成都市2009-2014年消除麻疹进展分析

The Progress of Measles Elimination in Chengdu,2009-2014

目的对成都市近几年麻疹流行病学特征和防控策略进行分析。方法 2009-2014年成都市麻疹监测系统（Measles Surveillance System,MSS）运转指标,麻疹发病情况以及采取的策略与措施进行描述流行病学分析。结果 2009-2014年麻疹年平均发病率为51/10万,麻疹病例主要集中在〈8月龄儿童和≥15岁青壮年人群占68.00%;8月～15岁以下发病儿童存在适龄儿童未及时接种麻疹疫苗和免疫空白的问题。MSS各项指标中,除2009年外,2010-2014年疑似麻疹病例48 h内完整调查率、血标本采集率、血清学检测结果 7 d内报告率均〉90%,2013、2014连续两年排除麻疹病例报告发病率均〉2/10万。结论成都市MSS敏感性和特异性较高,麻疹发病降到较低水平,麻疹发病率与消除麻疹目标（低于1/10万）还有较大差距,存在薄弱人群和薄弱环节,还需要保持MSS运转的敏感性,进一步提高适龄儿童麻疹及时和全程接种率,开展流动儿童搜索和查漏补种,做好麻疹疫情调查与处置,加强医源性感染控制等策略与措施。

Objective To investigate the epidemiological features of measles and the strategies of measles elimination in Chengdu. Methods The data from the Chengdu Measles Surveillance System（ MSS） were analyzed by descriptive epidemiology analysis from 2009 to 2014,and the strategies and measures of measles elimination were also described. Results The average annual incidence of measles was 0. 51 /105 in 2009- 2014. The measles cases were concentrated in children under 8 months and above 15 years old,which was counted 68. 00%. The vaccination rates of measles- containing vaccine（ MCV） during 8 months to 15 years were low and not on schedule. Each of the following MSS indicators were above 90%during 2009- 2014： proportion of suspected measles cases investigated within 48 hours,proportion of suspected cases with adequate serum specimens,percentage of serum specimen results reported within 7days. The non- measles cases reported over 2 /105 from 2013 to 2014. Conclusion The sensitivity and specificity of MSS were acceptable,the incidence of measles was low epidemic in Chengdu. There still is a gap between the incidence of measles and the goal of measles elimination（ less than 0. 1 /105）,and the weak population and progress existed. The MSS should keep the sensitivity,promote the integrity of MCV for children,develop the floating children search and fill the MCV gap. The investigation of measles should be complete,and the nosocomial infection should be control further.