2015～2017年日照市水痘患者资料和免疫接种效果分析

Analysis on the data of varicella patients and vaccination effect,Rizhao city,2015-2017

目的了解分析日照市水痘患者流行病学、临床和实验室检测资料,为进一步控制水痘发病提供依据。方法对日照市2015~2017年水痘病例情况进行描述和分析,同时1~11岁的491例病例进行疫苗接种史回顾性调查。结果日照市2015~2017年共报告水痘病例1 066例;发病高峰均在1和12月;发病地区主要集中在东港区和莒县;男女性别比为1.34∶1,0~1(发病率67.60/10~5)和10~19岁(发病率72.70/10~5)发病率较高,以学生、农民、散居儿童和工人为主(897例)。1~11岁的病例中明确有无免疫史的465例,发病前有无免疫史的差异有统计学意义(P<0.01);有、无免疫史的病例中发热>38℃的比例分别为23.84%、40.61%,差异有统计学意义(P<0.01);有、无免疫史的病例中疱疹数≥50个的比例分别为37.21%、48.81%,差异有统计学意义(P<0.01);有无免疫史的经过实验室检测结果差异无统计学意义(P>0.05)。结论日照市2015~2017年,水痘发病率居疫苗可预防传染病之首,1剂次疫苗接种对个体产生的保护效果有限,接种第2剂次水痘疫苗可以有效解决初次免疫后抗体衰减(或消失)的问题。

Objective To understand the epidemiological, clinical and laboratory test data of varicella patients in Rizhao city during 2015-2017,so as to provide the basis for further controlling varicella. Methods The data of varicella cases from 2015 to 2017 was described and analyzed, meanwhile the retrospective survey was conducted on the vaccination history of 491 varicella cases aged 1-11 years. Results A total of 1 066 cases were reported from 2015 to 2017, peaking at January and December,concentrating in Donggang district and Ju county;the sex ratio of male to female was 1. 34 : 1, the age group of 0-1(67. 60/10^5 ) and 10-19 years old (72. 70/10^5 ) had relatively high incidence;the occupations of cases were mainly students,farmers,scattered children and workers(totally 897 cases). There were 465 cases with a clear history of immunity among the cases aged 1-11 years old,and the difference in the history of immunity before the onset was statistically significant( P<0. 01);the ratio of had a fever >38℃ in patients with and without immunologic history was 23. 84 % and 40. 61 % respectively,and the difference was statistically significant ( P<0. 01);the ratio of the number of herpes ≥50 in patients with and without immunologic history was 37. 21% and 48. 81 % respectively, with statistically significant difference( P<0. 01);however there was no statistically significant difference in the results of laboratory tests between patients with or without immunological history( P >0. 05). Conclusion The incidence of varicella has been the highest among all vaccine-preventable infectious diseases in Rizhao city during 2015-2017. 1 dose of vaccination has limited protection effect on individuals,and the second dose of varicella vaccine can effectively solve the problem of antibody attenuation (or disappearance) after primary immunization.