浙江省台州市1954-2017年百日咳流行病学特征分析

Epidemiological characteristics of pertussis from 1954 to 2017 in Taizhou,Zhejiang

目的了解1954-2017年台州市百日咳的流行病学特征,为其防控提供依据。方法从《台州地区疫情资料汇编》和中国疾病预防控制信息系统收集疫情数据,从《台州市卫生防疫站志》等收集免疫规划历史资料,对台州市百日咳报告病例的三间分布、疫苗应用情况进行描述性流行病学分析。结果1954-2017年,台州市共报告百日咳病例158 947例,年均发病率为53.66/10万;报告死亡298例,年均死亡率为0.10/10万,病死率为0.19%。台州市百日咳的流行呈现周期性(1954—1989年),去周期性(1990-1999年),周期性(2000-2017年)三个阶段,每次流行的周期3~4年。百白破疫苗的应用使得百日咳发病率不断下降,免疫规划实施后百日咳发病率比实施前下降了92.41%。2000年以来,低发病水平下的百日咳周期性流行再现,年龄分布逐渐以1岁以下为主,2011—2017年占比达84.78%。2017年报告发病率达到2000年以来最高(0.21/10万)。结论1954-2017年台州市百日咳流行强度逐渐下降,实施免疫规划后效果明显,但近10多年的流行特征变化提示百日咳再现值得警惕。

Objective To explore the epidemiological characteristics of pertussis from 1954 to 2017 in Taizhou prefecture of Zhejiang, so as to provide evidence for disease control and prevention.Methods Clinical data were collected from Historical Epidemic Surveillance Data Collection of Taizhou Prefecture and China Information System for Disease Control and Prevention, and immunization information was mainly collected from Taizhou Contagious Disease Control Records. The epidemiologic distribution and vaccine application of pertussis were analyzed by descriptive method.Results A total of 158 947 pertussis cases were reported from 1954 to 2017, with an average annual incidence of 53.66 per 100 000 population. A total of 298 cases died with the average annual mortality of 0.10 per 100 000 population and case fatality rate of 0.19%. The epidemic of pertussis in Taizhou experienced three phases in terms of periodic phase (from 1954 to 1989) , deperiodic phase (from 1990 to 1999) and periodic phase (from 2000 to 2017) again, and the epidemic period was 3-4 years. The pertussis incidence declined constantly after the application of diphtheria-tetanus-pertussis vaccine (DTP) . The incidence of pertussis decreased 92.41% after implementation of Expanded Program on Immunization. Since 2000, the periodicity had reappeared with incidence at low level, and most cases were under 1 year old with the proportion of 84.78% during 2011 to 2017. The incidence rate in 2017 (0.21 per 100 000 population) had reached the highest since 2000.Conclusions From 1954 to 2017, the prevalence of pertussis decreases gradually in Taizhou. The effect of Expanded Program on Immunization is obvious, but the epidemic changes over the last 10 years suggest that the reemergence of pertussis should be vigilant.