哈尔滨市2009-2012年风疹流行病学特征及风疹监测系统运转情况分析

目的分析哈尔滨市2009-2012年风疹病例的流行病学特征及《麻疹/风疹专病监测信息报告系统》的运转情况。方法采用描述流行病学方法,对通过《麻疹/风疹专病监测信息报告系统》报告的风疹病例进行流行病学特征分析,并对监测指标进行分析评价。结果发病集中在4-6月份;男女发病比为1.74︰1;15岁~组发病率最高。共监测到孕妇风疹疑似病例8例。各年风疹监测信息报告管理系统指标情况:48 h内个案调查率分别为91.95%、85.90%、95.69%、99.34%;各年血清学检测结果≤7 d报告率分别为87.05%、81.01%、96.96%、97.46%;血标本采集率为80.43%。结论哈尔滨市风疹病例高发人群已转向大年龄,多为15~20岁组人群。《麻疹/风疹专病监测信息报告系统》的应用使风疹病例报告的及时性、敏感性、特异性均有大幅度的提高。     

济南市市中区2005年先天性风疹综合征回顾性调查分析

目的了解济南市市中区先天性风疹综合征发病情况。方法对辖区内综合性医院、妇幼保健部门在2000—2004年诊断为先天缺陷疾病,且登记住址为济南市的15岁以下住院病例进行了先天性风疹综合征病例调查。结果共调查先天缺陷病例447例,符合先天性风疹综合征病者16例,确诊3例,检出率为4.25%;其他428例因孕早期风疹感染和风疹实验室检测情况不详,不能做出明确的判定。结论先天性风疹综合征检出率明显偏低;先天缺陷以先心病为主,唇腭裂次之。加强宣传,使广大育龄妇女孕前接种风疹疫苗,是预防先天性风疹综合征的有效措施。     

2004-2010年乐山市风疹流行病学分析

目的 了解乐山市风疹流行情况,分析其流行病学特征,为风疹疫情的防控提供科学依据.方法 采用描述性流行病学分析方法,对2004 - 2010年乐山市风疹疫情资料进行分析.结果 2004 - 2010年乐山市共报告风疹病例2 794例,年均发病率为12.05/10万(1.64/10万～27.08/10万),2004 - 2007年呈上升趋势,继2007年疫情高发后,2010年再次出现流行高峰.2007年报告发病率最高.除金口河区无病例报告外,其余各区县均有病例报告.发病季节主要集中在4-6月,发病年龄主要集中在5～19岁(79.20％),职业分布以学生为主(73.44％).结论 2004 - 2010年乐山市风疹报告发病率呈现上升趋势,病例主要为学生,应加强对学校预防控制.     

北京市1990-2010年风疹流行病学分析

北京市从1990年开始系统收集上报风疹发病资料,这对于预测发病趋势、调整干预措施、提高监测水平具有重要作用。本研究利用疫情资料对北京市1990-2010年风疹发病情况进行分析。     

2005-2014年西安市风疹流行特征分析

目的分析探讨2005-2014年西安市风疹动态变化和流行特征,准确掌握西安市风疹发病趋势和疾病特点,为制定防制策略和防控措施提供科学依据。方法对2005-2014年西安市风疹疫情资料进行描述性研究,统计分析影响该病发病的主要因素。结果 10年间共报告发病5 179例,年平均报告发病率为6.47/10万;全年呈现一个发病高峰期为3-6月的春夏峰,发病占总发病的84.07%。职业分布以学生和幼托儿童为主,占发病总数的79.64%。发病年龄集中在20岁以下占总发病数的84.00%。结论西安市风疹发病的时间集中、地区差异明显、有人群聚集性,对于采取针对性预防风疹的控制措施提供了有利条件,当前防控风疹的关键在于预防学生和幼托儿童的发病和防止孕妇感染风疹引起的CRS。     

山东省监测地区先天性风疹综合征流行病学回顾性调查

风疹是由风疹病毒引起的急性呼吸道传染病.妇女孕早期感染风疹病毒会引起流产、死胎或婴儿出生后发生多器官严重损害的先天性风疹综合征(CRS).     

