一起麻疹、风疹混合流行调查分析

The investigation and analysis of a measles and rubella mix epidemic

目的 研究出疹性疾病流行的原因 ,探讨麻疹和风疹混合流行的特征 ,提出控制麻疹和风疹流行的措施。方法 采用个案调查的方法 ,对每一例发热或出疹性病例填写个案调查表 ,采集血清 ,采用 EL ISA法检测麻疹 Ig M抗体和风疹 Ig M抗体。结果 1999年 12月 2 1日～ 2 0 0 0年 4月 8日河北省沧州青县发生的出疹性疾病为麻疹、风疹混合流行 ,发生麻疹疑似病例 96例 ,罹患率 2 .5 9/ 10万 ,其临床症状相似 ;时间绵延 10 8d;病例年龄范围 5个月～ 4 2 a;发病地理范围波及全县 15个乡。经血清学确诊的麻疹病例 32例 ,风疹病例 15例 ,麻疹和风疹比为 2 .13∶ 1。尽管采取局部麻疹疫苗应急接种 ,但流行并未立即终止。结论 麻疹疑似病例的爆发或流行应及早作出血清学诊断 ,在掌握清楚的流行病学资料的前提下 ,对流行的年龄和地区范围的目标人群作出应急接种 ,强调较高的应急接种率 。

Objective To study the epidemic cause of the Rash and Fever Illness(RFIs), to investigate the epidemic feature of measles and rubella, to suggest the measures of controlling measles and rubella. Methods To inquire each RFIs and fulfil case table, to gather serum specimen, to detect the measles IgM antibody and the rubella IgM antibody by ELISA. Results A measles and rubella mix epidemic happened in Qing county of Hebei Province from December 21, 1999 to April 8, 2000. 96 suspected measles cases(attack rate, 2.59/100,000) had similiar clinical symptom with the age from 5 months to 42 years old. The epidemic lasted 108 days involving in 15 countries. There were 32 laboratary confirmed measles cases and 15 cases for rubella. Measles to rubella was 2.13 to 1. The epidemic was not stopped after urgent MV vaccination in Qing City in the end of January. Conclusions It suggested that when there was measles similiar breaking out or epidemic, the first case should be confirmed by laboratory in time. After holding detailed epidemic data, Urgent vaccination should be carried out as quickly as possible and as high vaccine cover rate as possible to the target population so as to control the epidemic as early as possible.