天津市百日咳不同聚集发病类型的传播特征研究

Type of clustering of pertussis cases in Tianjin

目的研究天津市百日咳聚集性发病的类型,揭示免疫规划时期百日咳传播的新特征。方法采用医院被动监测、社区症状主动监测相结合的方法,以描述流行病学方法对百日咳聚集发病资料进行调查分析。结果天津市百日咳聚集性发病存在4种类型,其中以家庭聚集性发病为主(85.33%,P<0.001),不同聚集发病类型交互存在。家庭聚集性发病类型中以成人-婴幼儿传播模式为主(67.19%),家庭罹患率平均为77.88%,父母亲为婴幼儿百日咳的主要传染源(78.44%)。学校聚集发病感染率高达64%。临床医生和疾控人员中也出现了聚集性发病。结论免疫规划时期百日咳的发病类型和传播模式已发生改变,应当采取针对性的监测、检测和预防措施予以控制。

Objective To understand the type of clustering of pertussis cases in Tianjin and the Transmission characteristics of pertussis in expanded immunization era. Methods Passive surveillance in hospitals and active surveillance in communities were conducted in Tianjin, and descriptive epidemiological analysis was done on the surveillance data of pertussis. Results Four types of pertussis case clustering were found in Tianjin, The major one was household clustering （85.33%）, but different clustering may co-existed. The transmission route in a household was mainly from adult to young child （67.19%） and parents were the major infection sources （78.44%）. The attack rate in households was 77.88%. The infection rate in schools was as high as 64%. Clustered pertussis cases also occurred in staff in medical institutions. Conclusion The incidence and transmission patterns of pertussis have changed in expanded immunization era. It is necessary to conduct targeted pertussis surveillance, detection and prevention.