1998～2003年芜湖市麻疹监测系统运行效果评价

Evaluation of Measles Surveillance System in Wuhu City During 1998-2002

目的 评价芜湖市麻疹监测系统运行效果及麻疹控制措施 ,为进一步促进麻疹控制工作提供依据。方法 通过对麻疹监测系统上报的麻疹个案调查及血清标本麻疹、风疹特异性IgM抗体的检测 ,分析、评价麻疹监测系统运行效果。结果 芜湖市麻疹监测敏感性已达到较高水平。 1998年以来 ,麻疹平均年发病率为 1.7/ 10万 ,已降至历史较低水平。麻疹的发病高峰季节为 3～ 6月份。除 2 0 0 0年麻疹发病以成人为主外 ,其它年份发病均以 5～ 15岁发病为多。 2 0 0 2～ 2 0 0 3年不满 8月龄发病有 10例 (4 .5 % ) ,提示现行的麻疹疫苗免疫程序有一定的缺陷。 2 0 0 2～ 2 0 0 3年有 2 1%的麻疹病例有免疫接种史 ,说明有麻疹疫苗免疫失败者。 2 0 0 3年有 4起麻疹、风疹病例的混合爆发或散发。结论 现行的麻疹疫苗基础免疫有必要进行调整。加强对中小学生的麻疹控制工作对降低麻疹发病率具有重要意义。

Objective In order to evaluate the effect of measles surveillance system (MSS) in Wuhu city and the control measures. Methods By investigating the measles cases which were reported from MMS, and testing the measles﹑rubella IgM antibody, we analyzed and evaluated performance of MSS. Results The results showed that the sensitivity of MSS had been increased year by year since the start of MSS in 1998. At present, all of the surveillance indicators had been reached to a high level. The incidence of measles was below 3 per 100 thousand, annual average incidence was 1.7 per 100 thousand. It had reduced to a low level in history. The peak time of the measles cases was from March to June, which accounted for 90.5 percent of the total cases. Most of the cases were 5 to 15 years old children except those in 2000 who were mainly the adults. In 2002﹑2003 ,the proportion of children measles cases aged 5 to 15 was 82.4 percent and 69.4 percent respectively. We found the incidence of infants under 8 months old (all cases occurred at 6-7months old) even accounted for 5 percent during 2002～2003, which indicated that the current MV immunization processes might be partly deficient. And there were unsuccessful results of MV immunization concluding from the fact that 21 percent measles cases had history of MV immunization during 2002～2003. In 2003, the cases of measles changed from past single sporadic cases or outbreak to various kinds of mixture infections with fever and rash. And according to our study, there were four times of mixture infections of measles and rubella that expressed as sporadic cases or outbreak in 2003. Conclusions We should consolidate our work of collecting qualified samples and the laboratory testing of them. It is essential to adjust the current basic MV immunization processes and it is of great significance to reduce the incidence of measles by reinforcing the work of controlling measles in primary and middle schools.