2022年山东省1岁内百日咳病例监测结果分析

Analysis on surveillance results of pertussis cases within 1 year of age in Shandong province in 2022

目的分析2022年山东省1岁内百日咳病例流行病学特征、临床特征和疫苗接种情况,为制定百日咳防控策略提供参考。方法对2022年通过中国疾病预防控制信息系统上报的山东省1岁内百日咳病例进行个案调查,获得病例流行病学特征、诊断及报告情况;通过山东省免疫规划信息系统获得病例含百日咳成分疫苗接种史。对病例以上特征进行描述性分析。结果2022年山东省共报告1岁内百日咳病例1136例,占全省报告病例总数的21.58%;其中2月龄及以下病例占1岁内病例的29.58%(336/1136)。2-4月和7-9月报告病例最多,分别为323和346例,占全年报告总数的58.89%。聊城市(248例)、济南市(137例)、滨州市(109例)报告病例最多,占全省报告总数的43.49%(494/1136)。34.77%(395/1136)病例在发病2周及以后诊断;不同级别医疗机构发病2周后诊断(χ^(2)=14.708,P<0.05)和不同月龄婴儿病例发病2周后诊断(χ^(2)=14.237,P<0.05)所占的比例差异均有统计学意义。70.34%(799/1136)报告病例无百日咳成分疫苗接种史;已接种者中,满接种月龄当月内接种者占76.92%(260/338)。接种疫苗后发病的病例中,发病时间与第一剂次和最后一剂次百日咳成分疫苗接种间隔中位数分别为37 d和28 d。结论山东省1/5以上百日咳病例为1岁内婴儿,患儿诊断延迟较为普遍。近70%的1岁内百日咳病例无百日咳疫苗接种史。

Objective To analyze the epidemiological and clinical characteristics,and the status of pertussis vaccination of reported pertussis cases within 1 year of age in Shandong province in 2022,so as to provide a reference for strategy-making of pertussis prevention and control.Methods Pertussis cases within 1 year of age reported from China Disease Prevention and Control Information System were investigated,and information on epidemiological characteristics,case diagnosis and report were obtained.The pertussis vaccination status of reported cases was collected from Shandong Immunization Program Information System.Descriptive analysis was used for the above characteristics of the cases.Results In 2022,totally 1136 cases of pertussis within 1 year of age were reported in Shandong province,which accounted for 21.58%of reported cases of all ages.Among these infant cases,29.58%were aged 2 months and under.The largest number of cases were reported from February to April and from July to September,with 323 and 346 cases respectively,accounting for 58.89%of the annual total.The cities with the highest number of reported cases were Liaocheng(248 cases),Jinan(137 cases),and Binzhou(109 cases),accounting for 43.49%of the total reported cases.There were 34.77%of cases(395/1136)diagnosed 2 weeks or later after hospital visit.There were significant differences in the proportion of cases with delayed diagnosis in different levels of medical institutions(χ^(2)=14.708,P<0.05)and different months of age(χ^(2)=14.237,P<0.05).About 70.34%of cases had no history of pertussis vaccination.Among the cases with at least 1 dose of pertussis vaccine,the timely immunization rate,which means completing pertussis vaccine within 1 month after attaining vaccination month-age,was 76.92%(260/358).In cases that developed pertussis after vaccination,the median interval between onset and the first and last doses of pertussis-containing vaccine was 37 and 28 days,respectively.Conclusion More than 1/5 infant pertussis cases in Shandong province were less than 1 year old.Delayed diagnosis was common for them.Nearly 70%of pertussis cases within 1 year of age had no history of pertussis vaccination.