山东省实施儿童风疹疫苗免疫后风疹发病年龄变化趋势的分析

Analysis on the changing of age patterns among rubella patients after rubella vaccine immunization for children in Shandong province, China

目的分析山东省自1995年开始实施儿童风疹疫苗免疫后风疹发病年龄的变化趋势。方法对1999-2004年通过麻疹疫情专报系统得到的风疹疫情资料以及风疹疫苗接种情况进行分析。结果1999-2004年山东省风疹年平均报告发病率为0.59/10万,多为暴发(占总病例数的81.17%);发病主要集中在7～15岁学龄儿童(77.77%),7岁以下发病较少(占7.93%),发病年龄中位数分别为10.37岁、11.66岁、11.41岁、12.81岁、14 28岁和13.96岁,发病高峰年龄逐年后移,成人发病有所增加;学龄前儿童风疹疫苗基础免疫估算接种率约为60%,学龄儿童约为20%。结论风疹发病年龄后移,将威胁育龄期妇女,增加发生先天性风疹综合征的危险性;应在继续做好儿童风疹免疫的同时,积极开展育龄期妇女风疹抗体筛查及疫苗接种工作。

Objective To analyze the changing of age patterns among rubella patients after implementing rubella vaccine immunization to children in Shandong province since 1995. Methods Epidemiologic data on rubella through surveillance system for suspected measles from 1999 to 2004 and data on rubella vaccination were used and analyzed. Results The annual average incidence rate of rubella from 1999 to 2004 had been 0.59 per 100 thousands population while 81.17 % of cases were concentrated during the outbreaks. 77.77 % of the cases were school children between 7-15 years old and 7.93 % of the cases were under 7 years old. The agekmedian of cases were 10.37, 11.66, 11.41, 12.81, 14.28 and 13.96 years old from 1999 to 2004, respectively. The estimated coverage of rubella vaccine for pre-school children was about 60 % but only 20 % were for school children. Conclusion The peak age of cases moved from youth towards adolescence which indicated that women with child-bearing age might have been under risk of developing the congenital rubella syndrome （CRS）. It is necessary to carry out screening test of rubella antibody and vaccination to women with child-bearing age and the immunization strategy should be established to guide the control of rubella and CRS.