1991-2018年济南市流行性脑脊髓膜炎流行特征及菌群变迁趋势分析

目的 分析济南市1991-2018年流行性脑脊髓膜炎（简称流脑）流行特征及菌群变迁趋势。方法 收集济南市1991-2018年疫情资料、2007-2016年急性脑炎脑膜炎症候群（AMES）监测数据和2008-2018年健康人群带菌状况调查资料进行流行病学分析。结果 1991-2018年济南市共报告流脑病例122例,年均发病率为0.07/10万;发病季节高峰期在1-5月（占80.32%）;发病以15岁以下儿童为主（占63.11%）,15岁以上病例构成逐年增加;职业构成主要为学生、散居儿童和农民。2007-2016年AMES监测系统检出脑膜炎奈瑟菌阳性共33例,占报告病例的1.17%,其中B群20例,C群10例,W群1例,不可分群（NG）2例。2008-2018年健康人群流脑带菌状况调查,共检出34株流脑菌株,A群流脑菌株6株,B群5例株,C群8株,X群2株,Y群1株,W135群5株,NG7株,平均阳性率为0.89%。结论 济南市流脑疫情维持在较低水平,流脑优势菌群已发生变迁,现阶段控制以B群为主的发病流行,成为流脑防控工作的重点。

Epidemiological characteristics of meningococcal meningitis and changing trend of serogroups of Neisseria meningitidis in Jinan, 1991-2018

To analyze the epidemiological characteristics of meningococcal meningitis(MM),the distribution of theserogroups of Neisseria meningitidis(Nm)and their switching trend in Jinan during 1991－2018.Methods The data fromthe epidemic datum in Jinan during 1991－2018,the surveillance of acute meningitis and encephalitis syndrome(AMES)from2007 to 2016,and the Nm carriage status in local healthy population during 2008 to 2018 were collected for descriptiveepidemiological analysis.Ｒesults The reported number of MM cases were 122 from 1991 to 2018,and the average annualincidence was 0.07 per 100,000 population.Incidences peaked from January to May(80.32%of cases).Most cases werechildren under 15 years old(63.11%),and the over－15－year－olds cases were increasing annually.The occupationalcomposition was mainly for students,diaspora children and peasants.33 were positive for Nm among AMES cases during 2007－2016 and the number of Group B,Group C,Group W and NG were 20,10,1 and 2 respectively.Among the strains of Nmfrom healthy people during 2008－2018,34 were positive and the number of Group A,Group B,Group C,Group X,GroupY,Group W135,and NG were 6,5,8,2,1,5 and 7 respectively.The carriage rate of Nm among healthy people was 0.89%.Conclusion The incidence of MM dropped to a very low level in Jinan.The predominant epidemic serogroup of Nm hasswitched.At the present,controlling the epidemic of group B has become the focus of prevention and control work of MM.