浙江省1954-2004年百日咳流行病学分析

Analysis on Pertussis Epidemiology in Zhejiang Province in 1954-2004

目的探讨浙江省百日咳流行病学特征,为制定有效控制策略提供科学依据.方法采用描述流行病学分析方法.结果浙江省百日咳发病分为3个阶段:未使用疫苗时期的1954～1959年,年平均报告发病率为212.67/10万;使用疫苗初期的1960～1984年,年平均报告发病率为102.17/10万;实施计划免疫时期的1985～2004年,特别是1988年起全省推广使用吸附全细胞百白破联合疫苗(DTwP),发病明显下降,1994年以来报告发病率＜1/10万.对DTwP免疫成功率监测表明,免疫后百日咳凝集抗体达到保护水平(≥1:320)者＞90%,几何平均滴度免疫后比免疫前增长29.4～210.5倍.结论目前浙江省百日咳的年平均报告发病率＜0.5/10万.有效的DTwP疫苗和高质量的全程免疫接种率,加强疫情和人群免疫水平监测,是控制百日咳的重要策略.

Objective To discuss the epidemic situation of pertussis in Zhejiang and provide theoretic basis for controlling the pertussis. Methods Description epidemiological methods were used in the study. Results The prevalence was divided into three stages. The first stage was from 1954 to 1959. The annual average reported morbidity was 212.67/100 000, the highest was 391.87/100 000 in 1959. The second stage was initial stage of usage of vaccine from 1960 to 1984. The annual average reported morbidity was 102.17/100 000, the lowest incidence was 47.36/100 000 in 1984. From 1985 to 2004, we have integrated pertussis vaccine into EPI. Since 1988, we have recommended to use adhesive-vaccine, incidence of pertussis has decreased significantly. From 1994, incidence was controlled below 1/100 000.The lowest incidence of history was 0.13/100 000 in 2003, and many counties have no reported patients. According to results of supervision of successful vaccine immunization, more than 90% vaccinated people＇s antibody reached protective level （1：320）. GMT increased 29.4-210.5 times. Conclusion Using effective vaccines, keeping high quality full coverage, improving supervisions of pertussis epidemic situation and immunization level will be important strategies to control pertussis.