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江苏省麻疹流行病学特征演变及消除措施分析 被引量:22

Analysis on epidemiological characteristics and measures of measles control in Jiangsu Province
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摘要 目的:分析1950年以来江苏省麻疹流行病学特征,为消除麻疹采取针对性措施提供依据。方法:采用描述流行病学对江苏省麻疹发病情况及采取的措施进行分析。结果:从自然感染,麻疹疫苗广泛应用,到计划免疫再到扩大免疫规划的50年间,江苏省麻疹整体发病率持续下降,维持在3/10万以下,但2005年发病率显著回升,至2009年年平均发病率达到了7.7/10万。同时发病年龄构成改变,〈1岁和20~39岁病例年龄平均构成比分别上升为22.69%和32.71%,〈1岁婴幼儿发病率最高。高发地区也由苏北转向苏南。冬春季流行季节性高峰改变不明显。麻疹病毒H1型基因型中的H1a基因亚型仍然是麻疹流行的绝对优势本土基因型。在2007~2010年3次8月龄至14周岁儿童的麻疹疫苗(measles vaccine,MV)强化免疫后,2010年发病率降为0.95/10万,已逼近历史最低水平。结论:江苏省控制麻疹成绩显著。MV强化免疫能迅速控制麻疹流行,减少麻疹发病,是消除麻疹的一项重要策略。根据现阶段麻疹流行特征,提高8月龄婴儿MV第1剂及时接种率、适龄儿童2剂次常规免疫接种率和成人麻疹病例周围的应急接种率,落实儿童入托入学时查验预防接种证工作,加强麻疹监测及高质量地运转麻疹实验室网络,对江苏省监测消除麻疹进程并最终接近消除麻疹目标十分必要。 Objective: To analyze the epidemiological characteristics of measles in Jiangsu Province during 1950-2010 and provide evidence for strategies and measures of measles elimination.Methods: Measles epidemiology and control measures were analyzed with descriptive epidemiology.Results: Following the EPI activities,the reported incidence of measles decreased greatly during the past 50 years in Jiangsu Province,sustaining at a lower level of 3/100 000 from 1998 to 2004.However,in 2005 through 2009,a dramatic increase in measles cases occurred,and the average annual incidence was 7.7/100 000 during this period.In addition to the increased number of cases,two changes in age and region distributions of cases occurred.During the resurgence,22.69% and 32.71% of all reported cases were in children 1 year and 20-to-39-year-old adults.The region of high incidence was transmitted from the north to south in Jiangsu.Genotype H1 is the major genotype,and H1a becomes the predominant sub-genotype of indigenous measles viruses circulated in Jiangsu.Measles vaccine(MV) supplementary immunization activities(SIAs) were implemented from 2007 to 2010 and the targeted age groups were children who were more than seven months and less than 15 years old.The incidence of measles declined rapidly and it was 0.95/100 000 in 2010.Conclusion: MV SIAs is an additional and effective support for routine immunization,and it played an important role for measles control.The timeliness and coverage of childhood vaccinations must be improved,and innovative strategies will be required to improve measles immunity among adults.A school entry requirement of two doses of MV should be strengthened in order to attain extremely high coverage.It is necessary to develop the further measles surveillance and measles virus laboratory net-works to monitor the progress and guide actions to achieve measles elimination.
作者 贾成梅 陶红 陆培善 丁晓艳 刘元宝 杨白艳 毕诚 张晋琳 汪志国 马福宝 羊海涛 JIA Cheng-mei,TAO Hong,LU Pei-shan,DING Xiao-yan,LIU Yuan-bao,YANG Bai-yan,BI Cheng,ZHANG Jing-lin,WANG Zhi-guo,MA Fu-bao,YANG Hai-tao(Jiangsu Province Center for Disease Prevention and Control,Nanjing 210009,China)
出处 《南京医科大学学报:自然科学版》 CAS CSCD 北大核心 2011年第9期1374-1378,共5页 Acta Universitatis Medicinalis Nanjing
关键词 麻疹 流行病学特征 消除 措施 measles epidemiology elimination measures
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