广东省深圳市某中学流行性腮腺炎暴发疫情防控效果评价

Evaluation of the effectiveness of measures for mumps outbreak in a middle school in Shenzhen of Guangdong

目的评价学校流行性腮腺炎暴发疫情防控措施的效果,为制定防控策略提供依据。方法以深圳市某中学暴发疫情为例,通过调查收集病例的隔离情况和疫苗接种史,运用Reed-Frost模拟暴发疫情的传播特征以及隔离效果;收集学生疫苗接种情况分析疫苗保护效果。结果模拟隔离模型的发病数与实际发病数进行曲线拟合结果显示,两者差异无统计学意义(χ~2=0.388,P>0.05)。该起暴发疫情的再生数R为1.18(95%CI:1.11~1.24),共发生5代病例,平均代间距为16 d,模型显示采取病例隔离措施,能将累计罹患率(Total attack rate,TAR)从33.09%降为2.22%。接种1剂次、2剂次含腮腺炎疫苗相对于未种者而言,发病情况差异无统计学意义(χ~2=0.51,χ~2=1.18,P>0.05)。结论 Reed-Frost模型对本起疫情的拟合效果理想,早期采取隔离措施可有效减少疫情的蔓延扩散;在某中学流行性腮腺炎暴发疫情中,既往疫苗接种的保护效果不佳,可能与上剂次接种间隔太长有关,建议在中小学补种1剂次腮腺炎疫苗。

Objective To evaluate the effectiveness ofprevention and control of mumps,and to provide basis for prevention and control strategies. Methods Taking an outbreak in a secondary school in Shenzhen as an example,through the investigation and collection of case isolation and vaccination history,Reed-Frost was used to simulate the spread characteristics and isolation effects of the outbreak,and the vaccination status of the students was collected to analyze the effect of vaccine protection. Results The results of curve fitting between the number of incidents and the actual incidence of the simulated isolation model showed that there was no statistical difference between the two(χ^2= 0. 388,P〉0. 05）. The number of regeneration R from the outbreak was 1. 18(95% CI： 1. 11 to 1. 24）. There were 5 generations of cases,and the average generation interval was 16 days. The model showed that the isolation measure was used to collect the total attack rate,TAR from 33. 09% to 2. 22%. There was no statistically significant difference in incidence between 1 dose and 2 doses of mumps-containing vaccine compared with non-types(χ^2= 0. 51,χ^2= 1. 18,P〉0. 05）. Conclusion The Reed-Frost model has a good fit to this epidemic. Early isolation measures can effectively reduce the spread of the epidemic. In the outbreak of epidemic mumps in a middle school,the vaccination protection effect is poor,and may be related to the long interval between the last dose of inoculation. It is recommended to vaccinate one more dose of mumps vaccie in primary and secondary schools.