2005~2019年莱州市猩红热流行病学特征及聚集性分析

Analysis on epidemiological characteristics and clustering of scarlet fever, Laizhou city,2005-2019

目的了解莱州市猩红热疫情流行病学特征和空间聚集性,为制定有效的防控措施提供数据保障和科学依据。方法对莱州市2005~2019年猩红热病例的流行特征和聚集性特征进行描述性统计分析,对采集的菌株进行耐药性检测。结果莱州市2005~2019年累计报告猩红热1 087例,年平均发病率为8.14/10万,2010年发病最低为1.68/10万,每隔3~5年出现1次发病高峰,整体呈波动式上升趋势,2019年发病最高达30.18/10万,2019年发病与其他3个发病高峰有统计学差异(P<0.01);疫情呈明显季节分布,11月至次年1月有发病高峰,4~7月有小高峰;3~10岁是猩红热高发年龄,幼托儿童和低年级小学生是猩红热高发人群,占总发病数的94.57%(1 028/1 087);猩红热发病有明显的地区聚集性,文昌路街道等6个镇街为猩红热的高发镇街;猩红热聚集性疫情发生有明显季节和地区聚集性,11月发病最高,占聚集性疫情病例的60.38%(32/53),文昌路街道是聚集性疫情的高发镇街,占全市聚集性发病的65.00%(13/20)。对2019年猩红热病例培养出的108株化脓链球菌进行耐药性检测,大多对克林霉素、四环素、红霉素耐药,对左旋氧氟沙星、万古霉素、头孢曲松、青霉素、阿莫西林敏感。结论莱州市猩红热疫情流行强度总体呈波浪式上升趋势,疫情高低与人口密度大小、适龄儿童多少、学校和托幼机构密集程度以及流动人口多少等因素有关。

Objective To understand the epidemiological characteristics and spatial clustering of scarlet fever in Laizhou city, so as to provide data guarantee and scientific basis for formulating effective prevention and control measures. Methods Descriptive statistical analysis was performed on the epidemiological characteristics and clustering characteristics of scarlet fever cases in Laizhou city during 2005-2019,and the collected strains were tested for drug resistance. Results A total of 1 087 cases of scarlet fever were reported in Laizhou city from 2005 to 2019,with the annual average incidence of 8.14/105.The lowest incidence was 1.68/105 in 2010,and the peak of incidence occurred once every 3-5 years, with a fluctuating upward trend as a whole.The highest incidence was 30.18/105 in 2019,and the incidence in 2019 was statistically different from the other 3 peaks(P< 0.01).The epidemic situation showed obvious seasonal distribution.There was a peak of incidence from November to January of the following year, and a small peak from April to July.The age group with high incidence of scarlet fever was from 3 to 10 years old, while preschool children and primary school students in lower grades were the group with high incidence of scarlet fever, accounting for 94.57%(1 028/1 087) of the total cases.The incidence of scarlet fever showed obvious regional agglomeration, 6 subdistricts such as Wenchang road were the ones with high incidence of scarlet fever.The epidemic situation of scarlet fever had obvious seasonal and regional clustering.The highest incidence was in November, accounting for 60.38%(32/53) of the cases of clustering epidemic.Wenchang road street was the street with high incidence of clustering epidemic, accounting for 65.00%(13/20) of the clustering epidemic in the whole city.In 2019,108 strains of Streptococcus pyogenes cultured from scarlet fever cases were tested for drug resistance, most of which were resistant to clindamycin, tetracycline and erythromycin, and sensitive to levofloxacin, vancomycin, ceftriaxone, penicillin and amoxicillin. Conclusion The epidemic intensity of scarlet fever in Laizhou City shows an overall wave-like rising trend.The level of the epidemic is related to such factors as the population density, the number of school-age children, the density of schools and kindergartens, and the number of floating population.