山东省2004年甲型病毒性肝炎发病和监测分析

Analysis on Incidence and Surveillance of Viral Hepatitis A of Shandong Province,China in 2004

目的了解山东省2004年甲型病毒性肝炎（甲肝）发病情况和流行因素，为制订防制措施提供依据。方法对法定传染病报告系统报告的甲肝病例进行描述流行病学分析，通过个案调查对监测系统报告的甲肝病例进行爆发分析和流行因素分析。结果山东省2004年甲肝发病季节性不明显，各市均有病例报告，30～55岁病例为主，2起爆发病例均为〈15岁儿童。爆发病例和散发病例甲肝疫苗接种率分别为13．64％和14．04％。甲肝病例诊断至报告为0～281d，3．61％的病例在诊断1个月后报告。结论山东省2004年甲肝流行病学特征类似低流行地区，学校和托幼机构是控制甲肝爆发的重点；加强甲肝疫苗接种，提高甲肝监测工作质量是目前防制甲肝的主要措施。

Objective To analyze the incidence and epidemic factors of viral Hepatitis A of Shandong Province in 2004 and provide evidences for the strategies of viral Hepatitis A controlling. Methods To analyze the distributions of viral Hepatitis A cases reported by the Notified Disease Reporting System and to make outbreak and epidemic factors analysis from the data of case investigation by EPI surveillance system. Results There was no obvious season peak for the incidence of viral Hepatitis A though a little more cases were reported in the spring and winter in 2004. The cases were found in each prefecture of the Province. Most cases were adults aging 30-55 years, but the age distributions for each prefecture were significantly different（ x^2 = 673.17, P 〈 0.01）. Two outbreaks were happened in the children under 15 year-old. The viral Hepatitis A vaccine coverage among outbreak cases and sporadic cases were 13.64% and 14.04% respectively.3.61% cases were reported after one month of diagnosis. Conclusion The epidemic characters of viral Hepatitis A in Shandong Province are similar to which in the low-incidence areas. Children in the schools and kindergartens are the high-risk groups for viral Hepatitis A outbreak. Viral Hepatitis A immunization, enhancing case reporting and surveillance are the main measures for the prevention and control of viral Hepatitis A in Shandong Province.