中国流行性腮腺炎发病率模型拟合及预测效果比较

背景　流行性腮腺炎（流腮）是中国极为严重的疾病。充分认识中国流腮的规律性并构建模型预测,对其预防和控制有重要意义。目的　评价季节性自回归移动平均模型（SARIMA）、指数平滑模型、SARIMA-广义回归神经网络（GRNN）组合模型和指数平滑-GRNN组合模型在流腮发病率拟合及预测中的应用效果。方法　利用全国2004年1月-2016年6月的流腮逐月发病率数据拟合、训练模型,建立SARIMA、指数平滑模型、SARIMA-GRNN组合模型和指数平滑-GRNN组合模型。预测2016年7-12月流腮的逐月发病率并与实际值比较,采用平均绝对误差百分比（MAPE）、平均误差率（MER）、均方误差（MSE）和平均绝对误差（MAE）评价模型拟合及预测效果。结果　SARIMA（0,0,2）（0,1,1）12为最优SARIMA模型;Holt-Winters相乘模型为最优指数平滑模型,SARIMA-GRNN组合模型和指数平滑-GRNN组合模型的SPREAD最优参数分别为0.026、0.031。SARIMA模型、指数平滑模型、SARIMA-GRNN组合模型和指数平滑-GRNN组合模型拟合的MAPE、MER、MSE和MAE依次分别为15.350%、14.976%、0.336、0.286,14.346%、14.249%、0.326、0.272,7.390%、6.320%、0.034、0.123,6.952%、5.776%、0.028、0.113。SARIMA模型、指数平滑模型、SARIMA-GRNN组合模型和指数平滑-GRNN组合模型预测的MAPE、MER、MSE和MAE依次分别为11.998%、12.260%、0.022、0.138,39.582%、38.462%、0.199、0.432,8.892%、9.677%、0.020、0.109,8.872%、9.672%、0.021、0.109。结论　指数平滑-GRNN组合模型为最优模型,拟合及预测效果最好,用于全国流腮发病率预测精度高;SARIMA-GRNN组合模型次之;SARIMA模型拟合及预测效果一般;指数平滑模型拟合效果较好,但预测效果较差。     

干扰素治疗流行性腮腺炎并睾丸炎疗效观察

目的　探讨干扰素治疗流行性腮腺炎并发睾丸炎 (简称流腮并睾丸炎 )的疗效。方法　将 5 2例病人 ,分为干扰素组 32例 ,肌注干扰素 5 0 0 0IU/kg ,每天 1次 ,连用 5天 ;病毒唑组 2 0例 ,病毒唑 15～ 30mg/kg ,加入 5 %葡萄糖2 0 0ml静滴 ,每天 1次 ,连用 5天 ,治疗后观察其疗效。结果　干扰素组和病毒唑组的退热时间 ,腮腺肿痛消退时间、睾丸肿痛消退时间 ,前者分别为 2 6 1± 0 .80、2 40± 0 .80、3.0 0± 0 .70天 ,后者分别为 3.2 1± 0 .70、3.0 8± 0 .91、4.2 0± 0 .6 0天 ,两者之间均有显著性差异 (P <0 .0 1)。结论　干扰素的疗效明显优于病毒唑。     

2006～2010年厦门市流行性腮腺炎流行病学特征分析

目的了解厦门市扩大国家免疫规划实施前后（2006～2010年）流行性腮腺炎（流腮）的发病现状及流行趋势。方法采用描述流行病学方法对2006～2010年厦门市《疾病监测信息报告管理系统》和《突发公共卫生事件管理信息系统》报告的流腮疫情资料进行分析。结果厦门市2006～2010年共报告流腮病例3 038例,年平均发病率为25.05/10万,发病有明显的季节性,12月到次年1月和5～7月有两个发病高峰。发病主要集中在2～15岁的学生和幼托儿童,占报告病例总数的81.44%。2起暴发疫情均发生在小学。结论 2008年起将腮腺炎疫苗纳入扩大国家免疫规划,只能逐渐产生效果,不能快速建立起免疫屏障,短期内的发病不能很快下降。尽快出台流腮监测方案,以便积累更加丰富的发病资料,为进一步研究流腮防治措施提供基础信息。     

