北京市朝阳区2012-2017年百日咳流行病学特征分析

Epidemiological characteristics of pertussis in Chaoyang District of Beijing from 2012 to 2017

目的:分析2012—2017年北京市朝阳区百日咳流行病学特征,了解朝阳区百日咳流行现状及危险因素。方法:采用描述性流行病学方法对数据进行整理分析,采用病例对照研究分析百日咳疫苗保护效果。结果:2012—2017年北京市朝阳区共报告百日咳99例,年发病率为0.08/10万~0.72/10万,2014年开始百日咳发病出现明显上升,之后两年维持在较高水平。4~10月(75.76%,75/99)是发病高峰。乡镇发病率高于街道(χ^2=20.624,P<0.05)。病例均为散居儿童,其中3~5月龄儿童病例数最多,占40.40%(40/99)。58.59%(58/99)病例无免疫史,55.56%(55/99)适龄接种儿童病例无全程接种完基础免疫针次,病例数随着免疫针次的增加有所减少。病例对照研究显示1剂及以上百日咳成分疫苗者的发病风险是无免疫史者的0.126倍(95%CI:0.048~0.332),疫苗保护效果为87.4%(95%CI:66.8%~95.2%)。结论:北京市朝阳区百日咳发病率明显上升,以3岁以下散居儿童为主。进一步开展百日咳主动监测,探究百日咳真实发病水平及传播模式将为百日咳防控策略提供科学依据。

Objective:To analyze the epidemiological characteristics of pertussis in Chaoyang District of Beijing from 2012 to 2017,and to realize the epidemic situation and risk factors of pertussis in Chaoyang District.Methods:The data were analyzed by descriptive epidemiological methods,and the protective effect of pertussis vaccine was analyzed by case-control study.Results:A total of 99 cases of pertussis were reported in Chaoyang District of Beijing from 2012 to 2017,with an annual incidence of 0.08/100,000 to 0.72/100,000.The incidence of pertussis increased significantly since 2014 and remained at a high level in the following two years.The peak of morbidity was from April to October(75.76%,75/99).The incidence in villages and towns were higher than that in streets(χ^2=20.624,P<0.05).All the cases were all scattered children,with the largest number of cases in children aged from 3 to 5 months,accounting for 40.40%(40/99).58.59%(58/99)cases had no history of immunization,and 55.56%(55/99)children of school age did not have the full number of basic immunization injections,and the number of cases decreased with the increase of immunization injections.Case-control studies showed that the risk of developing pertussis vaccine with one dose or more was 0.126 times higher than that of those without immunization history(95%CI:0.048-0.332),and the protective effect of the vaccine was 87.4%(95%CI:66.8%-95.2%).Conclusion:The incidence of pertussis in Chaoyang District of Beijing has increased significantly,most of them were scattered children under 3 years old.Active monitoring of pertussis,exploring the real incidence and transmission mode of pertussis will provide a scientific basis for pertussis prevention and control strategies.