攀枝花市两起学校风疹聚集性疫情的流行病学调查分析

Epidemiological investigation and analysis on epidemics of two school rubella clusterings in Panzhihua

目的对攀枝花市两起同期发生的学校风疹聚集性疫情进行流行病学调查分析,为风疹的预防和控制提供参考依据。方法采用描述性流行病学方法对两起疫情的相关数据进行分析。结果两起疫情共报告学生病例27例,年龄13~17岁,均无疫苗接种史;风疹核酸检测阳性率高于IgM阳性率(χ^(2)=9.43,P<0.05);2017年攀枝花市健康人群风疹抗体水平在不同年龄组间差异有统计学意义(χ^(2)=41.56,P<0.05);实施风疹防控措施和应急接种疫苗后,新发病例明显减少,疫情得到有效控制。结论学校的日常防控措施流于形式,专职校医缺乏,疾病监测敏感性低,病例发现和报告不及时使风疹的自然流行未得到有效控制,形成聚集性疫情;在控制聚集性疫情时,接种疫苗依然是最高效、最便捷的防控措施;对风疹疑似患者开展核酸检测,作为风疹IgM抗体检测的补充,可进一步减少漏诊,对控制风疹疫情十分有利。

Objective To conduct epidemiological investigation and analysis on two two school rubella clustering epidemics during the same period, and to provide the reference basis for the prevention and control of rubella.Methods Descriptive epidemiological method was used to analyze related data of two epidemics.Results A total of 27 student cases completely aged between 13 and 17 years old without vaccination history were reported in two epidemics;the positive rate of rubella nucleic acid tests was higher than that of IgM tests(χ^(2)=9.43,P<0.05);the difference in the rubella antibody level of healthy populations in Panzhihua was statistically significant among different age groups(χ^(2)=41.56,P<0.05) in 2017;and the number of new cases decreased significantly after implementing rubella prevention and control measures and emergency vaccination, and the epidemics were effectively controlled.Conclusion Daily prevention and control measures of schools are mere formalistic, natural epidemics of rubella fail to be effectively controlled due to the lack of full-time school doctors, low sensitivity of disease surveillance and untimely case detection & reporting, thus forming clustering epidemics;vaccination remains to be the most efficient and convenient prevention and control measure while controlling clustering epidemics;the nucleic acid test imposed on suspected patients with rubella as a supplement to rubella IgM antibody detection is eligible to further reduce missed diagnosis, making for the control over rubella.