应用自回归移动平均模型预测分析江西省流行性腮腺炎的发病趋势

目的 应用自回归移动平均模型（ARIMA）预测分析江西省流行性腮腺炎的发病趋势。方法 利用ARIMA对江西省2015-2019年每月流行性腮腺炎报告发病数进行建模,预测12个月的发病数,并与2020、2021、2022年报告发病数进行比较分析。结果 最优模型为ARIMA（0,2,1）（1,2,0）₁₂。预测发病数显著高于2020、2021、2022年报告发病数。2020、2021、2022年流行性腮腺炎报告发病数较预测发病数分别减少54.02%、63.40%、66.09%。结论 2020-2022年江西省流行性腮腺炎报告发病数明显低于预测发病数,考虑与非药物干预措施、免疫策略的改变等有关,建议进一步加强流行性腮腺炎监测,以更好应对流行性腮腺炎疫情。     

云南省2007--2009年流行性腮腺炎病毒SH和HN基因的遗传特征分析

目的 分析2007-2009年云南省腮腺炎病毒(MuV)分离株的SH和HN遗传特征.方法 采用反转录-聚合酶链反应从Vero细胞分离的病毒株基因组中扩增出SH基因和HN基因,测序后用Mega4.1软件分析其遗传特征.结果 云南省分离14株MuV的SH基因其核苷酸和氨基酸同源性为98.3%～100.0%和96.5%～100.0%,与其他省份比较其同源性为92.6%～99.4%和87.7%～100.0%,其中Wsh1和Wsh2与其他F基因型差异较大;与疫苗株同源性为84.5%～85.1%和77.2%;与其他基因型同源性为83.4%～90.9%和70.1%～86.0%.6株MuV分离株的HN基因与核苷酸和氨基酸同源性分别为99.3%～99.5%和99.1%～99.7%;与中国分离株SP株的核苷酸和氨基酸同源性均为99.8%;与其他基因型同源性为94.7%～96.8%和95.5%～99.1%;与疫苗株的同源性为92.4%～93.2%和95.5%～96.4%.结论 2007-2009年云南省流行的MuV均为F基因型;其HN基因比SH基因保守.

Abstract：

Objective To analyze genetic characterization of the small hydrophobic and hemagglutinin-neuraminidase genes of mumps virus(MuV)isolated in Yunnan province,China from 2007 to 2009.Methods Fourteen MuV strains were isolated in Yunnan,China from 2007 to 2009.Using RT-PCR,the SH gene fragments contained 316 nucleotides in all strains and HN gene of six strains were sequenced.The sequences were aligned with other mumps virus sequences downloaded from GenBank using Mega 4.1 software.Results Fourteen isolated strains were closely related to other reference strains of F genotypes.In SH gene,the homology of nucleotide and amino acid among the fourteen isolated strains were 98.3%-100.0%and 96.5%-100.0%,respectively,and 92.6%%-99.4%and 87.7%-100.0% of homology when compared with that of strains isolated from other provinces in China,respectively.Wsh1 and Wsh2 strains had less homology when compared to other strains of F genotypes.The fourteen strains had homology of 84.5%-85.1%and 77.2%compared to vaccine strains on nucleotide and amino acid,respectively,and had homology of 83.4%-90.9% and 70.1%-86.0% compared to that of other genotypes.In HN gene,the homology of nucleotide and amino acid among the six isolated strains were 99.3%-99.5% and 99.1%-99.7%,respectively,and also 99.8% and 99.8% of homology respectively when compared to the SP strain in China.All the six strains had homology of 92.4%-93.2% and 95.5%-96.4% when compared to the vaecine strains on nucleotide and amino acid,respectively,and had homology of 94.7%-96.8% and 95.5%-99.1%compared to other genotypes.Conclusion Fourteen strains isolated in Yunnan from 2007 to 2009belonged to F genotype of MuV while the HN gene seemed more conservative than SH gene.     

230例儿童流行性腮腺炎临床分析

目的 分析流行性腮腺炎患者的临床表现和流行病学特征,并探讨其防治方法,为防治该病提供依据.方法 利用描述流行病学的方法对2009年3月-2012年4月收治的230例流行性腮腺炎患者的流行病学特征、临床特点及治疗转归进行分析.结果 230例患者均有发热且伴双侧或单侧腮腺肿大.56例出现头痛(占24.3％),恶心、呕吐10例(占4.3％),腹痛10例(占4.3％),睾丸肿胀2例(占0.9％).18例并发中枢神经系统感染(占7.8％),睾丸炎2例(占0.9％),胰腺炎10例(占4.3％).结论患者以5-10岁居多(占72％);发病季节以冬春季3-5月为主;230例中有并发症32例,并发症多为中枢神经系统感染(7.8％,18/230),其次为睾丸炎和胰腺炎.经积极抗病毒和对症治疗后,所有病例均治愈.结论 流行性腮腺炎患者以5-10岁发病为主,患者易并发中枢神经系统感染、睾丸炎和胰腺炎,及时有效的接种疫苗是预防该病的根本措施.     

