1950-2008年成都市流脑疫情分析

Epidemiology of Meningococcal Disease in Chengdu,1950-2008

目的分析成都市1950—2008年流行性脑膜炎的流行病学特征，为探索有效控制流脑暴发及流行的预防控制策略提供流行病学依据。方法采用描述性流行病学分析方法。结果1950—2008年，全市共报告病例19119例，死亡病例1004例；1950—1982年间，平均5～7年发生1次大流行，1983年以后无明显周期性，1990年以后发病率降至0．5／10万以下。全市20个区县均有病例报告，以双流县、金堂县、金牛区、成华区等发病病例较多；各年2～4月发病例数占全年发病总例数的75．89％；年龄组发病数前3位分别为15～19，10～14，6～9岁组，分别占总发病例数的16．21％、15．02％和13．83％，农民发病最多占34．11％，其次为学生占28．04％，第3位为托幼儿童和散居儿童共占23．36％。结论1950—1982年流脑的流行具有周期性，平均5～7年发生1次大流行，1983年后，流脑呈高度散发，改变了流脑流行的周期性规律，且发病率保持在较低水平，可看出成都市流脑防治取得了显著的成效，但仍存在流行的隐患，应针对薄弱环节，以加强监测为主，掌握流行动态，辅以疫苗和综合防治可能出现的流行。

Abstract Objective To analyze the epidemiological characteristics of meningococcal disease in Chengdu from 1950 to 2008 and provide scientific evidence for the development of strategy to prevent and control the epidemic or outbreak of the disease. Methods Descriptive epidemiological analysis was conducted. Results From 1950 to 2008, a total of 19119 cases, including 1004 deaths, were reported in Chengdu. From 1950 to 1982, the epidemic occurred every other 5 - 7 years, and there was no obvious periodicity of the disease epidemic after 1983. The incidence of the disease declined to ≤0. 5/10^5 in 1990s. The cases were reported in all 20 counties （districts） of Chengdu with higher incidence in Shuanliu county, Jintang county, Jinniu district and Chenghua district. The cases occurred during February April each year accounted for 75.89% of the total cases in a year. The first three age groups with the case proportions in total cases were age groups 15 - 19 years （ 16. 21% ）, 10 - 14 years （ 15.02% ） and 6 - 9 years （ 13.83% ）. The cases in farmers accounted for the largest proportion （34. 11% ）, followed by students （28.04%）, children in care setting and scattered children （23.36%）. Conclusion The results indicated that the epidemic had its periodicity with an interval of 5 -7 years from 1950 to 1982. The disease began to occur in a highly sporadic way in Chengdu after 1983, resulting in the change of the periodicity of disease epidemic and sustained low incidence of the disease. This indicated the effective prevention and control of the disease in Chengdu, but the epidemic potential still exists, it is necessary to strengthen the surveillance and conduct comprehensive prevention activity including vaccination to prevent the disease outbreak.