发热出疹性疾病暴发的流行病学特征及控制策略

Epidemic Feature and Control Strategy About RFIs Outbreak

目的 对发热出疹性疾病 (RFIs)暴发疫情进行流行病学特征分析 ,探讨RFIs的防治对策。方法 对绵阳市近 3年发生的 2 1起 5 79例RFIs暴发疫情进行流行病学调查 ,并采集病例的急性期血清进行麻疹、风疹IgM抗体检测。 结果 2 1起RFIs暴发疫情 ,血清学确诊为麻疹的有 15起 4 2 6例 ,确诊为风疹 2起 5 6例 ,其它RFIs 4起 96例。RFIs的发病高峰季节为春季。麻疹发病以冬、春季为主 ,风疹和其它RFIs发病全部在 2月、 5月。麻疹发病年龄以 4～ 14岁为主占 77 2 % ,风疹和其它RFIs全部是 7～ 14岁的中、小学生。确诊为麻疹的病例中有明确麻疹疫苗免疫史的占 5 2 % ;不详的占 4 3 8% ;未免疫的占 4 2 %。麻疹IgM抗体阳性检出率 5 3 3% ;风疹IgM抗体阳性检出率35 7%。结论 RFIs暴发疫情以麻疹为主 ,血清学诊断是科学鉴别RFIs病种的重要手段。调整免疫策略 ,将复种提前到 4岁 ,可降低麻疹发病率和在学龄前儿童和中、小学校的暴发和流行。

Objective To probe the ways of RFIs prevention by analysing the epidemiologic feature of RFLs outbreak Methods Totally 21 times and 579 cases in RFIs outbreak, which happed in recent 3 years in Mianyang city, were investigated, and the aucte serum of the cases were collected to detect the antibody IgM of both measles and rubella Results Among the 21 times of the RFIs, 15 times and 426 cases were serological diagnosed measles, 2 times and 56 cases were rubella and the rest 4 times, 96 cases were other RFIs Most cases occurred in spring Majority of measles occurred in winter and spring, rubella and other RFIs occurred in February and May Measles focused mainly in 4～14 years , about 77 2% of the all cases, rubella and other RFIs were 7～14 years Among the measles identified, 52% of the cases had definitely immunization history, 43 8% had unknown immunization history, and 4 2% never had any measles vaccination The positive rate of measles antibody IgM was 53 3% and rubella was 35 7% Conclusions The majority of RFIs was measles The serological diagnosis is the important way to differentiate the sorts of RFIs To adjust the immunization strategy and proceed second vaccination at 4 years, it should descend the rate of incidence of measles and decreas the outbreak and prevalence among the tre school children and students in primary and middle school