上海地区2005年儿童麻疹临床流行病学特征分析

Clinical epidemiological characteristics of children with measles in Shanghai from January to June in 2005

目的对上海地区2005年1月至6月儿童麻疹流行和临床特征进行分析。方法对567例麻疹初诊病例及其中333例住院病例进行临床流行病学分析。结果567例初诊患儿中有64例为外地发病至上海就医者，在上海发病的503例患儿中：外来儿童305例，占60．6％，本市儿童198例，占39．4％；〈9月龄为301例，占59．8％，≥9月龄为202例（其中81．7％为外来儿童）。发病高峰为4～5月份。333例住院患儿中仅20例可以确定接种过麻疹疫苗，临床上仍以典型麻疹为主要表现，麻疹合并肺炎181例，占54．4％，其中129例为〈1岁婴儿，占71．3％。529例送检麻疹特异性IgM抗体，502例为阳性，占94．9％。结论本次麻疹发病数明显高于往年，发病者绝大部分未接种过麻疹疫苗，高发年龄为〈9月龄婴儿。肺炎仍是婴儿麻疹的常见并发症。

Objective To analyze the epidemiological and clinical characteristics of children with measles in Shanghai area from Jan. to Jun. in 2005. Methods Total 567 first-visit cases were investigated for epidemiological information and the clinical data of 333 hospitalized cases were collected and analyzed for clinical features. Results A total of 567 children with measles were reported from Jan. to Jun. in 2005 in Shanghai, and the prevalent seasons were from April to May. In these 567 firstvisit cases, 64 children got infection in foreign provinces while 503 children got infection in Shanghai area. Among these 503 cases, 60.6% were floating children, 39.4% were Shanghai permanent children. 301 cases （59.8%） aged from 1 to 8 months were consisted of 161 Shanghai permanent children and 140 floating children, respectively. On the other hand, 202 cases （40.2%） aged from 9 months to 15 years were consisted of 165 floating children and 37 Shanghai permanent children, respectively. Three hundreds and thirty-three of 567 cases were hospitalized. Most inpatients presented typical clinical manifestations of measles. One hurdred and eighty-one patients were complicated with pneumonia, of which 71.3% （129 cases） were infants. In 529 children detected for measles specific IgM antibody, 502 cases （94.9%） were positive. Conclusions The prevalence rate of measles during Jan. to Jun. in 2005 in Shanghai was extensively higher than before. The group with highest prevalence rate is infants younger than 9 months. The most common complication of measles in infants is pneumonia.