2010—2019年茂名市流行性乙型脑炎实验室监测病例特征分析

Characteristics of Japanese encephalitis cases monitored by laboratories in Maoming city, 2010-2019

目的收集茂名市流行性乙型脑炎(简称乙脑)实验室病例监测结果,分析近十年乙脑的流行病学和临床特征,为乙脑的防控提供科学依据。方法用ELISA对2010—2019年茂名市乙脑监测病例进行IgM抗体检测,使用描述性流行病学对确诊病例资料进行回顾性分析。结果2010—2019年茂名市共报告乙脑监测病例423例,其中实验室确诊病例69例,死亡4例。年平均发病率0.11/10万,病死率5.80%。男女比例为1.76∶1;流行时间以5—6月份为主;地区分布呈高发区域环形分布特点;发病人群以散居儿童和学生为主,病例集中在2~12岁年龄儿童,无成人病例。病例人群以无免疫史和免疫史不详为主,占89.86%。病例临床分型以中重型为主,临床症状明显。结论茂名市近十年乙脑的流行呈明显下降趋势,病例发病具有明显的季节性、人群特异性和周边县区多发的地域特点,发病以低龄免疫空白的散居儿童为主。需加强乙脑疫苗适龄儿童的查漏补种和防蚊灭蚊的控制措施,并持续开展乙脑病例和媒介的监测,以防止乙脑的流行暴发。

Objective To collect the laboratory surveillance results of Japanese encephalitis(JE) cases in Maoming city, to analyze the epidemiological and clinical features of JE in recent ten years, and to provide a scientific basis for JE prevention and control. Methods Enzyme linked immunosorbent assay was used to detect the JE IgM antibody in monitored cases of JE in Maoming city from 2010 to 2019, and descriptive epidemiological methods were employed to retrospectively analyze the data of confirmed cases. Results A total of 423 monitored cases of JE were reported in Maoming city from 2010 to 2019, including 69 laboratory-confirmed cases and 4 deaths. The average annual incidence rate was 0.11/100,000, and the case fatality rate was 5.80%. The ratio of male to female was 1.76∶1. The epidemic period was mainly between May and June. The regional distribution was in a circular pattern with high incidence. The majority of the patients were scattered children and students. Most of the cases were children aged 2-12 years, and no adult cases were found. The majority of the patients had no immunization history or an unknown immunization history, accounting for 89.86%. The clinical types of the cases were mainly moderate and severe types with obvious clinical symptoms. Conclusions The epidemics of JE in Maoming city have been obviously decreasing in the past ten years, and the JE cases show apparent seasonality, population specificity and regional characteristics of surrounding counties or districts with high incidence. Most of the patients are young scattered children without an immunization history. It is necessary to strengthen the control measures for JE vaccine leakage and catch-up and mosquito eradication among the age-appropriate children and continuously conduct surveillance of JE cases and vectors so as to prevent the outbreak of JE epidemic.