不同风疹疫苗接种策略对广东省风疹流行的影响

Impact of different rubella immunization strategies on incidence of rubella in Guangdong province

目的了解不同风疹疫苗接种策略对广东省风疹流行的影响。方法采用描述流行病学方法对广东省1997-2010年风疹流行情况进行分析。结果广东省自20世纪90年代开始推广风疹疫苗接种,通过2000年15岁以下儿童的风疹疫苗普种、2001年风疹疫苗接种纳入计划免疫管理和2008年9月实施扩大免疫规划,风疹年平均报告发病率由1997-2000年的3.20/10万降至2001-2008年的0.78/10万和2009-2010年的1.11/10万;0～19岁青少年儿童发病比例减少,20～39岁年龄组人群发病比例增加,其中育龄妇女病例比例增加明显,分别为20.48%、33.82%和49.38%。2010年20～39岁本地户籍育龄妇女风疹IgG抗体阳性率为81.30%。结论通过实施不同风疹疫苗接种策略,广东省风疹发病率下降,儿童青少年发病比例减少,发病年龄后移,育龄妇女感染风疹的风险加大,发生先天性风疹综合征的危险增加。

Objective To study the impact of different rubella .immunization strategies on the incidence of rubella in Guangdong province. Methods Descriptive epidemiological analysis was conducted on the incidence data of rubella in Guangdong from 1997 to 2010. Results Rubella vaccine was used in immunization in 1990s in Guangdong. The average annual incidence of rubella declined from 3.20/lakh during 1997-2000 to 0.78/lakh during 2001 -2009 and 1.11/lakh during 2009-2010 after the universal rubella immunization in children aged 〈 15 years in 2000, inclusion of childhood rubella vaccination into routine service in 2001 and implementation of Expanded Program on Immunization in September in 2008. The case proportion declined in age group of 0 - 19 years （20.48%） but increased in age group of 20-39 years（ 33.82% ）, especially in child bearing aged woman （49. 38% ）. The IgG positive rate in local child bearing aged woman（20 - 39 years old） was 81.30% in 2010. Conclusion Since the implementation of different rubella immunization strategies, the incidence of rubella has declined in Guangdong. The case proportion declined in children and adolescents, but increased in young adults, indicating that child beating aged women are at greater risk to be affected by rubella, which would resulting in congenital rubella syndrome（CRS） in infants.