中国2011～2013年麻疹监测信息报告管理系统监测病例分类情况分析  

The Classification of Measles Cases Reported from Measles Surveillance Information Reporting Management System in China,2011-2013

作　　者：苏琪茹[1] 马超[1] 郝利新[1] 温宁[1] 樊春祥[1] 王华庆[1] 罗会明[1] 李黎[1] 

机构地区：[1]中国疾病预防控制中心免疫规划中心,北京100050

出　　处：《中国疫苗和免疫》2014年第3期200-204,215,共6页Chinese Journal of Vaccines and Immunization

摘　　要：目的分析中国2011～2013年麻疹监测信息报告管理系统（未包括香港、澳门特别行政区和台湾地区，下同）监测病例的分类情况，为加强麻疹监测提供参考。方法采用描述流行病学方法，分析监测病例分类与初次报告病种、实验室检测结果的相互关系，血标本采集和检测情况等。结果监测病例分类为麻疹的病例中，〉97％来自初次报告为麻疹的病例，〈2％来源为初次报告为风疹的病例。初次报告为麻疹的病例，或最终分类为麻疹的病例，〉90％有麻疹的实验室检测结果。初次报告为风疹的病例，或最终分类为风疹的病例，约20％有麻疹、风疹实验室检测结果，且各省（自治区、直辖市）间差异较大。排除了麻疹和风疹，且分类为其他法定报告传染病的监测病例，有麻疹检测结果的比例明显低于分类为无明确病名的病例。分类为麻疹的病例中，有流行病学联系的病例所占比例较低。初次报告为麻疹的病例，约50％的首份血标本于出疹后3d内采集，存在6％～16％的假阴性，仅10％～13％采集了第二份血标本。结论初次报告为风疹的监测病例的实验室检测工作有待加强。对麻疹病例应开展传播链调查，明确有流行病学联系的病例。分类为其他法定传染病的监测病例，应进行麻疹和风疹实验室检测，有依据地排除麻疹和风疹。血标本于出疹3d内采集时实验室检测存在一定的假阴性，建议及早采集监测病例的血标本和病原学标本，将核酸检测结果作为病例分类的依据。Objective To analyze the classification of measles cases reported from the measles surveillance information reporting management system in China during 2011 - 2013. Methods Description statistics were used to determine the final classification of reported measles cases and the relationship with the initially reported disease, laboratory testing results, and blood sample collection. Results For the reported measles cases, 〉97% were initially reported as measles, while 〈2% were initially reported as rubella. For cases reported as measles initially or cases classified as measles finally ,90% were lab confirmed. For eases reported as rubella initially or cases classfied as rubella finally, approximately 20% had lab tests results, and the percentage varied considerably across provinces. For cases classified as ＂other notifiable diseases,＂ the proportion with measles lab testing results was much lower than cases classified as no specific disease name. In eases classified as measles, the proportion of cases with epidemiological linkage was low. In eases reported as measles initially, around 50% blood samples collected within 3 days after rash onset, and their false negative rate was 6% - 16%. In only 10% - 13% of these eases were second blood samples obtained. Conclusions Lab testing should be conducted in eases initially reported as rubella. Cases classified as ＂other notifiable diseases＂ should have measles and rubella lab testing to support their final classification. Epidemiological investigations and transmission chain tracing should be carried out for measles cases. False negative lab tests may happen among eases whose blood samples collected for lab testing are obtained less than 3 days after rash onset. In cases in which earlier blood and etiological samples are collected, polymerase chain reaction can be used for diagnosis and classification.

关 键 词：麻疹监测信息报告管理系统 病例分类 麻疹 风疹 监测 

分 类 号：R511.1[医药卫生—内科学]