only 15.30% of them had a clear history of vaccination.Conclusion The incidence rate of measles decreased 89.14% in Loudi,while in recent years a recurring increase was seen,which may have resulted from relatively low immunization coverage and gaps in population immunity.In recent years of high epidemic,onset seasons became earlier with stronger epidemic strength,and characterized by a little-age epidemic pattern.