广州市萝岗区2005-2014年麻疹三个流行阶段疫情特征比较分析

Comparison of epidemic characteristics of measles in three stages in Luogang District,Guangzhou City,2005-2014

目的分析比较2005—2014年广州市萝岗区麻疹高发、低发、反弹三个流行阶段疫情特征，为制定麻疹防控工作策略提供科学依据。方法查阅2005—2014年传染病报告信息管理系统、麻疹监测信息报告管理系统、档案资料的麻疹个案信息，分析麻疹发病水平并比较三个阶段流行特征。结果2005—2014年广州市萝岗区麻疹累计发病269人，年平均发病率为8．26／10万。2005—2008、2009—2012、2013—2014年分别为高发期、低发期、反弹期，年平均发病率分别为15．39／10万、1．26／10万、8．02／10万；3-6月是高发期和反弹期的发病高峰，此外12月一次年1月是反弹期另一个发病高峰，低发期发病季节性不明显，但4月均有病例；发病年龄由高发期以8月-14岁免疫目标人群为主逐渐转变为反弹期以〈8月、〉14岁为主的非免疫目标人群，年龄分布差异有统计学意义（χ^2=14．583，P=0．006）；散居儿童在三个流行阶段职业分布排序中均为第l位，学生、托幼儿童在高发期为2、3位，而工人在低发和反弹期均为2位；三个流行阶段流动人口均超过50．00％，反弹期户籍人口比例升高（χ^2=11．295，P=0．004）；三个流行阶段患者性别比、免疫史、发病前7-21d医疗机构暴露史差异无统计学意义（P〉0.05）。结论2005—2014年萝岗区麻疹发病经历了高发、低发、反弹三个流行阶段，发病高峰、年龄、职业、流动人口构成在三个阶段分布有差异，应根据不同阶段麻疹的流行病学特征，采取针对性的麻疹防控措施。

Objective To analyze and compare the epidemic features of measles in the high-occurrence, low-occurrence and rebound stages in Luogang District, Guangzhou City from 2005 to 2014 so as to provide scientific evidence for formulating measles prevention and control strategies. Methods We analyzed and compared the incidence and epidemic characteristics of measles in the three stages based on measles surveillance data from Infectious Disease Information Reporting and Management System, Mea- sles Ssurveillanee Information Reporting and Management System and archival materials concerning measles case information from 2005 to 2014. Results A total of 269 measles cases were reported in Luogang District, Guangzhou City in 2005-2014, with the annual average incidence rate of 8.26/100,000. The high-occurrence stage, the low-occurrence stage and the rebound stage were found in the periods of 2005-2008, 2009-2012 and 2013-2014 respectively, and the annual average incidence rates of mea- sles in the 3 stages were 15.39/100,000, 1.26/100,000 and 8.02/100,000 respectively. In March to June each year, there was a peak for measles incidence in both high-occurrence and rebound stages. In December to next Januaiy, there was another peak in the rebound stage. No obvious measles incidence peak was found in the low-occurrence stage, but there were cases reported in April each year. The main involved age group gradually changed from the targeted population for vaccination aged 8 months to 14 years in the high-occurrence stage to the population aged 〈 8 months and 〉 14 years in the rebound stage, and there were statisti-cally significant differences in the age distribution among the 3 stages （χ^2= 14.583, P= 0.006）. As for the occupation distribution of the cases, scattered children ranked the first in all the three stages, and students and preschoolers ranked the second and the third respectively in the high-occurrence stage, while workers ranked the second in the low-occurrence and rebound stages. Of the cases reported in all the stages, more than 50% were floating population, but the proportion of permanent residents increased in the rebound stage （χ^2= 11.295, P= 0.004）. No statistically significant differences were found in the distribution of gender, vaccination history and medical institution exposure 7-21 days before measles onset among the three stages （P〈0.05）. Conclusions The epidemic of measles in Luogang District, Guangzhou City from 2005 to 2014 experiences high-occurrence, low-occurrence and rebound stages. The incidence peak each year, the distribution of age, occupation and floating population in measles epidemic are significantly different among the three stages. It is necessary to take targeted prevention and control measures based on the epidemiological characteristics of different stages of measles.