上海市卢湾区1956～2000年百日咳流行动态及免疫效果分析

Disease pattern and immunological surveillance of pertussis in Luwan district of Shanghai in 1956-2000

[目的 ] 了解上海市卢湾区历年百日咳的流行动态以及疫苗的免疫效果。 [方法 ] 根据历年的百日咳疫情资料、预防接种资料及免疫监测资料 ,计算百日咳的发病率、百日咳疫苗免后抗体阳性率。 [结果 ] 卢湾区 195 6～ 2 0 0 0年百日咳经历了 8次大小流行。在疫苗使用前 ,百日咳的发病率很高 ,195 8年高达 1133.0 0 / 10万 ;自 1978年实施计划免疫后 ,随着使用百白破混合制剂 (DPTw)及全程免疫接种率提高至 95 %以上 ,百日咳的发病逐年下降 ,已控制在 0 .5 0 / 10万以下。DPTw的免疫监测结果显示 ,免疫后百日咳的凝集抗体较免前增长 40倍以上 ,抗体阳转率和达保护水平率分别高达 95 %和 70 %以上。 [结论 ] 在保持高接种率的基础上 ,提高免后百日咳抗体保护水平率和GMT水平 。

To explore the disease pattern of pertussis and immune effect of pertussis vaccine in Luwan district during 1956 to 2000. All data of incidence of pertussis,vaccination and result of serological surveillance were used.The incidence of pertussis and sero-positive rate of post-vaccination of pertussis vaccine were analyzed. From 1956 to 2000,there were eight pertussis epidemics of different scales.The reported incidence reached 1133.00/100,000 in 1958.The extended program on immunization has been carried out since 1978,the incidence of pertussis decreased gradually to under 0.5/100,000 as DPTw inoculation rate exceeded 95%.Long-term surveillance of pertussis vaccine showed that level of anti-pertussal agglutitin antibody had a 40 times rise after children were immunized with DPTw,seroconversion rate and protection rate exceeded 95% and 70% respectively. [Conclusion] Increasing the protective rate and GMT of pertussis antibody is the key strategy for pertussis control and elimination, while there is a high coverage of vaccination in the population.