2008年桂林市麻疹流行分析

目的了解桂林市麻疹发病情况,为控制麻疹制定科学依据。方法采用描述流行病学方法统计分析。结果 2008年全市报告麻疹病例192例,报告发病率3.87/10万,<8月龄51例,占总病例数的26.6%,>15岁病例51例,占26.6%,散居儿童发病125例,占65.1%;病例以市区为主,占病例数的52.6%,主要集中在流动人口较多的城乡结合部;病例中未免疫的128例,免疫史不祥的52例,分别占总病例数的66.7%、27.1%。结论桂林市麻疹发病以小年龄婴儿和成人为主,要控制麻疹,在做好常规免疫工作的同时,必须加强流动人口的管理,提高流动儿童的接种率。     

1999～2004年新疆兵团农七师麻疹流行病学特征分析

目的了解和掌握新疆生产建设兵团农七师近几年来麻疹疫情,以求进一步做好控制工作. 方法对农七师1999～2004年麻疹流行病学特征进行分析. 结果 1999～2004年农七师共发生麻疹81例,年平均报告发病率7.21/10万(1.66/10万～13.81/10万),无死亡病例,呈散发.与1987～1998年相比,麻疹发病下降了0.3倍.发病高峰在每年的3～6月份.外来人口麻疹发病率32.09/10万,外来人口发病率非常显著高于常住人口发病率.无免疫史者58例(占71.60%).61.73%的病例集中在7～39岁间. 结论外来人口发病是农七师麻疹发病的主要因素,无MV免疫史、免疫失败是导致麻疹发病的关键原因.     

甘肃省武威市麻疹疫情流行病学特征分析

目的分析2005─2014年甘肃省武威市麻疹发病的流行病学特征及防控措施,为全面消除麻疹采取针对性的措施提供依据。方法采用描述流行病学方法分析2005─2014年武威市麻疹发病资料,了解其发病与流行病学特征。结果 2005─2014年武威市共报告麻疹确诊病例791例,无死亡病例,年平均发病率4.34/10万,不同年份发病率差异有统计学意义(χ2=70.30,P0.05);发病高峰为4─7月,报告病例599例,占病例总数的75.73%,不同月份发病率差异有统计学意义(χ2=36.88,P0.05);总体呈小年龄组人群发病为主的模式特征,5岁以下儿童发病486例、占病例总数的61.44%;流动人口发病275例,占病例总数的34.77%;病例中有麻疹免疫史占63.08%,无免疫史占17.70%,免疫史不详占19.22%。结论武威市麻疹发病率总体处于散发水平,对适龄儿童及时、完整地开展麻疹疫苗接种、完善麻疹监测体系、积极开展医院和校园内培训、探索新模式管理流动人口,是控制并消除麻疹的有效手段。     

2008年新疆库车县571例麻疹的流行病学分析

目的通过对麻疹发病情况进行分析,了解麻疹流行病学特点,为控制麻疹提供科学依据。方法对库车县2008年1-6月各级医疗卫生单位诊断的571例麻疹病例进行描述流行病学分析。结果2-3月是麻疹的高发季节,发病占全部病例的80.73%。发病年龄集中在3岁以下儿童,占总病例数的66.90%。免疫史调查526例中有麻疹免疫史136例（25.85%）,无免疫史254例（48.30%）,免疫史不详136例（25.85%）。结论加强麻疹疫苗的常规免疫,尤其要提高接种的及时率和流动儿童的接种率。     

2009～2011年新疆阿克苏地区麻疹流行病学特征分析

目的了解2009～2011年新疆阿克苏地区麻疹流行特征,探讨麻疹流行特征和发病特点。方法对2009～2011年阿克苏地区的麻疹监测资料进行描述性流行病学分析。结果 2009～2011年阿克苏地区累计报告51例麻疹病例,年均发病率2.06/10万;由于经过2008年麻疹强化免疫,不同年份间发病率的差异无统计学意义(χ2=6.00,P>0.05);3～5月为发病高峰,占总报告病例数的68.6%。结论新疆阿克苏地区麻疹病例中成人和未到免疫年龄段人群占较大比例,具有双向移位特征;要达到消除麻疹目标,在提高适龄儿童常规免疫接种率、疫苗成功率以及加强麻疹监测系统灵敏性的同时,建议适时开展成人强化免疫工作和提前麻疹疫苗初次免疫时间,进而达到消除麻疹的目标。     

