辽宁省鞍山市2014年麻疹流行病学特征与监测系统运转情况分析

Analysis of Epidemiological Characteristics of Measles and Performance of Measles Surveillance System in Anshan City of Liaoning Province,2014

目的分析辽宁省鞍山市2014年麻疹流行病学特征,为制定消除麻疹策略和措施提供科学依据。方法采用描述流行病学方法对2014年鞍山市麻疹监测数据进行统计分析。结果 2014年鞍山市麻疹发病大幅度上升,报告麻疹489例,发病率为13.46/10万,比2013年上升了162倍,为8年来最高;3~6月为麻疹发病高峰期;农村和城乡结合部为麻疹发病高发地区;麻疹病例主要集中在0~1岁、30~39岁和10~14岁人群;无含麻疹成分疫苗（MCV）免疫史和免疫史不详392例,占80.16%。2014年排除病例报告发病率为18.26/10万,48小时内完整调查率为99.91%,血标本采集率为96.70%,血标本3日内送达率为99.35%,实验室检测结果 4日内报告率为98.25%。麻疹爆发疫情7起,实验室确诊率为100%,病原学标本采集率为85.71%。结论 2014年鞍山市麻疹防控形势严峻,疫情反弹明显;要实现消除麻疹,必须保证高质量的麻疹监测和疫情处置水平,同时增加农村和城乡结合部地区MCV接种频次,提高适龄儿童MCV接种率和及时率,适时开展重点人群的强化免疫。

Objective This study is to analyze the epidemiological characteristics of measles in Anshan city in 2014 ,and to provide scientific evidence for making measles elimination strategies and measures. Methods The measles surveillance data in Anshan city in 2014 were analyzed with descriptive epidemi- ological methods. Results A total of 489 cases of measles were reported in Anshan city in 2014, with an incidence rate of 13.46 per 100 000 population,which increased by 162 folds than in 2013 and was the highest since 2007. March and June were the peaks of incidence. The incidence in rural and rural-urban areas was higher than in urban areas. The measles cases mainly occurred in people aged 0-1,30-39 and 10-14 years. 392 （80. 16% ） cases had no or unknown history of measles-containing vaccine （MCV） im- munization. The reported incidence rate of discarded measles cases was 18.26 per 100 000 population, with an adequate investigation rate within 48h of 99. 91% , a blood specimen collection rate of 96.70% , a blood specimen delivery rate within 3d of 99. 35% and a timely laboratory result reporting rate within 4d of 98. 25%. 7 measles outbreaks occurred, and all were laboratory confirmed and specimen were col- lected from 85.71% outbreak cases for virus detection. Conclusion Measles prevention and control in Anshan city faced a difficult challenge ,with a reemerging epidemic of measles in 2014. In order to eliminate measles,it is necessary to maintain a high-quality level of measles surveillance and responses,to increase the frequency of routine immunization service in rural and rural-urban areas, tO increase routine immunization coverage and timely coverage of MCV among eligible children, and to conduct MCV supple- mentary immunization activity among priority population.