西安市2005-2018年麻疹流行病学特征和免疫策略分析

Epidemiological characteristics of measles and considerations for immunization strategies in Xi’an city,2005-2018

目的分析西安市麻疹流行病学特征,探讨麻疹免疫策略。方法通过麻疹病例专报系统收集西安市2005-2018年麻疹报告病例和含麻疹成分疫苗(MCV)接种数据,描述性分析麻疹发病的流行特征和MCV覆盖率。结果西安市2005-2018年共报告麻疹2497例,年均发病率为1.84/10万(2005年vs2018年:13.81/10万vs0.06/10万);3-6月份发病占65.44%;中心城区、城乡结合区、郊县年均发病率分别为3.49/10万、1.94/10万、1.08/10万;0-4岁儿童年均发病率为20.62/10万,其中0岁儿童为50.23/10万。在8月龄-6岁儿童病例中,无MCV免疫史占63.14%。2008-2018年适龄儿童第1剂和第2剂MCV常规免疫接种率均>95%;2005-2018年目标儿童MCV补充免疫接种率均>95%。结论2005-2018年西安市麻疹发病率继续呈下降趋势,但仍未达到消除麻疹目标。需努力提高儿童两剂次MCV及时接种率,做好MCV查漏补种工作。

Objective To determine epidemiological characteristics of measles in Xi’an city and explore measles immunization strategies.Methods We used the National Measles Surveillance System to obtain data on measles cases and measles-containing vaccine(MCV)vaccination status during 2005-2018 in Xi’an.We conducted descriptive analyses to determine epidemiological characteristics of measles and MCV coverage.Results A total of 2497 measles cases were reported during 2005-2018 in Xi’an,for an average annual incidence of 1.84 cases per 100000 population(2005 vs 2018:13.81 per 100000 vs 0.06 per 100000);65.44%of cases occurred between March and June.Average annual incidences in urban,urban-rural,and rural areas were 3.49,1.94,and 1.08 per 100000,respectively.Average annual incidences for children aged 0-4 years were 20.62 per 100000 and 50.23 per 100000 for infants;63.14% of children aged 8 months to 6 years reported to have measles had not received MCV.Routine immunization coverage rates for the first dose and the second dose of MCV were all>95%among age-eligible children during 2008-2018;supplemental immunization MCV coverage rates during 2005-2018 were all>95%among target children.Conclusions The incidence of measles continued to decline during 2005-2018 in Xi’an,but did not meet the goal of eliminating measles.We should improve timely vaccination with two doses of MCV for children and reduce missed opportunities to vaccinate.