2018~2021年章丘区流行性腮腺炎的流行病学特征分析

Epidemiological characterization of mumps in Zhangqiu District from 2018 to 2021

目的 了解2018~2021年章丘区流行性腮腺炎流行病学特征,比较2018~2021年流行性腮腺炎发情况,为有效防控流行性腮腺炎提供依据。方法 对章丘区2018~2021年流行性腮腺炎及疫情监测资料进行描述性分析。结果 2018~2021年济南市章丘区通过国家疫情网络系统直报流行性腮腺炎510例,年平均发病率为11.83/10万,发病率呈现上升的趋势。2018年流行性腮腺炎年平均发病率低于2019年、2020年、2021年,但差异无统计学意义(χ^(2)=0.649、0.360、1.621, P=0.420、0.549、0.203>0.05);2020年流行性腮腺炎年平均发病率低于2021年,但差异无统计学意义(χ^(2)=0.460, P=0.498>0.05)。2018~2021年中各月均有发病,发病集中在5~7月、9~11月,共324例,占63.53%。2018~2021年章丘区18个街道(镇)均有发病,城区(明水、双山)年均发病率为19.72/10万(245/1242272),农村(剩余街道或镇)为8.64/10万(265/3068589),比较差异有统计学意义(χ^(2)=91.873, P=0.000<0.01)。510例患者中男性324例,女性186例,男女比为1.74:1,男性多于女性。发病年龄最小8月龄,最大82岁,以0~10岁为主,占总病例数的85.49%;>15岁发病48例,占总病例数的9.41%。510例患者中,学生158例,占30.98%;托幼机构儿童242例,占47.45%;散居儿童81例,占15.88%;农民19例,占3.73%;其他10例,占1.96%;以学生和托幼机构儿童为主,占总病例数78.43%。510例患者中,有明确麻疹腮腺炎风疹(麻腮风)疫苗免疫史159例,占总病例数的31.18%,其中6~15岁学生98例,占19.22%(98/510),占学生发病例数的62.03%(98/158);无免疫史或免疫史不详351例,占总病例数的68.82%,主要为流动儿童和成人。510例患者中28例有合并症,占5.49%。其中,合并颌下腺肿大20例,占总病例数的3.92%;合并脑炎4例,占总病例数的0.78%,均为学生;合并睾丸炎4例,占总病例数0.78%,均为>15岁青春期少年或成人。结论 病例以学龄期儿童和托幼机构儿童为主,学校和托幼机构是预防控制腮腺炎的重点,严格入托入学查验接种证工作,消除免疫空白,提高腮腺炎疫苗两剂次接种率,同时加强对学校和托幼机构的督导力度,大力开展健康教育,是降低腮腺炎发病的主要措施。

Objective To understand the epidemiological characteristics of mumps in Zhangqiu District from^(2)018 to 2021 and compare the occurrence of mumps from 2018 to 2021,so as to provide a basis for effective prevention and control of mumps.Methods Descriptive analysis of mumps and epidemic monitoring data in Zhangqiu District from 2018 to 2021.Results From 2018 to 2021,510 cases of mumps were directly reported through the national epidemic network system in Zhangqiu District,Jinan City,with an average annual incidence rate of 11.83/100000,showing an increasing trend in incidence rates.The average annual incidence of mumps in 2018 was lower than in 2019 and 2021,but the difference was not statistically significant(χ^(2)=0.649,0.360,1.621;P=0.420,0.549,0.203>0.05).The average annual incidence of mumps in 2020 was lower than that in 2021,but the difference was not statistically significant(χ^(2)=0.460,P=0.498>0.05).The incidence of mumps occurred in all months in 2018-2021,and the incidence was concentrated in May-July and September-November,with a total of 324 cases,accounting for 63.53%.In 2018-2021,all 18 streets(towns)in Zhangqiu District had morbidity,and the average annual morbidity rate in urban areas(Mingshui and Shuangshan)was 19.72/100000(245/1242272),and in rural areas(remaining streets or towns)was 8.64/100000(265/3068589),and the difference was statistically significant(χ^(2)=91.873,P=0.000<0.01).Among 510 patients,there were 324 males and 186 females,with a male to female ratio of 1.74:1,with more males than females.The minimum age of onset was 8 months old and the maximum age was 82 years old,with 0-10 years old accounting for 85.49%of the total number of cases,and 48 cases>15 years old,accounting for 9.41%of the total number of cases.Among the 510 cases,158 cases were students,accounting for 30.98%,;242 cases were children in nursery institutions,accounting for 47.45%;81 cases were scattered children,accounting for 15.88%,;19 cases were farmers,accounting for 3.73%;and 10 cases were others,accounting for 1.96%;students and children in nursery institutions predominated,accounting for 78.43%of the total number of cases.Among the 510 patients,there were 159 cases with a clear history of immunization against measles-mumps-rubella vaccine,accounting for 31.18%of the total number of cases,of which 98 cases(19.22%)were students aged 6-15 years(98/510)and accounted for 62.03%of the cases of student morbidity(98/158).There were 351 cases with no or unknown immunization history,accounting for 68.82%of the total number of cases,mainly migrant children and adults.Among the 510 patients,28 cases had comorbidities,accounting for 5.49%.Among them,there were 20 cases of submandibular gland enlargement,accounting for 3.92%of the total number of cases;4 cases of encephalitis,accounting for 0.78%of the total number of cases,all of them were students;and 4 cases of orchitis,accounting for 0.78%of the total number of cases,all of them were adolescents>15 years of age or adults.Conclusion The cases are mainly school-age children and children in nursery institutions,and schools and nursery institutions are the focus of prevention and control of mumps.The main measures to reduce the incidence of mumps are to strictly check the vaccination certificate for school enrollment,eliminate immunization gaps,improve the rate of two-dose mumps vaccination,strengthen the supervision of schools and nursery institutions,and vigorously carry out health education.