2004-2009年安岳县麻疹流行病学特征分析

目的分析2004-2009年安岳县麻疹发病与流行趋势,为控制和消除麻疹提供依据。方法对2004-2009年安岳县麻疹监测系统确诊的632例病例进行流行病学分析。结果 2004-2006年麻疹发病率呈下降趋势,2007年发病数显著上升,且呈现散发与局部暴发并存的态势。2008年3月全县开展8月龄1~5岁儿童普种麻疹疫苗,疫情得到明显控制,2009年发病数仅有3例。发病高峰集中在3-7月;病例中有免疫史的占30.54%,无免疫史和免疫史不详的占44.78%和24.68%。结论麻疹初免及加强免疫接种不及时、流动儿童增多是造成麻疹发病上升的主要原因。提高麻疹疫苗接种质量和及时接种率,加强流动人口管理是控制麻疹暴发和流行的重要手段。     

2010—2022年山东省聊城市麻疹流行病学特征

目的 分析2010—2022年山东省聊城市麻疹流行病学特征,为聊城市消除麻疹工作提供依据。方法 采用流行病学方法回顾分析2010—2022年聊城市麻疹流行特征。结果 2010—2022年聊城市共报告麻疹病例1 356例,其中实验室确诊1 262例,临床诊断94例,年均报告发病率1.77/10万,报告发病率呈下降趋势(趋势χ²=2 934.037,P<0.001)。2010年和2013—2016年报告发病率较高,其余年度为散发,发病高峰主要集中在1—6月和12月。报告发病率全市前三位依次为东昌府区、高唐县和东阿县。病例集中在≤3岁儿童和≥20岁成人、占报告病例总数的91.15%。无含麻疹成分疫苗(MCV)免疫史病例占58.92%,免疫史不详病例占25.00%。基因型鉴定232例麻疹监测病例中,226例为本土H1型,6例为疫苗株A型。结论 2010—2022年聊城市麻疹报告发病率呈下降趋势,2020年麻疹报告发病率最低。需继续维持适龄儿童2剂次MCV高水平覆盖率和接种及时率,主动开展大年龄组人群,尤其是人口流动较大和与外省(市)交界的县(区)重点人群的MCV接种...     

甘孜州2006年麻疹流行病学分析

目的了解甘孜州2006年麻疹流行病学特征,为制定防制策略提供科学依据。方法对甘孜州2006年疾病监测报告管理系统和麻疹监测系统的数据进行描述性流行病学分析。结果2006年甘孜州共发生麻疹病例71例,发病率7.91/10万,无死亡病例。3-4月份为发病高峰期,共发病44例;占发病总数的61.97%,病例分布以学生为主,其中学生占发病总数的83.09%。病例中无免疫史或免疫史不详占56例。结论未接种麻疹疫苗是造成发病的主要原因。提高常规免疫接种率,及时对适龄儿童进行麻疹疫苗复种,并有计划地开展麻疹疫苗强化免疫,加强学校传染病防治工作,消除免疫空白,是甘孜州控制麻疹需要解决的问题。     

2001～2012年甘肃省庆城县麻疹流行病学分析

目的了解2001～2012年甘肃省庆城县麻疹流行病学特征。方法根据庆城县常规传染病监测报告资料,对2001～2012年麻疹病例进行描述性流行病学分析。结果 2001～2012年甘肃省庆城县麻疹发病率0～38.90/10万,发病呈梯形下降趋势,以4～7月为高发季节,发病以学生及儿童为主;41.00%的病例麻疹疫苗(MV)免疫史不详,14.50%的病例无麻疹疫苗免疫史。结论为实现消除麻疹目标并巩固已取得的成效,今后要提高流动儿童的麻疹接种率,提高MV第一剂次初种、第二剂次复种的及时接种率,加强麻疹监测。     

