贵州省流行性乙型脑炎病例监测的研究

Study on cases surveillance of Japanese encephalitis in Guizhou province

目的通过对贵州省2004-2005年流行性乙型脑炎（乙脑）病例监测的研究，了解乙脑实验室确诊病例占报告病例的比例，掌握贵州省乙脑真实流行状况，为乙脑防治提供科学依据。方法根据疫情信息监测管理系统、个案调查资料、实验室结果及2个国家级监测县的病例监测进行综合分析。结果2004、2005年分别报告乙脑病例1230和1038例，15岁以下病例分别占总病例数的96．58％（1188／1230）和97．69％（1014／1038），男性与女性病例之比分别是1．58：1和1．57：1；发病主要集中在7-8月，分别占78．21％（962／1230）和79．09％（821／1038）。监测县7-8月病例占88．36％（319／361）。发病有明显季节性，且为高度散发；有免疫史的分别为6．90％（26／377）和8．86％（32／361）；实验室乙脑IgM抗体阳性率分别为74．90％（188／251）和71．74％（259／361）。监测县乙脑IgM抗体阳性率为71．88％（23／32）。乙脑病例监测：2005年比2004年下降15．61％。监测县2005年乙脑发病数比2004年下降39．47％。结论贵州省实验室确诊乙脑病例数占总报告病例数的71．88％-74．90％。应进一步加强乙脑专项监测和提高实验室诊断技术，使非乙脑报告病例得到明确诊断；继续对15岁以下儿童实施乙脑疫苗预防接种为主的综合防治措施。

Objective According to cases surveillance data of Japanese encephalitis（JE） from 2004 to 2005 in Guizhou province, understand the proportion of JE diagnosed cases to reported JE cases and master the epidemic status of JE to provide the science base for the control of JE case. Methods To analyze synthetically JE epidemic status based on epidemic situation surveillance management system, JE cases questionnaire, laboratory results and JE cases information of 2 surveillance counties. Results There were 1230 and 1038 cases in 2004 and 2005 respectively. The cases under 15 years old accounted for 96.58 % （1188/1230） and 97.69% （1014/1038） respectively. The ratio of male to female was 1.58：1 and 1.57：1, respectively. The cases peak was in the 7-8 month, accounted for 78.21% （962/1230） and 79.09% （821/1038）. The cases accounted for 88.36%（319/361） in two national surveillance counties. It was remarkable seasonal and highly dispersed for JE. The population with vaccine history was only 6.90 % （26/377） and 8.86 % （32/361）. The positive rate of JE IgM antibody was 74.90 % （188/251） and 71.74 % （259/361） respectively. And it reached 71.88 % （23/32） in surveillance counties. The JE cases reduced 15.61% in 2005 compared to that of 2004, and it decreased 39.47 % in surveillance counties. Conclusion The diagnosed JE cases accounted for 71.88 %-74.90 % in Guizhou province. It should further strengthen JE surveillance system, enhance laboratory diagnosis technique so as to diagnize effectivly JE cases, and put the emphasis on the immunization of JE vaccine to the population of under 15 years old.