石家庄市2001-2010年流行性乙型脑炎流行特征分析

目的通过分析石家庄市2001-2010年发生的流行性乙型脑炎(乙脑)个案,探索其流行特征、发病强度与蚊虫间的关系,为科学防控乙脑疫情提供依据。方法 2001-2010年,采取专病被动监测、疑似脑炎/脑膜炎症状主动监测相结合的方法监测乙脑疫情,回顾分析河北省、石家庄市疾病预防控制中心实验室共同确认的ELISA检测乙脑IgM阳性病例;使用捕蚊管或电动捕蚊器捕获蚊虫等方法于5-10月对媒介蚊虫种类与密度进行监测。结果累计报告乙脑病例75例,死亡2例,年平均发病率、病死率分别为0.08/10万和0.26%。男女性别之比为1.78:1,有5～15岁和≥40岁年龄组2个发病高峰,常住居民与流动人口比为2.57:1。一年四季均有病例发生,但以8-10月为主。淡色库蚊和三带喙库蚊是石家庄市的主要传播媒介,分别占当地蚊虫种类的54.07%和32.83%,乙脑疫情与同期媒介蚊虫密度有相关性(rs=0.5506,P=0.000)。24h内诊断为乙脑的比例为28.95%。结论石家庄市乙脑疫情呈现波动性缓慢上升,流动人口病例逐年增加的趋势;加强疑似脑炎、脑膜炎患者的流行病学、病原学监测对乙脑防治有重要意义;加强疫苗接种为主的综合措施是乙脑的防控策略。

Epidemiological characteristics and prevention strategy of Japanese encephalitis from 2001 to 2010 in Shijiazhuang

Objective To provided evidence for the development of Japanese encephalitis(JE) control and prevention strategies by analysis of the epidemiological characteristics and the relationship between JE and mosquitoes.Methods During 2001-2010,JE cases were collected from the passive surveillance.At the same time,the acute encephalitis and meningitis symptom surveillance were conducted to identify JE cases from the perspective observational study during 2007-2010.Participating facilities included one children hospital,three provincial general hospitals and three rural county-level general hospitals in five county districts with random assignment.ELISA was used to detect the agent in blood and cerebrospinal fluid(CSF).The mosquito specimens were collected with labor hour method from May to October.Results There were 75 JE cases reported in Shijiazhuang.The annual average incidence rate and the fatality rate were 0.08/105 and 0.26%,respectively.Two peaks in age distribution were observed:one with children of 5-15 years,and the other with adults of 40 years and older.The inhabitant to floating population ratio was 2.57:1.The time distribution was mainly in August,September and October.Culex pipiens pallens and Cx.tritaeniorhynchus were the dominant species.Correlation was found between JE epidemic and mosquitoes density(rs=0.5506,P=0.000).The ratio of JE diagnosed was 28.95% among the first visiting patients.Conclusion JE epidemiological characteristics are changing with a gradually increasing incidence and increasing cases among floating population.It is important to enhance epidemiology and pathogen surveillance with acute encephalitis and meningitis for JE prevention and control.The preventive strategy for JE should be a comprehensive system based on vaccines immunization.