2008年新疆阿勒泰地区麻疹流行特征分析

目的分析2008年新疆阿勒泰地区麻疹流行病学特征,为政府加速控制麻疹提供科学依据。方法对麻疹疫情报告资料进行描述流行病学分析。结果 2008年阿勒泰地区麻疹发病大幅上升,报告发病率为198.79/10万,明显高于1998～2007年的发病水平。发病以≥15岁成人为主,占发病总数的62.23%,多为无明确麻疹减毒活疫苗免疫史和免疫史不详者。8月龄～1岁病例中无免疫史者占52.94%,发病集中在2～5月,农牧区发病人数占72.81%。结论麻疹母传抗体下降、麻疹疫苗接种不及时、传染病报告不及时和传染源管理不严等是造成本次麻疹流行的主要原因。     

成都高新区麻疹减毒活疫苗强化免疫效果分析

目的 分析高新区麻疹减毒活疫苗强化免疫活动效果.方法 收集高新区2008年麻疹疫苗强化免疫活动报表及2007 - 2009年疫情资料,并对其进行统计分析.结果 对32 525名目标儿童接种麻疹疫苗,报告接种率96.17％,评估接种率97.61％,知晓率99.64％,未种率3.83％,其原因主要为生病、家长拒种、过敏史和怕接种反应.2009年发病率降到0.69/10万,2007年与2008年、2008年与2009年发病率差异均有统计学意义(P＜0.01).结论 麻疹强化免疫成效显著,麻疹发病率显著降低.     

2005～2012年甘肃陇南市麻疹疑似病例IgM抗体检测结果分析

目的检测麻疹疑似病例血清中麻疹IgM抗体,为麻疹的预防和控制提供科学依据。方法用酶联免疫吸附试验（ELISA）对2005～2012年甘肃陇南市839例麻疹疑似病例的血清标本进行IgM抗体检测,数据用Spss19．0软件进行统计学分析。结果共检出麻疹IgM抗体阳性534份,阳性率63．6％;每年都有病例报告,其中2008年阳性率最高,为82．6％;各区（县）均检出阳性病例,不同地区阳性检出率差异有统计学意义（χ2=86．917,P〈0．05）;发病人群集中在8月龄。25岁年龄段,占阳性病例总数的74．5％;麻疹每月均有发病,但高峰在3～7月。结论检测麻疹IgM抗体对病例的早发现、早诊断、早治疗、及时采取控制措施起到关键作用,各级医疗机构要重视疑似病例的血清采集工作,同时应大力加强麻疹基础免疫和重点人群的强化免疫工作;高度重视查漏补种工作,消除免疫空白点,提高免疫接种的覆盖率和及时率;加强健康教育工作,提高麻疹预防知识的知晓率。     

Progress toward measles and rubella elimination in Egypt

Measles and rubella were common infectious diseases in Egypt during the prevaccine era. Monovalent measles vaccine was introduced in 1977, and measles vaccination coverage increased from <50% to >90% from 1980 to 1999; however, measles outbreaks continued to occur at 2- to 4-year intervals during this period. After the introduction of a second routine dose of measles vaccine as a combined measles-mumps-rubella (MMR) vaccine in 1999 and the implementation of measles immunization campaigns targeting 6- to 16-year-old children during 2000-2003, reported measles cases dramatically decreased by 2003. In 2002, Egypt established a goal to eliminate measles and rubella and to prevent congenital rubella syndrome (CRS) by 2010. Large-scale rubella and measles outbreaks in 2005-2007, however, led to a revision of the plan of action to achieve the 2010 goals. A nation-wide measles-rubella immunization campaign, targeting children, adolescents, and young adults 2-20 years old, was conducted in 2 phases during 2008-2009 and achieved coverage >95%. With the decrease to record low levels of cases of measles and rubella in 2009 and 2010, Egypt should achieve measles and rubella elimination in the near future, but high coverage(>95%) with 2 doses of measles-rubella vaccine needs to be maintained, measles-rubella surveillance strengthened, and CRS surveillance developed.     

