不同免疫策略下衢州市流行性腮腺炎发病特征分析

Epidemiological characteristics of mumps with different immunization strategies in mumps containing vaccine in Quzhou

目的比较含腮腺炎成分疫苗不同免疫策略下衢州市的流行性腮腺炎(简称流腮)发病特征,探讨适宜的疫苗免疫方案。方法对衢州市2004-2016年报告的流腮病例,按照含流腮成分疫苗(MuCV)自费接种期、MMR免费接种1剂期和MM强化后+MMR常规1剂期,分析流腮发病特征。结果 2004-2016年衢州市累计报告流腮9 323例,年均报告发病率为28.67/10万,其中在MuCV自费接种期、MMR免费接种1剂期和MM强化后+MMR常规1剂期,流腮年均报告发病率分别为45.24/10万、41.01/10万和12.54/10万,呈逐渐下降趋势(P<0.01)。MuCV自费接种期和MMR免费接种1剂期流腮发病有一定季节性,发病高峰均为5月和11月。随着接种率的提高,发病率明显下降。MuCV自费接种儿童和MM强化1剂儿童发病高峰分别为4岁和3岁,间隔7年后均有一个小高峰,而MM强化+MMR常规各1剂儿童和MMR免费接种1剂儿童发病高峰均在3～5岁,且发病率均明显下降。结论 MMR扩大免疫规划初期,流腮发病变化不明显。MM强化免疫后,流腮发病迅速下降。接种1剂MuCV保护效果有限,建议常规MMR免疫的基础上适时开展MuCV强化免疫。

Objective To analyze the epidemiological characteristics of mumps with different immunization strategies in mumps containing vaccine(MuCV) in Quzhou,explore appropriate vaccine immunization strategies.Methods Incidence data of mumps during 2004 and 2016 in Quzhou were divided into the period of MuCV self inoculation,the period of one-dose MMR free inoculation,the period of one-dose MM in SIA and one-dose MMR in routine immunization.Concentration and circular distribution method were used to compare the changes of mumps incidences in the three periods.Results There were a total of 9 323 cases of mumps in Quzhou during 2004 and 2016,the average annual incidence rates among the period of MuCV self inoculation,the period of one-dose MMR free inoculation and the period of one-dose MM in SIA and one-dose MMR in routine immunization were 45.24,41.01 and 12.54 per 100 000 population,respectively.It showed a trend of gradual decline(P<0.01).There were two peaks in the periods of MuCV self inoculation and one-dose MMR free inoculation,in May and November.The incidence rate decreased obviously with the increase of the coverage of MuCV,the peak age of children with self-inoculation MuCV and supplementary immunization one-doses MM were obviously 4 and 3 years old,respectively,and there was a small peak at the age of 10 years old too.But the incidence of mumps declined significantly among children of one-dose MM and one-dose MMR and routine one-dose MMR,and the small peak was between 3 and 5 years old,the incidence of the disease decreased significantly.Conclusion In the initial stage of Expanded Program on Immunization(EPI) with MMR,the incidence of mumps did not change significantly.But after SIA with one-dose MM,the incidence decreased rapidly.The protective effect of one-dose MuCV was limited,it is suggested that MuCV should be strengthened in a timely manner based on routine MMR immunization.