2007～2009年阿坝州麻疹疑似病例血清IgM抗体检测分析

Analysis on detection results of serum IgM antibody in suspected measles cases in A′ ba prefecture during 2007-2009

目的了解阿坝州2007～2009年麻疹疑似病例血标本采集率和实验室确诊率,探讨阿坝州麻疹发病的流行病学特点,为进一步控制和消除麻疹提供科学依据。方法对2007～2009年收集的435份麻疹疑似病例早期血清标本,采用抗体捕捉酶联免疫吸附试验(ELISA)检测麻疹IgM抗体,结合流行病学资料进行分析。结果2007～2009年阿坝州共报告麻疹疑似病例824例,采集血标本435份,随着麻疹监测工作方案的开展和实施,标本采集逐年提高(2007年37.7%,2009年85.0%)。麻疹抗体阳性236例,实验室确诊率53.6%。全年每月均有发病,主要集中在2～7月为发病高峰。15岁以下年龄组为麻疹的高发年龄组,20～30岁年龄组有发病增多的趋势。对麻疹病例免疫接种史分析,有明确麻疹疫苗免疫史的共有41例,占总病例数的25.3%;无免疫史的114例,占总病例数的48.9%;免疫史不详81例,占总病例数的27.6%。结论提高麻疹疑似病例的血清标本采集率,及时对疑似病例进行确诊。加强室内质控,提高检测结果的准确性。进一步加强对预防接种工作的管理,尤其是对免疫空白进行强化免疫,以达到2012年基本消除麻疹的目标。在较大年龄组中开展麻疹疫苗的复种或强化免疫工作。

Objective To understand the collection rate of blood specimens and the laboratory diagnostic rate in suspected measles cases in A＇ba prefecture during 2007--2009 and to explore the epidemiological characteristics of measles morbidity in order to provide scientific basis for further controlling and eliminating measles. Methods 435 suspected measles cases were reported during 2007--2009 were detected measles IgM antibody by using antibody capture enzyme-linked immunosorbent assay （ ELISA ） and the results were analyzed by combining with the epidemi- ologieal data. Results 824 suspected measles eases were reported in At ba prefecture during 2007-- 2009 . 435 blood specimens were collected from suspected eases. Along with the development and implementation of the measles sur- veillance work program, the specimen collection was increased year by year （37.7% in 2007, 85.0 % in 2009 ）. 236 cases were measles antibody positive, the laboratory diagnosis rate was 53.6 %. There was occurrence in each month all the year,the incidence peak mainly concentrated from February to July. The under 15-year- old age groups was the measles high-risk group, the 20-30-year-old age group had the trend of increasing incidence. In the measles im- munization history analysis, 41 cases had clear history of measles vaccine immunity, accounting for 25.3 % of the to- tal cases, 114 cases had no immunization history accounting for 48.9 % of the total cases and 81 cases had unknown immunization history （27.6%）. Conclusion The serum specimen collection rate of suspected measles cases should be increased and the suspected cases should be diagnosed in time. The internal quality control should be strengthened and the accuracy of the test results should be increased. The preventive vaccination work management should be fur ther strengthened, especially conducting reinforcement immunization on the immune blank to achieve the goal of basi- cally eliminating measles until 2012. Besides, revaccination or reinforcement immunization in older age groups should be carried out.