2013—2015年绵阳市麻疹疫情分析

Analysis on epidemic situation of measles in Mianyang City from 2013-2015

目的继续稳步推进消除麻疹工作,进一步为消除麻疹提供防控策略和措施,努力实现消除麻疹目标。方法收集整理2013—2015年绵阳市所有麻疹监测病例个案信息,运用描述流行病学方法对全市麻疹疫情状况及流行病学特征进行分析。结果麻疹年平均发病率0.32/10万,无暴发疫情,无死亡病例。流行的麻疹病毒基因型为H1型。病例人群分布主要是8月龄以下、8月龄～2岁及15岁以上人群,构成比分别是20.00%、31.11%、37.78%;发病时间集中在4和5月,占全年发病数的48.89%;全市12个县市区有10个县市区有病例报告,年均发病率居前3位的是游仙区、涪城区和三台县。属于免疫规划管理的8月龄～14岁病例中有63.16%的病例有1剂次以上免疫史,36.84%的病例无免疫史。2岁以下婴幼儿病例发病前去过医院的占45.45%,医院感染可能性大。结论绵阳市麻疹消除工作受阻。全市在扎实推进常规免疫工作的同时,需要加强对重点地区和薄弱人群的免疫规划管理。加强对疫苗冷链、疫苗计划和接种技术操作方面的监管、督导和培训。将8月龄~2岁的散居儿童、流动儿童作为重点管理对象,确保麻疹类疫苗合格接种率≥95%。加强医院感染控制,防止疫情传播蔓延。

[Objective]Continue to promote the elimination of measles,provide prevention and control strategies and measures for further elimination,and achieve the goal of measles elimination.[Methods]All surveillance information of measles cases in Mianyang City from 2013 to 2015 were collected.The epidemic situation and epidemiological characteristics were analyzed by the descriptive epidemiology method.[Results]The average annual incidence rate of measles was 0.32/lakh,and there was no outbreak or death.The epidemic genotype of measles virus was H1.The measles mainly occurred in people under 8 months,8months to 2 years old and over 15 years old,which the constituent ratio was 20.00%,31.11% and 37.78%,respectively.The epidemic peak appeared April to May,accounting for 48.89% of the total cases in the whole year.The cases were reported in10 of 12 counties/cities/districts in Mianyang City,and top 3 areas with highest annual incidence rate were Xianyou District,Fucheng District,and Santai County.Among patients aged 8 months to 14 years old,who were the targeted population of EPI,63.16% had immunization history of measles vaccine at least one dose and 36.84% had a blank measles vaccine history.45.45% of child patients under 2 years old have visited hospital before onset,and there was a high possibility of infection in hospital.[Conclusion]The elimination of measles is impeded in Mianyang City.While advancing the routine immunization work,the immune planning management in key areas and high-risk population should be strengthened.It is necessary to strengthen the supervision and training in vaccine cold chain,vaccine plan and inoculation technique,focus on the scattered and migrant children aged 8 months to 2 years old,ensure the eligible immunization rate of measles vaccine higher than or equal to 95%,and strengthen the control of hospital infection to prevent the epidemic spreading.