延安市2004-2010年风疹流行病学特征分析

目的了解延安市2004-2010年风疹的流行病学特征,为预防控制风疹提供科学依据。方法采用描述性流行病学的方法,对2004-2010年延安市风疹发病情况进行分析。结果 2004-2010年延安市共发生风疹1 128例,年平均报告发病率为7.60/10万,2006年的发病率最高,为36.08/10万。全市各县区均有发病,黄龙县的发病率最高,为103.99/10万。各年份均有发病,3~7月为发病高峰期,人群分布以学生、托幼儿童和散居儿童为主,年龄分布以5~14岁年龄组发病人数最多,占发病总数75%。结论风疹严重影响儿童的身体健康,接种风疹疫苗是控制风疹发病及暴发流行的有效措施。     

山东省监测地区先天性风疹综合征流行病学回顾性调查

风疹是由风疹病毒引起的急性呼吸道传染病.妇女孕早期感染风疹病毒会引起流产、死胎或婴儿出生后发生多器官严重损害的先天性风疹综合征(CRS).     

2013-2014年淄博市肾综合征出血热监测分析

摘要:目的　掌握淄博市肾综合征出血热的疫情动态和流行规律,掌握其宿主动物的分布、种类及感染情况,为合理的防控策略的提出提供依据。方法　分析2013-2014年淄博市肾综合征出血热的疫情及宿主动物监测资料。结果　淄博市出血热发病以农民为主,男女之比为2∶1,季节分布由秋冬季高峰为主向春季高峰转变。居民区以褐家鼠为优势鼠种,占93.62%,且居民区褐家鼠平均带毒率12.50%;野外褐家鼠及黑线姬鼠均较多,分别占62.12%、28.78%,野外老鼠未检测出汉坦病毒。2014年与2013年相比,鼠密度有所增加,但带毒率的升高不明显。结论　目前我市是以家鼠为主的混合疫区,重点是在春季加强居住区家鼠的灭鼠工作。     

Surveillance of congenital rubella syndrome (CRS) in tertiary care hospitals in Hanoi,Vietnam during a rubella epidemic

ObjectiveTo describe the epidemiology and clinical features of congenital rubella syndrome (CRS) in Hanoi, Vietnam.MethodsProspective surveillance of CRS between May 2011 and March 2012 in Hanoi, Vietnam. CRS burden was assessed by clinical examination and collection of serum samples from infants in neonatology, cardiology and pediatric departments of two tertiary care hospitals in Hanoi. All infants born during the study period with clinical manifestations of CRS and seropositivity (IgM) for rubella were included in this study.ResultsDuring the surveillance period 113 infants were identified with confirmed CRS (clinical features and positive rubella IgM). Their mean age at diagnosis was 38.4 days (range 1–152 days) and 61% were female. Clinical manifestations of CRS included low birth weight <2500 g (86.0%), congenital heart disease (63.7%), hearing impairment (63.7%) and ophthalmological abnormalities (46.9%). Other clinical features at birth included: thrombocytopenia (85.0%), neonatal purpura (74.3%), splenomegaly (63.7%), hepatomegaly (62.8%) and blueberry muffin rash (61.1%). Among the mothers of infants with confirmed CRS none had received a rubella vaccine in the past and 88.4% gave a history of rubella contact during the pregnancy under study. In most cases (84.1%) maternal infection occurred in the first trimester. During the surveillance period the estimated annual incidence of CRS was 1.13/1000 live births (95% CI 0.92–1.34).ConclusionsThese preliminary baseline data show a high burden of CRS in Hanoi, Vietnam and the urgent need for universal vaccination. Surveillance to determine and monitor the national burden of CRS is essential.     

Epidemiology of rubella and congenital rubella syndrome in Japan before 1989

Epidemiological studies of rubella and congenital rubella syndrome (CRS) in Japan have been conducted since the first nationwide rubella epidemic of 1965–1969 and subsequent epidemics of 1975–1977, 1982, 1987–1988, and 1992–1993. Rubella was non-endemic in Japan before the 1975–1977 epidemic, and endemic thereafter. Japan started a selective rubella vaccination program for junior high school girls in 1977, and universal rubella vaccination of children of both sexes in 1989. No nationwide rubella epidemics have occurred since 1994.Only three children with CRS were reported in Japan before 1964; however, many children with CRS were identified in 1965 when a rubella epidemic struck Okinawa, which has many the United States military bases. After the 1965–1969 and 1975–1977 rubella epidemics on the Japanese mainland, small numbers of children with CRS were identified (hospital survey). These findings led to the hypothesis that, compared to U.S. rubella virus strains, Japanese strains of rubella virus are less teratogenic. This hypothesis strongly affected the development of rubella vaccines in Japan. However, retrospective seroepidemiological studies attributed the CRS in many children in Okinawa to the high rate of rubella infection in pregnant women. According to the survey conducted at special schools for the deaf, 83, 232, 77, and 167 children were born with CRS on the Japanese mainland respectively after the 1965–1969, 1975–1977, 1982, and 1987–1988 nationwide rubella epidemics, suggesting that the incidence of CRS in Japan is in fact comparable to that in the U.S. and Europe.Rubella epidemics in children have been effectively prevented since 1994. However, a rubella outbreak among adult males and CRS occurred between 2012 and 2014.     

