广东省2003年流行性乙型脑炎流行病学特征及控制策略的探讨

Description of Japanese B Encephalitis Epidemiological Characters in Guangdong Province in 2003 and Discussion on the Control Strategy

广东省流行性乙型脑炎 (乙脑 )经过连续 6年的低水平流行 (发病率 0 13/10万～ 0 19/10万 )后 ,2 0 0 3年发生局部地区的流行。为了解其流行病学特征 ,对当年乙脑监测资料进行了分析。结果显示 :乙脑疫情波及全省 2 1个市中的 19个市 ,乙脑发病率 0 5 0 /10万 ,病死率 7 81%。其中 4个市的病例数占全省的 6 8 4 9% ( 2 6 3/384 )。 6月为发病高峰 ,当月病例数占全年病例数的 6 5 10 %。乙脑病例中≤ 6岁占 5 7 5 5 % ,7～ 9岁占 2 9 4 3% ,≥ 10岁占13 0 2 % ,与往年相比 ,2 0 0 3年大年龄组病人比例有增高的趋势。无免疫史或免疫史不详者占乙脑病例的82 0 3%。为了控制乙脑流行 ,5～ 6月在流行地区开展乙脑灭活疫苗应急接种 ,在非流行地区开展乙脑疫苗的查漏补种 ,适龄儿童报告接种率达 96 6 8% ( 5 5 4 4 4 81/5 7346 5 9)。结果使全省乙脑流行时间缩短了 1个月。为全面落实乙脑疫苗的预防接种 ,建议把乙脑疫苗纳入儿童计划免疫。

The epidemic Japanese B Encephalitis (JE) occurred in local area of Guangdong priovine after it's low epidemic for six years (incidence:0 13～0 19/100,000) The JE surveillance data was analyzed to know about it's epidemiological characters The results indicated the epidemic spreaded 19 cities of Guangdong province,incidence and fatality rate were 0.50/100,000 and 7.81% respectively.The cases in 4 cities were 68 49% (263/384) of the total cases June is the epidemic peak period,the cases in June were 65 10% of the total cases in the whole year The proportions of cases aged 6 years and younger, 7～9 years,10 years and older were 57 55%,29 43% and 13 02% respectively,comparing with those in the former years, in 2003 the proportion of elder cases had a upward trend The proportion of those cases no or no clear immunization history was 82 03% To control the JE epidemic,in May and June, the JE vaccine high-risk response vaccination was carried out in epidemic areas, and in other areas the unimmunized children were checked and provided JE vaccines Reported coverage among legal children was 96 68%(5,544,481/5,734,659) which made the epidemic period shortened for one month To put immunoprophylaxis of JE into effect,we suggested that JE vaccine should be incorporated into EPI in Guagngdong province