Interruption of measles transmission in Brazil, 2000-2001

In 1992, Brazil adopted the goal of measles elimination by the year 2000; however, in 1997, after a 4-year period of good control, there was a resurgence of measles in Brazil. In 1999, to achieve the elimination goal, Brazil implemented the Supplementary Emergency Measles Action plan, with one measles surveillance technician designated to each state. Of 10,007 suspected measles cases reported during 1999, 908 (9.1%) were confirmed, and of them 378 (42%) were confirmed by laboratory analysis. Of 8358 suspected measles cases reported in 2000, 36 (0.4%) were confirmed (30 [83%] by laboratory); 92% of the discarded cases were classified on the basis of laboratory testing. In 2001, only 1 of 5599 suspected measles cases was confirmed, and it was an imported case from Japan. The last outbreak occurred in February 2000, with 15 cases. Current data suggest interruption of indigenous measles transmission in Brazil.     

Progress in the control of measles in Ghana, 1980-2000

By review of available literature, routine surveillance data, coverage surveys, and hospital records, measles control in Ghana was assessed since vaccinations began in 1978. Nationally, measles vaccination coverage increased from 24% in 1980 to 84% in 2000. This achievement is attributed to health sector reforms that included a higher district share of the total recurrent health budget from 20% in 1996 to 42% in 1999. The budget reallocation resulted in improved access to immunization services, supply procurement, transport management, staff motivation, and information flow. On the client side, the age of the child, socioeconomic status of parents, and type of prenatal care were associated with vaccination coverage. Routine vaccination coverage of >80% has resulted in lower measles incidence, a longer interepidemic interval, and a shift in cases to older children. Ghana recently developed a strategic plan to reduce measles deaths to near zero.     

Progress toward interruption of endemic measles transmission in Tunisia

Measles was the second leading cause of infant mortality in Tunisia prior to introduction of measles vaccination in 1979. The number of reported measles cases has decreased from 3007 in 1981 to 47 cases in 2000 due in part to the high coverage rates achieved after 1992. During 1998, a measles catch-up campaign vaccinated 1,846,657 children (95%) aged 6-16 years, and a follow-up campaign for children aged 9 months to 5 years in 2001 reached 547,766 (94%). During 1999-2001, 1717 cases of rash and fever illness were tested for measles; only 3 (0.2%) were positive for measles. From February to July 2002, an outbreak of measles involving 87 cases occurred in Tunisia in a health care setting and 56 (64%) patients were aged 15-30 years. The low number of laboratory-confirmed measles cases during 1999-2001 suggests endemic measles transmission may have been interrupted.     

A 24-year review on the epidemiology and control of measles in Singapore, 1981-2004

The objective of our paper is to review the epidemiology of measles in Singapore and the impact of the measles vaccination program on the control of measles. Our review will form the basis for a critical appraisal of our future measles control program. We analyzed the trend of reported measles cases in relationship to measles vaccination coverage from 1981 to 2004 using routine measles notifications and measles vaccination data submitted to the Ministry of Health and the National Immunization Registry, respectively. We determined the measles vaccine efficacy using data from epidemiological investigations of reported institutional measles outbreaks. The herd immunity of the population against measles was accessed through three seroepidemiological surveys that we conducted in 1989/1990, 1993 and 1998. In addition, we collected blood specimens from every clinically diagnosed case of measles notified to the Ministry in 1998/1999 to for measles-specific IgM antibodies in order to evaluate the proportion of clinically diagnosed cases of measles that were laboratory confirmed. The incidence of measles has decreased significantly since 1981 as a result of increased vaccination coverage of 89-93% following implementation of compulsory measles vaccination in 1985. However, resurgences still occurred in 1992/1993 and 1997. With the implementation of the two-dose measles vaccination schedule, the annual number of laboratory confirmed cases of measles to date has been less than 150. Vaccine efficacy of the trivalent MMR vaccine based on institutional outbreak investigations was consistently above 92%. We also found that the overall seroprevalence of the population to measles has decreased from approximately 91.5% in 1989/1990 to 1993 to 77.9% in 1998 (mainly in children < 4 years old) and that only 7% of clinically notified cases of measles were serologically confirmed to be positive for measles. Achieving a vaccination coverage of more than 95%, tightening our MMR vaccine delivery system and strengthening surveillance of measles are essential components which must be addressed in order to interrupt measles transmission in Singapore.     

