开平市某镇学生流行性腮腺炎爆发的流行病学调查及处理措施评价

Epidemiological Investigation and Evaluation on Control Measures of Outbreak of Mumps Among Students in A Town of Kaiping City

目的了解开平市某镇学生流行性腮腺炎爆发流行的原因和评价防治措施。方法对发病学生作流行病学个案调查,并对其中30人采血样检测血常规及腮腺炎特异性IgM抗体;现场快速评估学生的腮腺炎疫苗接种情况;对发病学生进行隔离治疗;对学校课室、教师办公室、饭堂和发病学生家居等场所及其环境消毒、清洁;对其他师生进行医学观察等处理措施。结果圩镇两所学校(5月24日～6月3日)共有68名学生发病,平均罹患率5.52%,其中中心学校罹患率4.41%(36/817),莨畔学校7.71%(32/415),两者有显著性差异(χ2=5.7627,P<0.05);患者分布7个年级22个班,六年级人数最多占32.35%,26名发病学生血清检出腮腺炎特异性IgM抗体;中心和莨畔学校学生疫苗的接种率分别为43.33%和17.14%,两者具有显著性差异(χ2=5.3565,P<0.05)。结论免疫接种率低,患者就诊率低,疫情报告迟,是疫情爆发的主要原因。采用综合的防治措施有效控制疫情。

Objective To investigate the cause of an outbreak of mumps among students in a town of Kaiping, and evaluate the control measures. Methods Individual investigation of the students who got mumps within the past 25 days was conducted. The serum samples were collected for diagnosis and tested for anti-mumps IgM. The mumps vaccination status of students was also investigated. A more comprehensive measure was used to control the disease. Results There were 68 students got mumps in that peroid （May 24 to June 4）, with an incident rate of 5.52 %, among which the rates of center school and Lang-pan were 4.41% and 7.71%, respectively. The incident rate in center school was significantly lower than that in Lang-pan （χ^2=5.7627, P〈0.05 ）. The affected students were distributed in 22 classes of 7 grades. 30 serum samples were tested for anti-mumps IgM, of which 26 were positive. The rate of mumps vaccination in center school was 43.33%, which was significantly higher than that in Lang-pan （17.14%;χ^2=5.3565,P〈0.05）. There were no mumps-cases after June 4. Conclusion The rate of the regular and booster vaccination was low. Many patients did not see doctor promptly and the case was reported late could be the major cause of the outhreak of mumps. A more comprehensive control measure was effective to prevent and control the outhreak of mumps.