Current epidemiology of rubella and congenital rubella syndrome in Australia: progress towards elimination

This study evaluates the evidence for elimination of rubella and congenital rubella syndrome (CRS) in Australia, drawing on three national serosurveys conducted between 1996 and 2007 and supported by statutory notification and vaccine coverage data. Anti-rubella IgG seropositivity was defined as ≥ 10 IU/ml by EIA. Between 1998 and 2007, rubella notifications fell >100-fold, to an average of 2 cases per million and there were five confirmed cases of CRS, two of which were locally acquired in 2003. Weighted overall seropositivity remained constant among 1-49 year-olds (89.6% in 1999; 88.1% in 2007). Between 2002 and 2009, 95% of children received at least one dose of the measles-mumps-rubella (MMR) vaccine. All three serosurveys provided estimates for R less than 0.5, well below the epidemic threshold of 1. All available data are supportive of Australia being considered for elimination status. Further reductions in incidence of CRS will require continued attention to vaccine coverage in overseas-born women, as well as the maintenance of current high coverage level of two-dose MMR vaccination.     

Safety profile of rubella vaccine administered to pregnant women: A systematic review of pregnancy related adverse events following immunisation,including congenital rubella syndrome and congenital rubella infection in the foetus or infant

BackgroundData on the safety of inadvertent rubella vaccination in pregnancy is important for rubella vaccination programs aimed at preventing congenital rubella syndrome.MethodsThe association between monovalent rubella or combination vaccinations in or shortly before pregnancy and potential harm to the foetus was examined by conducting a systematic review and meta-analysis using fixed effect methods and simulation.ResultsFour cohort studies of inadvertently vaccinated and unvaccinated women were found, 15 cohorts of pregnant women who were rubella susceptible at time of inadvertent vaccination and 9 cohort studies with no information on susceptibility and case series. No case of vaccine associated congenital rubella syndrome (CRS) was identified. Cohort studies with an unvaccinated comparison group were limited in number and size, and based on these only a theoretical additional risk of 6 or more cases of CRS per 1000 vaccinated women (0% observed, upper 95% CI 0.6%) could be excluded. Based on cohorts of vaccinated rubella susceptible pregnant women a maximum theoretical risk of 1 CRS case in 1008 vaccinated women (0% observed, upper 95% CI 0.099%) was estimated. Asymptomatic rubella vaccine virus infection of the neonate was also noted (fixed effects estimate of risk overall 1.74%, 95% CI 1.21, 2.28).ConclusionThere is no evidence that CRS is caused by rubella-containing vaccines but transplacental vaccine virus infection can occur. CRS is effectively prevented by vaccination, thus the risk/benefit balance is unequivocally in favour of vaccination. The data confirm previous recommendations that inadvertent vaccination during pregnancy is not an indication for termination of pregnancy.     

Surveillance of congenital rubella and rubella infections in pregnancy in EU/EEA countries, 2012: Current status and future perspective to monitor elimination

IntroductionRubella elimination and congenital rubella syndrome (CRS) prevention are targets for achievement by 2015 in the WHO-EURO Region. This paper describes the existing surveillance systems for CRS and rubella in pregnancy in order to critically interpret the findings in relation to the 2012 WHO-EURO surveillance guidelines.MethodsIn 2012 we conducted a survey to collect information on surveillance of CRS and rubella in pregnancy in 29 EU/EEA countries. Questionnaires explored the characteristics of the surveillance systems, case definition, epidemiological investigation and follow-up of cases, reference laboratories and types of tests performed.ResultsTwenty-eight countries had surveillance systems for CRS, mostly nationwide, mandatory, passive and case-based; 23 collected information on the origin of the infection; 11 reported asymptomatic infections; 6 required zero-reporting. Case definitions varied among countries, although 24 used the EU definition. Laboratories reported cases in 18 countries. Twenty countries collected information on pregnancy within the rubella surveillance system and 5 had specific surveillance for rubella in pregnancy. Two countries did not monitor outcomes of suspected infections in pregnancy; infants with CRS were monitored in all the remaining countries; asymptomatic infected infants in 15; stillbirths and fetal deaths in 13; therapeutic and spontaneous abortions in 8 and 7. Twenty-seven countries had a national reference laboratory for CRS and rubella in pregnancy; genotyping was performed in 15.DiscussionThe current surveillance systems allow adequate CRS monitoring in EU. Further efforts are needed to improve their quality, including uniform case definitions, collection of information on the origin of infection, and promotion of reporting from laboratories. Follow-up of pregnant women with suspected infection should be strengthened because it is an entry point for CRS, including detection of fetal deaths, stillbirths and abortions. Laboratory capacity for confirming congenital rubella infections and infections in pregnancy is good in EU, however the use of genotyping should be encouraged.     

