广州市海珠区76例婴儿麻疹病例分析

目的对广州市海珠区76例婴儿麻疹病例进行分析，以了解其不断增多的原因，制定防制策略。方法将国家疾病监测信息报告管理系统中上报的该区婴儿麻疹病例采集静脉血测麻疹IgM抗体，并问卷调查，然后进行分析。结果76例病例中，有55例麻疹抗体阳性，21例抗体阴性。阳性病例中，小于8月龄26例（47．3％），而≥8月龄（麻疹免初月龄）的29例病例中有麻疹疫苗（MV）接种史的占31．0％，其中本地病例接种率为63．6％，外地病例为11．1％，差异有统计学意义（χ^2=6．518，P〈0．05）。病例调查前后的诊断一致率为81．6％（χ^2=25．47，P〈0．05）；医院未抽血检验的达19例（25．0％），其误诊率达31．6％。结论抽血送检率低、误诊率较高、外地儿童增多且其MV及时接种率低、存在免疫失败、母传抗体低使未到MV初免月龄的婴儿发病增多等是导致该区婴儿麻疹病例不断增多的原因。

Analysis of 76 Infant Measles Cases in Haizhu District of Guangzhou

Objective To find out the causes of the increase of infant measles cases and make control strategies through analyzing 76 infant measles cases in Haizhu district of Guangzhou. Methods Blood samples were collected from infant measles cases reported from case-reporting for measles IgM detection. Parents were invested by questionnaire. Results 55 cases were measles IgM positive and 21 were negative. Among the positive cases, 26 cases were less than 8 months（47.3%） and 29 older than 8 months. 31.0% of 38 months infants had been vaccinated with MV. The vaccination rates of local infants ≥8 months and foreign infants ≥8 months were 63.6% and 11.1%, respectively, and their difference had statistical significance （χ^2=6.518, P〈0.05 ）. The rate of the diagnosis consistency before and after this research was 81.6%（χ^2=25.47,P〈0.05）;19 cases（25.0%） had not diagnosed for measles IgM, and 31.6% of were misdiagnosed. Conclusion Low rate of blood detection, high rate of misdiagnosis, low timely MV vaccination of the foreign infants, failure of immunization, and low maternal antibody were the causes of the increase in infant measles cases in Haizhu district of Guangzhou.