Vaccination coverage and sociodemographic determinants of measles–mumps–rubella vaccination in three different age groups

WHO-Europe's goal is to eliminate measles and rubella by 2010 which will require a coverage rate of 95% for both MMR-vaccine doses. Belgian recommendations include a first MMR vaccine at 12 months and a second at 10-12 years of age. To survey MMR vaccination coverage, EPI two-stage random cluster samples of 1,500 toddlers (18-24 months of age), 900 primary school children (born in 1997), and 1,500 adolescents (born in 1991) living in Flanders (Belgium) were drawn. Documented MMR-vaccination was recorded and a questionnaire on sociodemographic factors was completed at home by trained interviewers in 2005. Missing data were retrieved from well-baby clinics and school health service documents. The overall response rate was 89.5%, leaving 3,490 subjects fit for analysis. MMR coverage (first dose) was 94.0% in the toddler group, 88.0% in the 7-year-olds, and 80.6% in adolescents. The 10- to 12-year dose was documented in 83.6% of the adolescents, but only 74.6% had proof of both MMR vaccines. A lower MMR coverage was noted in single or divorced parents (toddlers, adolescents), families with more than four children (toddlers, adolescents), non-Belgian parental origin (children, adolescents), lower education or unemployment of parents (toddlers, children, adolescents), low family income (children, adolescents), vaccination by the GP (toddlers, children), and education-related factors (children, adolescents). The recommended WHO coverage rate of 95% for MMR is within reach in toddlers. Documentation of vaccination is a major concern in older age groups and may explain lower coverage estimates. Children growing up in a less privileged environment deserve special attention.     

Detection of IgG-class antibodies to measles,mumps, rubella,and varicella-zoster virus using a multiplex bead immunoassay

Serologic testing for measles, mumps, rubella, and varicella (MMRV) IgG is traditionally performed by immunofluorescence assay or enzyme immunoassay (EIA). Although sensitive and specific, these methods are labor intensive, time consuming, and require separate assays for each analyte. This study evaluated the performance of the MMRV IgG AtheNA Multi-Lyte® assay using nonclinically characterized serum specimens submitted to our laboratory for routine MMRV IgG testing. Mumps (n = 492) or rubella (n = 500) IgG were initially tested by enzyme-linked fluorescent antibody (ELFA), whereas measles (n = 494) or varicella (n = 497) were analyzed by EIA. Each sample was also tested by the AtheNA Multi-Lyte assay. Discordant results were retested by the predicate method and the multiplex assay, with further discrepancies being arbitrated by a third test. Compared to EIA/ELFA for MMRV IgG, the AtheNA assay demonstrated an overall agreement of 97.4%, 98.2%, 97.6%, and 100%, respectively. Use of this multiplex assay allows for the simultaneous detection of MMRV IgG, potentially decreasing cost, sample volume requirements, aliquot errors, and hands-on testing time.     

2005 - 2016年桂林市流行性腮腺炎的流行特征和时空分析

目的 了解桂林市2005 - 2016年流行性腮腺炎的流行病学特征和聚集区分布,为该地区的腮腺炎防治提供有效的依据。方法 对所收集的报告病例进行人群、时间、地点的三间分布情况进行描述,进一步运用地理信息系统对桂林市各区县进行空间自相关分析和时空扫描分析,识别腮腺炎发病的时空聚集区。结果 2005 - 2016年,桂林市共20 796例腮腺炎报告病例,平均发病率35.4/10万,男女比例为1.4∶1,以5～9岁儿童多见,占总人群的40.7%,流行高峰在春末夏初的5 - 7月,主要发生于幼托机构及学校。空间自相关结果显示,Moran's I＞0、P＜0.05,表明桂林市腮腺炎的发病有地区聚集性。时空扫描结果显示:一级聚集区发生在象山区、秀峰区、叠彩区、七星区和雁山区,聚集时间为2010年5月 - 2012年6月,聚集范围半径为17.6 km。结论 针对桂林市流行性腮腺炎主要发生于幼托机构和5～9岁儿童,且主要聚集在五大城区,提示今后应根据桂林市腮腺炎疫情的高危人群和热点区域制定针对性的干预措施。