2008-2014年烟台市学校水痘流行特征分析

摘要:目的　分析烟台市学校水痘流行病学特征，为完善水痘防控策略提供依据。方法　对2008-2014年学校水痘发病进行描述流行病学分析。结果　各类学校共报告水痘病例6306例，发病率逐年下降。水痘发病与学生在校时间一致，呈春、冬季双峰，各占病例数的27.77%和31.41%。城市高于农村（χ2＝2229.75，P＜0.05），城乡比2.66:1，芝罘区（398.22/10万）、莱山区（304.33/10万）、福山区（170.64/10万）发病率较高。男女性别比1.27:1，历年性别差异无统计学意义（χ2＝3.58，P＞0.05）。各类学校发病率不同（χ2＝1187.45，P＜0.05），平均发病率最高的是小学。随着小年龄组疫苗接种，小学和幼儿园发病下降最快，降幅达82.77%、57.12%。历年发病年龄不同（F＝74.60，P＜0.05），分别为（10.23±4.992）岁、（10.38±4.927）岁、（11.08±4.643）岁、（11.14±4.885）岁、（12.49±4.919）岁、（13.52±4.772）岁、（13.63±4.675）岁，呈明显上升趋势；年龄高峰由6～7岁、9岁移至12岁。88.46%的病例未接种过水痘疫苗，79.67%的患者接种超过5年。7年发生7起水痘突发事件，5起在小学。结论　各类学校均有水痘防控压力，应加强病例监测，隔离水痘病例、严把复课关、落实疫苗接种。

Epidemiological analysis of school varicella in Yantai, 2008-2014

Abstract: Objective To explore the epidemiological characteristics of school varicella, and to make effective strategies on school varicella control. Methods we analyzed varicella incidence characteristics in various schools from 2008 to 2014. Results 6306 varicella cases were reported in schools. The incidence declined year by year. Spring and Winter were two incidence peaks, accounting for 27.77% and 31.41%, which were consistent with school time. The higher incidence was in Zhifu (398.22/100, 000), Laishan (304.33/100, 000), Fushan (170.64/100, 000). The incidence ratio of urban and rural areas was 2.66:1 (χ2=2229.75, P<0.05). The sex ratio of male and female was 1.27:1 (χ2=3.58, P<0.05). The incidence was different in various schools (χ2=1187.45, P<0.05) and the highest rate was in primary schools. Owing to vaccination, the incidence of primary schools and kindergarten fell fastest, 82.77% and 57.12%, respectively. The average age was rising in different years (F=74.60, P<0.05), 10.23±4.992 years old, 10.38±4.927 years old, 11.08±4.643 years old, 11.14±4.885 years old, 12.49±4.919 years old, 13.52±4.772 years old, 13.63±4.675 years old, respectively. The age peak was increasing obviously, from 6-7 years old, 9 years old to 12 years old. 88.46% cases had no varicella vaccination. 79.67% cases were vaccinated over 5 years. 7 public health emergencies occurred in the past seven years, including 5 in elementary schools. Conclusion There are pressures in school varicella prevention. Effective measures should be taken, such as monitoring cases, isolating cases, resuming class strictly and put the vaccination into practice.