浙江省2010-2014年水痘聚集性疫情流行病学分析

Epidemiological analysis on varicella outbreaks in Zhejiang province during 2010-2014

目的对浙江省水痘聚集性疫情现状进行分析,为开展水痘防控工作提供参考依据。方法对浙江省2010-2014年通过＂突发公共卫生事件管理信息系统＂报告的水痘聚集性疫情资料进行描述流行病学分析。结果2010-2014年浙江省共报告水痘聚集性疫情52起,82.69%的水痘聚集性疫情发生在小学校,其中又以农村小学校为主。累计报告发病1 116例,总罹患率为20.26‰。时间分布上有两个高峰（11-12月和5-6月）,第一个高峰明显高于第二个。报告病例集中在6~11岁,且部分病例有水痘疫苗接种史。首发病例与接报时间间隔中位数为16.50d（7.22~22.29 d）,个案分布呈现明显的＂代际＂现象。结论小学校尤其是农村小学校是水痘聚集性疫情发生的主要场所,应在流行季节重点加强小学校及托幼机构水痘疫情的监测和防控;接种水痘疫苗虽然不能完全阻断疫情的传播,但仍是降低疫情强度和减轻病症的有效手段,今后应重点做好接种效果评估并及时调整免疫策略。

Objective To analyze the epidemiological characteristics of cases in varicella outbreaks, and to provide suggestions for prevention and control. Methods A descriptive epidemiological analysis was used on the data of public health emergencies from Emergency Public Reporting System, which caused by varicella during 2010-2014 in Zhejiang province. Results A total of 52 public health emergencies caused by varicella and 1116 cases were reported during 2010-2014. Attack rate was 20.26‰. 82.69% of varicella outbreaks occurred in primary schools, in which rural schools comprised a significant majority. November to December and May to June were the two peak-seasons and the first one was more obvious. Majority of patients were children aged 6 during 11, some of whom had received varicella vaccine. It took16.50 days to report the public health emergency from its occurrence generally（p25-P75： 7.22~22.29 days）. The temporal distribution of cases displayed an obvious periodicity. Conclusion Because primary schools, especially rural primary schools, are the places where varicella emergency usually happen, surveillance and other infection-control measures should be strengthened in peak seasons. The current immunization strategy can＇t block varicella spread in schools and kindergartens completely, but it＇s the effective measure to reduce the severity of emergency and alleviate the symptoms.Evaluating the effect of varicella vaccine and adjusting immunization strategy timely are the key work in future.