贵州省2004年流行性乙型脑炎监测与控制策略探讨

目的通过对贵州省2004年流行性乙型脑炎(乙脑)监测及高发地区预防接种的实施,分析乙脑流行状况,并探讨控制策略。方法对疫情信息监测管理系统信息、个案调查资料、实验室结果进行分析;在4个乙脑高发地区,对≤10岁儿童接种乙脑疫苗并进行综合分析。结果2004年共报告乙脑1 230例,≤10岁病例占总病例数的86.59%(1 065/1 230)。男女性发病比例为1.58∶1;全年除1月外均有报告病例,主要集中7~9月;遵义市、毕节地区、黔东南苗族侗族自治州、黔西南布依族苗族自治州乙脑病例数占全省总病例数的65.85%(810/1 230)。有免疫史的占6.90%(26/377),无免疫史和免疫史不详的占93.10%(351/377)。实验室检测乙脑IgM抗体阳性率为74.90%(188/251),实验室诊断病例数占总病例数的15.28%。与2003年比较乙脑发病下降29.80%。结论建立并提高乙脑监测及实验室血清学诊断水平,实施乙脑疫苗预防接种为主的综合防治措施,尤其对高发地区的≤10岁儿童开展乙脑疫苗预防接种,进一步降低乙脑发病率。

Search for Surveillance and Control of Japanese Encephalitis in Guizhou Province in 2004

Objective According to the Japanese Encephalitis(JE) cases surveillance and implement of vaccine injection in 2004 in Guizhou Province,the JE epidemic status and search the control strategy were analyzed.Method Using epidemic situation surveillance administration system and JE Cases Questionnaire and laboratory assay and 4 risk areas vaccine injection under 10 years old children in Tongren and Zunyi and Bejie and Qiandonan Prefecture.To analyze the result of JE epidemic trend.Result There are total 1230 cases and 0-10 years old children case account for 86.59%(1065/1230) in 2004 in Guizhou Province.Male to female is 1.58 to 1.00.There are JE cases in whole year except the January and cases concentrate in July-September.The cases of Zunyi City area and Bijie and Qiandonan and Qianxinan Prefecture account for the 65.84%(810/1230).JE Vaccine History is only 6.90%(26/377) and no vaccine history and unknown is 93.10%(351/377).JE IgM antibody positive rate is 74.90%(188/251) and laboratory diagnosis case is 15.28% of total case.The JE case reduce the 29.80% compare with up year.The decreased remarkably area is Tongren which reduced 74.62% in 2004.Conclusion JE case concentrated mainly under 10 years old children and high peak season is from July to September in Guizhou Province.Among them,so many cases without JE Vaccine History or unknown vaccine history is the main risk areas are Zunyi city and Bijie and Qiandonan and Qianxinan Prefecture.Strengthen staff training and set up and improve JE surveillance and prefecture laboratory diagnosis level should be suggested.We need carry on the immunization campaign of JE vaccine and combine with other synthesizing measure,especially to the risk areas to implement to the 0-10 years old children to JE vaccine and reduce the morbidity in Guizhou Province.