2001-2003年四川省麻疹流行病学分析及控制策略探讨

Epidemiological Analysis and Control Strategies for Measles in Sichuan in 2001-2003

目的 探讨控制麻疹的策略和措施。方法 对四川省 2 0 0 1- 2 0 0 3年麻疹的发病情况、麻疹暴发疫情、麻疹疫苗接种率、麻疹疫苗强化免疫等进行综合分析。结果 四川省麻疹报告发病率呈上升趋势 ,发病以小年龄组和学龄儿童为主 ,1～ 14岁占 80 %以上 ;发病地域广泛 ,以春季高发 ;暴发病例占总病例的 10 4 4% ;10 73%的报告病例无免疫史 ,5 4 2 5 %免疫史不详。 2 0 0 2年对 8～ 30月龄儿童进行麻疹疫苗强化免疫后 ,根据出生队列分析 ,除 2岁组 (该年龄组全体儿童进行强化免疫 )发病率下降了 31 4 9%外 ,其余各年龄组发病率均较 2 0 0 2年有所上升。未开展麻疹强化免疫的各年龄组发病率上升幅度大于开展部分儿童强化免疫的 1岁和 3岁组发病率。结论 在麻疹常规接种率较低情况下 ,要在短时间内提高易感人群免疫力 ,应尽快对 14岁以下儿童进行麻疹强化免疫 ,以减少暴发 ,降低发病率。

Objective To further discussion on strategies and measures of measles control Method We analyzed the measles incidence,outbreak, coverage rate and supplementary immunization from 2001 to 2003 in Sichuan Results It showed the measles incidence has been increasing currently High proportion of measles cases were among young children and school age children, more than 80% cases were children under 14 year old The cases distributed widely and most cases happened in spring Outbreak cases accounted for 10 44% of the total number of measles cases 10 73% of the cases were not immunized and 54 25% without vaccination records After fulfilled the supplementary immunization for children age from 8 to 30 months in 2002,according to birth cohort analysis, the aged incidence rate of the rest age group increased comparison with that of in 2002, except for 2 year old age group (all children in this age group immunized) whose incidence rate decreased 31 49% The incidence rate is bigger increased in age group without supplementary immunization than that of age group with supplementary immunization Conclusion In the situation of low measles vaccine (MV) coverage rate (63 72%),in order to improve the immunity of susceptible people in a short time, it is necessary to carry out MV supplementary immunization for children age less than 14 year old so as to decrease measles incidence and outbreak in Sichuan