摘要
目的 了解浙江省2005年麻疹爆发疫情的流行因素，总结控制工作中的经验。方法 描述流行病学分析浙江省麻疹流行近况；流行病学分析麻疹的流行因素，包括人群免疫状况、感染方式、传染源管理、麻疹病毒基因型和麻疹疫苗（MV）保护效力，对免疫干预措施效果进行评价。结果 流动儿童MV接种率低于常住儿童，儿童家长文化程度低，对免疫规划缺乏了解，是限制需方主动获得免疫服务的原因。流出地未提供免疫服务，流入地卫生人力资源配置不足，是供方未及时对流动儿童提供第1针MV免疫服务的重要原因；不在学校接种MV，后期又无督促机制，严重影响MV第2针接种率。成人发生麻疹主要是由于既往未获得免疫，目前尚不能排除继发性免疫失败的可能。感染麻疹的主要因素为医院暴露、与病例接触、未接种MV。传染源管理目前存在薄弱环节。本次流行的麻疹毒株基因型仍为H1亚型，毒株虽发生了一些变异，但现用MV仍有很好保护效果。结论 提高流动儿童MV接种率需要按照全人群比例配置卫生资源，多部门联合，或专门的“流动人口管理单位”管理。按卫生部新免疫程序针对2～6岁儿童开展MV接种，浙江省可通过对入托、入学查验预防接种证确保所有儿童完成全程接种。针对≥15岁成人麻疹的控制，尚需现场证据证明其有效和可行性。减少暴露机会、控制传染源等措施需引起重视。
Objective To analyze and summarize the reasons of measles prevalence in Zhejiang Province in 2005. Methods Descriptive epidemiology was used to describe the prevalence in recent years; epidemiological analysis was used to identify the related risk factors, such as herb immunity, infection ways, case management, virus genotype,vaccine efficacy and evaluation the immunization intervention effect. Results Coverage in floating children was lower than in residents. Lower education and lack of awareness of the importance to EPI in parents of floating children were the main reasons. The main reason of failing to offer first immunization for the infants was that the place people floating out did not offer immunization and the place people floating into was short of human resources,then the children were not immunized in schools,and even did not receive the second immunization because them was no inspection. ReNted risk factors include hospital exposure, contact with illness and non-receiving vacdne. Infectious source management is still shortadge. Virus with H1 genotype is the prevalence virus,and measles vaccine still has high protection effect though virus has rome variation. Conclusions Health source should be proportionate to total population, multi-sectors are needed to cooperate or special floating management authority be established. National cooperation immunization activity focus on the children aged 2- 6 yrs are needed both in Zhejiang and other provinces, which can ensure the quality by strengthening school entry requirement. Control such as decreasing exposure opportunities control infection sources should be emphasized.
出处
《中国计划免疫》
2006年第5期342-349,共8页
Chinese Journal of Vaccines and Immunization
关键词
麻疹
爆发
流行因素
Measles
Outbreak
Epidemiology factors