2007—2010年天津市和平区风疹流行病学分析

目的了解天津市和平区风疹发病概况,为有效预防控制风疹流行提供科学依据。方法利用中国疾病预防控制信息系统的数据分析天津市和平区2007—2010年风疹的流行病学特征。结果 2007—2010年全区共报告377例风疹,年平均发病率25.56/10万,无死亡病例。高发时间每年4—6月份,70%的病例集中在人口密度较大的南营门街、劝业场街和新兴街,60.21%的病例为在校学生,年龄集中在10～19岁的病例占全部病例的53.31%,全部病例中有免疫史的仅10%。结论对高发地区应加强疾病监测,对学龄儿童及青少年可考虑接种风疹疫苗,准备妊娠的妇女可考虑接种麻腮风疫苗,有利于减少风疹及先天性风疹综合征的发生。     

Surveillance for congenital rubella in Australia since 1993: Cases reported between 2004 and 2013

Objective

To describe the epidemiology of congenital rubella infections notified to the Australian Paediatric Surveillance Unit (APSU) from 2004 to 2013 and compare that with previously published APSU data for 1993–2003.

Methods

Active national surveillance for congenital rubella infection has been conducted through the APSU since 1993. Monthly reporting by child health clinicians according to pre-defined case criteria triggers requests for clinicians to provide de-identified clinical, epidemiological, and laboratory information. Data were extracted for cases reported between January 2004 and December 2013 and compared with previous years.

Results

Five cases of confirmed congenital rubella infection were identified during the reporting period. All five infants had defects consistent with congenital rubella syndrome (CRS). Four of the infants were born in Australia during the study period, and all were born to mothers born overseas. Three of the five mothers had not had rubella vaccination, and in two vaccination status was unknown, although both were from countries without routine rubella immunization programmes. Since 1993, there have been 57 notifications of congenital rubella infection to the APSU; 40 of these infants were born between January 1993 and December 2013, of whom 34 had confirmed CRS.

Conclusions

Congenital rubella infection in Australia is predominantly among children born to unimmunized immigrant mothers. Migrant women born in rubella endemic countries without routine immunization remain an important group to target for vaccination. Rubella-susceptible women, especially those in the early stages of pregnancy, should also carefully consider the risks of travelling to rubella endemic countries.     

A systematic review of rubella vaccination strategies implemented in the Americas: impact on the incidence and seroprevalence rates of rubella and congenital rubella syndrome

Objective

To evaluate the impact of rubella vaccination strategies on the rates of acquired rubella and congenital rubella syndrome in the Americas.

Methods

We conducted a systematic review of the literature (MEDLINE, PubMed, EMBASE, Cochrane Library, Artemisa Database, LILACS Database, Evidence Portal, VHL-PAHO Portal, Scielo, and Grey-Literature sources) that was published from 1969–2010. We included studies on rubella incidence and seroprevalence rates that were associated with rubella vaccination. The quality of the studies was evaluated according to international guidelines.

Results

A total of 14 studies were identified: 2 clinical trials, 2 cohort studies, 3 transversal studies, 5 ecological studies, and 2 mathematical models. Childhood vaccination reduced the incidence of rubella by 23.6% to 99.6%, increased the occurrence of epidemic cycles in Argentina and in the United States, and shifted the illness to susceptible adults. Vaccination strategies that focused on women and children in Brazil were associated with a 5.5-fold greater incidence of rubella in men leading to new outbreaks and CRS. A combined vaccination strategy with a universal approach that included routine vaccination for boys, girls, women, and men in Mexico and in Costa Rica reduced the incidence of rubella by more than 98% and led to absence of CRS since 2008. A medium and a low risk of bias were found in 3 and 4 articles, respectively.

Conclusion

The results of this review demonstrate that the combined vaccination strategy with a universal approach was the most effective strategy as evidenced by a drastic reduction in the number of cases and the interruption of endemic transmission of rubella in the Americas.     

山东省监测地区先天性风疹综合征流行病学回顾性调查

风疹是由风疹病毒引起的急性呼吸道传染病.妇女孕早期感染风疹病毒会引起流产、死胎或婴儿出生后发生多器官严重损害的先天性风疹综合征(CRS).