2013年广东省江门市麻疹发病特点及流行因素调查

Study on incidence pattern of measles and related risk factors in Jiangmen,Guangdong,2013

目的分析江门市2013年麻疹流行病学特征及流行因素,为制定消除麻疹策略提供参考依据。方法采用描述性流行病学分析江门市2013年麻疹流行病学特征;采用病例交叉研究对病例发病前7~21天和37~51天医院暴露率进行比较,分析医院暴露对麻疹发病的影响;采用病例对照研究分析患者接触史和疫苗接种因素对麻疹流行的影响。结果江门市2013年麻疹发病率为6.22/10万,发病时间高峰为7-11月。≤14岁病例占总病例数的67.97%。外来人口（χ^2=238.50,P〈0.01）、医院暴露（OR=6.64,95%CI：3.88~11.43）、麻疹患者接触史（OR=6.67,95%CI：2.75~16.96）是本次疫情流行的危险因素,接种疫苗（OR=0.07,95%CI：0.04~0.14）是保护因素。麻疹病例24 h流行病学调查率95.31%,48 h检验报告率80.00%,64.06%病例诊断时间超过7 d。48 h疫苗补种率仅13.67%,每起疫情平均补种6.79针次。结论外来人口、医院暴露、麻疹患者接触史和未进行疫苗接种是麻疹流行的主要危险因素。

Objective To understand the reasons for the high incidence of measles in Jiangmen,Guangdong province,in 2013,and provide evidence for measles prevention and control. Methods Descriptive epidemiologic analysis was conducted to describe measles case distribution in Jiangmen in 2013. Case crossover study was performed to compare the cases＇ hospital exposure rates 7-21 days and 37-51 days before the onset,and case control study was conducted to identify the related risk factors,such as hospital visiting history,contact history with measles cases and vaccination.Results The incidence rate was 6. 22 / lakh in 2013,and the cases aged ≤14 years accounted for 67. 97%（ 174 /256） of the total. The incidence peak was from July to November. Being floating population（ χ^2= 238. 50,P〈0. 01）,hospital visit（ OR = 6. 64,95% CI： 3. 88-11. 43） and measles case contact（ OR = 6. 67,95% CI： 2. 75-16. 96） were risk factors for measles incidence,while vaccination（ OR = 0. 07,95% CI： 0. 04-0. 14） was a protective factor. The case survey rate within 24 hours was 95. 31%,the detection and reporting rate within 48 hours was 80. 00%. Up to 64. 06%of the cases sought medical care after more than 7 days and the emergency vaccination rate within 48 hours was only13. 67% and the average number of vaccinated persons were 6. 79 per outbreak. Conclusion Bing floating population,hospital visit,contact with measles cases and receiving no vaccination were the risk factors for measles.