Approach to verify the status of measles, rubella, and congenital rubella syndrome elimination in Costa Rica

Costa Rica introduced the measles-mumps-rubella (MMR) vaccine in 1986. The Ministry of Health adopted the goal of eliminating endemic measles in 1991 by achieving and maintaining high vaccine coverage through routine delivery, mass campaigns and outreach activities, and the strengthening of expanded program on immunization (EPI) surveillance. Measles and rubella immunization strategies shifted susceptibility to older age groups, leading to the introduction of MMR2 in 1992, administered at age 7 years. In 2000, the goal of accelerated rubella control and congenital rubella syndrome prevention was established, and a nationwide vaccination campaign targeting men and women aged 15-39 was implemented to immunize the population of reproductive age. The last endemic case of measles was confirmed in 1999, and at the end of 2001 Costa Rica reported the last endemic cases of rubella and congenital rubella syndrome. Imported cases of measles and rubella were detected in 2003 and 2005, with no secondary cases detected. In 2008, Costa Rica established a National Committee of Experts, supported by technical teams, to collect the evidence required to verify the interruption of endemic transmission of the measles and rubella viruses. The evidence includes information on trends and epidemiologic analysis, molecular epidemiology, population immunity, the quality of surveillance, and the sustainability of the EPI program.     

Measles outbreak epidemiology in the United States, 1993-2001

To evaluate the extent of measles virus circulation and populations at risk in the United States, we reviewed measles outbreaks during 1993-2001. A total of 120 measles outbreaks, constituting 1804 outbreak-related cases, were reported during this period. The maximum outbreak size decreased from 233 cases in 1993-1995 to 119 cases in 1996-1998 and 15 cases in 1999-2001. The maximum outbreak duration decreased from 127 days in 1993-1995 to 65 days in 1999-2001. The majority of outbreaks resulted from documented spread from an internationally imported case (42%) or had a strain of measles virus not endemic in the United States (12%). Outbreaks in which adults were the predominant age group affected accounted for 35% of all outbreaks, compared with 29% of outbreaks predominantly affecting preschool children, 30% predominantly affecting school-aged children and adolescents, and 6% with no predominant age group. The extremely limited size and duration of measles outbreaks indicates very high population immunity to measles and suggests that measles is no longer endemic in the United States.     

Measles hospitalizations, United States, 1985-2002

Cases of measles that require hospitalization are a good marker of the burden of clinically severe measles in the United States. Measles hospitalizations routinely are monitored by the National Notifiable Disease Surveillance System (NNDSS). Our objectives were to describe measles hospitalizations reported to the NNDSS in 1985-2002, to use hospital discharge data from independent data sets (the National Hospital Discharge Survey [NHDS] [data available for 1985-1999] and the Health Care Investment Analysts [HCIA] hospital discharge database [data available for 1985-1996]) to provide additional estimates of total measles hospitalizations, and to compare trends in measles-associated hospitalizations. In 1985-2002, a total of 13621 patients with measles reported to the NNDSS were hospitalized (annual average, 757; range, 19-5856 patients). In 1985-1996, a total of 13472 measles hospitalizations were reported from NNDSS, compared with 28047 estimated from the NHDS and 19352 extrapolated from HCIA data. In the NNDSS, the annual total number declined after 1992 to 相似文献