CAJ | 학술논문

目的分析上海市闵行区1998-2007年麻疹流行病学特征变化规律,探讨麻疹控制策略,为加速控制麻疹提供科学依据.方法根据上海市常规传染病报告系统和人口学资料,对1998-2007年麻疹疫情资料进行描述流行病学分析.从疑似患者的咽拭子样本分离病毒,分析其基因特性及抗原性.结果麻疹年平均发病率为17.69/10万,主要是20岁以上成人和小于8月龄幼儿;发病季节高峰在3-5月,户籍人口麻疹流行无明显周期性,非户籍人口2～3年一个流行高峰.健康人群不同年龄组抗体水平差异有统计学意义(x2=86.06,P<0.01),抗体水平在20～30岁最低.从10例疑似患者咽拭子样本中分离到4株麻疹病毒株,与麻疹疫苗株S191分属于不同的基因型,抗原性有一定的差异.结论麻疹流行特征已发生根本性改变,流行周期不明显,发病年龄呈双向移位,不典型症状增多.非户籍人口的发病特征更接近于自然感染,对全市麻疹流行病学特征产生了重要的影响.麻疹病毒株与疫苗株存在差异,因此监测地方性流行株的基因和抗原变化很有必要.现阶段应在对儿童保持高水平麻疹疫苗接种率的前提下,对特定人群开展麻疹疫苗强化免疫,采取针对性免疫策略和加强麻疹监测工作是减少麻疹发病的主要策略.
목적 분석상해시민행구1998-2007년마진류행병학특정변화규률,탐토마진공제책략,위가속공제마진제공과학의거.방법 근거상해시상규전염병보고계통화인구학자료,대1998-2007년마진역정자료진행묘술류행병학분석.종의사환자적인식자양본분리병독,분석기기인특성급항원성.결과 마진년평균발병솔위17.69/10만,주요시20세이상성인화소우8월령유인;발병계절고봉재3-5월,호적인구마진류행무명현주기성,비호적인구2～3년일개류행고봉.건강인군불동년령조항체수평차이유통계학의의(x2=86.06,P<0.01),항체수평재20～30세최저.종10례의사환자인식자양본중분리도4주마진병독주,여마진역묘주S191분속우불동적기인형,항원성유일정적차이.결론 마진류행특정이발생근본성개변,류행주기불명현,발병년령정쌍향이위,불전형증상증다.비호적인구적발병특정경접근우자연감염,대전시마진류행병학특정산생료중요적영향.마진병독주여역묘주존재차이,인차감측지방성류행주적기인화항원변화흔유필요.현계단응재대인동보지고수평마진역묘접충솔적전제하,대특정인군개전마진역묘강화면역,채취침대성면역책략화가강마진감측공작시감소마진발병적주요책략.
Objective To study the epidemiological characteristics and control strategy of measles in Minhang district of Shanghai from 1998 to 2007, and to provide scientific methods for measles controlling. Method Descriptive epidemiology study was conducted to analyse on the epidemiology of measles epidemics from the regular report system of infectious diseases and annual statistics of measles from 1998 to 2007. Collect laryngopharyngeal swabs from 10 suspect pa-tients to separate measles virus, analyze its genotype and antigen variation. Rusults The incidence rate was 17.69/105 annually. The peak age of measles was adults above 20 years age and children below 8 months. And there was a seasonal peak between March and May. There was no periodical change in native population. However, it still existed in floating population with epidemiological peak of 2 to 3 years each. Antibody monitored results showed that it was the lowest at ages between 20 and 30 in healthy population which was accorded with the peak age. There was a statistical difference between ages ( x2 = 86.06, P < 0.01 ). From 10 suspect measles patients, 4 measles strains were separated, the genotypes were different from vaccine strains. Conclusions The epidemiological characteristics of measles has been changed substantial-ly, that is, the epidemic period is disappeared, and the age of onset is changed, the symptom is non-typical. The charac-teristics of measles in floating population in Minhang is more like natural infection that it exert an important influence on the epidemiological characteristics of measles in Shanghai. Monitoring variation in genes and antigens for endemic field strains become necessary. A high level of regular immunization should be maintained, while it should be strengthened to the specific groups. Specific immune strategy and measles monitoring should be taken to decrease the incidence rate of measles.