温州市2005—2018年流行性脑脊髓膜炎流行病学特征分析

Epidemiological characteristics of meningococcal meningitis in Wenzhou,2005-2018

目的分析温州市流行性脑脊髓膜炎流行病学特征,了解流行现状及流脑菌群变化趋势,为制定流脑防控措施提供依据。方法收集2005-2018年传染病报告信息管理系统和流脑专病监测信息报告管理系统中的温州市流脑病例资料,使用Excel 2007软件处理数据,采用IBM SPSS Statistics 23.0软件进行χ^2检验和趋势χ^2检验。结果 2005-2018年温州市累计报告流脑病例51例,年发病率为0.0437/10万。死亡8例,病死率15.69%,年死亡率为0.0069/10万,流脑发病率和死亡率存在随年份增长而降低的趋势(χ^2=62.94、17.61,P值均<0.01)。发病时间以冬春季为主,共报告41例(占80.4%),3月最多(占33.3%)。发病年龄以≤15岁儿童构成比最高,占58.8%。男女性别比为1.22:1。2005年实验室确诊率为8.3%(2/24),2006-2018年期间实验室确诊率为48.1%(13/27),差异有统计学意义(χ^2=9.70,P<0.01)。实验室确诊病例共15例,分离出菌株7株,其中B群4株(占57.1%),C群和X群分别为2株、1株。结论温州市流脑发病维持在较低水平,近年来在菌群分布上呈现B群流脑病例构成比上升,C群、X群流脑散发的趋势。

Objective To analyze the epidemiological characteristics of meningococcal meningitis in Wenzhou,understand the current status and the changes of meningococcal flora,provide evidence for prevention and control.Methods The incidence data of meningococcal meningitis in Wenzhou from 2005 to 2018 were collected from national notifiable diseases registry system and meningococcal meningitis surveillance system for a descriptive epidemiological analysis.Excel 2007 and IBM SPSS Statistics 23.0 Software were used for Chi-square and Chi-square trend test.Results From 2005 to 2018,a total of 51 cases of meningococcal meningitis were reported in Wenzhou.The average annual morbidity rate was 0.0437/100 000.There were 8 deaths,the case fatality was 15.69% and the average annual mortality rate was 0.0069/100 000.The morbidity rate and the mortality rate showed a significant decreasing trend(χ^2=62.94,17.61,P<0.001).The incidence peak of meningococcal meningitis was during winter-spring and a total of 41 cases(80.4%) were reported.The largest number of cases occurred in March(33.3%).The main age of onset was children under 15 years old(58.8%).The sex ratio was 1.22:1.The laboratory diagnosis rate was 8.3%(2/24) in 2005 and 48.1%(13/27)between 2006 and 2018.There was a statistical difference(χ^2=9.70,P<0.01).Among the 15 Laboratory confirmed cases,a total of 7 N.meningitidis strains were isolated,the number of serogroup B was 4(57.1%),C and X strains were 2 and 1 respectively.The other 8 were Ungrouped.Conclusion The prevalence of meningococcal meningitis in Wenzhou is at a low level.In recent years,the proportion of serogroup B meningococcal meningitis cases has increased,and the meningococcal meningitis of serogroup C and X exist sporadically.