马关县苗族村寨麻疹爆发的调查

目的了解云南省马关县苗族村寨2005年10月16日~11月12日麻疹爆发的原因。方法对麻疹疫情进行流行病学调查分析,收集患者急性期鼻咽拭子和尿标本,分离麻疹病毒;采集现症病例和未发病人群血清标本,用酶联免疫吸附试验检测抗体。结果119例麻疹分布于4个村。年龄最小的8月龄,最大32岁,0~13岁占84.87%。现症病人63.16%无麻疹减毒活疫苗(MV)免疫史,31.58%免疫史不详。疫区301名儿童MV接种率88.37%,疫苗效力88.79%,麻疹感染人群中62%有接触史。患者血清标本麻疹IgM抗体阳性率59.09%,未发病人群血清标本麻疹IgG抗体阳性率61.76%。分离到麻疹病毒4株,基因型为H1。结论马关县苗族村寨发生的经血清学和病毒学检测证实的麻疹疫情,由于卫生院报告疫情滞后,部分村寨存在免疫空白,MV接种不落实导致爆发。麻疹感染者作为传染源应引起重视。

Epidemiological Analysis of a Measles Epidemic in Miao Village of Maguan County

Objective To investigate the reason of a measles outbreak in Maguan County,Wenshan Zhuangzu and Miaozu Autonomous Region,Yunnan Province,for 27 days during October 16,2005 to November 12.Methods To make epidemiologic analysis on measles outbreak,collect the serum speciment for serological detection,pick throat-swab and urinary specimen to isolated measles virus.Results Total of 119 cases were reported in this measles outbreak,the cases covered 4 administrative villages.The age of the cases was 8 months to 32 years old,age of 0-13 years accounted for 84.87%.63.16% of the current cases had not been vaccinated,while 31.58% unknown the immunization history.In epidemic villages 301 children were investigated.Among them,the vaccination rate was 88.37%,the effective of measles vaccine was 88.79%,16.61% of children were infected measles and 62.% of the cases contacted with measles patients.Measles IgM positive rate was 59.09% in current cases and IgG antibody positive rate was 61.76% in healthy group.Four measles virus strains were isolated,it belongs to gene H1 type.Conclusion This measles outbreak was confirmed by serology and virology.After receiving the measles epidemic report,the township clinic did not inform the higher level epidemic department.In some villages where the vaccination policy could not be carried out,some unvaccinated confronted infection,thus causing a typical natural measles outbreak.The inapparent infection should be attached important as infected agents.