2013-2017年阿坝州麻疹疑似病例检测结果分析

Detection Results of Suspected Measles Cases in Aba Prefecture From 2013 to 2017

目的分析2013-2017年阿坝州麻疹监测结果,了解麻疹流行特点和变化规律,为控制和消除麻疹提供依据和参考。方法采用酶联免疫法(ELISA)对麻疹疑似病例血清标本进行麻疹、风疹IgM抗体检测,采集咽拭子用RT-PCR进行核酸检测,对结果进行流行病学分析。结果 2013-2017年共检测疑似麻疹血清标本506份,麻疹IgM抗体阳性435份,阳性率85.97%;咽拭子标本367份,核酸阳性300份,阳性率为81.74%。确诊阳性病例主要集中在1-5月,发病以牧区县为主,8月龄~6岁和14岁以上的散居儿童、牧民、农民最多。2017年发病率最高。结论麻疹监测同时检测血清麻疹IgM抗体和麻疹病毒核酸,可以提高阳性检出率。阿坝州应提高适龄儿童麻疹疫苗及时、全程接种率,重点地区开展补充免疫活动,加强麻疹监测,做好麻疹疫情调查与处置,关注小月龄婴儿和成人易感者在麻疹病毒传播中的作用、探讨针对性的策略与措施。

Objective To analyze the results of measles surveillance in A＇ba Prefecture from 2013 to 2017. To understand the epidemic characteristics and changing laws of measles. To provide basis and reference for the control and elimination of measles. Methods Enzyme-linked immunoassay（ ELISA） was used to detect the measles and rubella Ig M in the suspected cases of measles,the pharynx swab was used to detect nucleic acid by RT-PCR,and the results were analyzed in epidemiology. Results A total of 506 samples of suspected measles serum were detected from 2013 to 2017,about 435 samples were positive for measles Ig M,and the positive rate was 85. 97%. There were 367 swab samples and 300 were nucleic acid positive,with a positive rate of 81. 74%.The positive cases were mainly concentrated from January to May,and the counties with high morbidity were mainly in pasturing area,most of the cases came from live scattered children between 8 months to 6 years old and above 14 years of age,herdsmen and farmers. The year of 2017 had the highest incidence. Conclusion The measles surveillance detected both the serum measles Ig M antibody and measles virus nucleic acid can improve the positive detection rate. The inoculation rate of measles vaccine for children should be improved,timely and completely,supplementary immunization activities should be carried out in the key areas,measles surveillance,investigation and disposal on the measles epidemic situation should be strengthened. We should pay more attention to the susceptible such as infants and susceptible adults during the spread of measles virus,and find out the targeted strategies and measures.