南通市水痘暴发疫情中突破病例的流行特征及其免疫策略  

Epidemiological characteristics of breakthrough varicella cases in outbreaks and immunization strategies in Nantong City

作　　者：侯晓艳[1] 张烽[1] 王智泉[1] 廉丽华[1] 金红梅[1] 

机构地区：[1]南通市疾病预防控制中心免疫预防科,江苏南通226007

出　　处：《职业与健康》2016年第17期2417-2419,共3页Occupation and Health

摘　　要：目的分析南通市水痘暴发疫情中突破病例的发生情况及其流行病学特征,为进一步探讨水痘疫苗的免疫策略提供依据。方法收集国家突发公共卫生事件管理信息系统中南通市2011—2015年水痘暴发疫情数据和南通市免疫规划信息管理系统中的病例的免疫接种数据进行流行病学分析。结果南通市2011—2015年间共报告水痘暴发疫情32起,累及10例以下病例的1起,10~24例病例27起,25例以上病例的3起,共累及发病儿童数541例,其中189例为突破病例,占比34.94%。突破病例发病率为0.90%,人群分布主要集中在4~13岁之间,其中7~13岁儿童居多;男女性别比为1.01∶1;职业主要是托幼机构和小学生;发病时间多分布在春季入学后（3—6月份）和初冬（10—12月份）;各县（市）、区均有报告,如东县、启东市和海安县报告居多;突破病例发病与接种疫苗最短间隔65 d,最长12 a,平均发病间隔为（5.63±2.01）a,时间间隔呈单峰正态分布（偏度=0.11,P=0.54〉0.05;峰度=2.83,P=0.81〉0.05,联合检验χ~2=0.45,P=0.80〉0.05）。结论南通市暴发疫情中突破病例占比较高,提示1剂次水痘疫苗的免疫程序可能不足,其疫苗保护效果有待进一步分析评估。[Objective] To analyze the incidence rate and epidemiological characteristics of breakthrough varicella cases in outbreaks in Nantong City,provide the basis for exploring the immunization strategies of varicella vaccine.[Methods]The data of varicella outbreak in Nantong from 2011 to 2015 which collected from the National public health emergency management information system and the vaccination data from the Nantong immunization management system were analyzed.[Results]A total of 32 varicella outbreaks were reported in Nant ong from 2011- 2015, in which 1 outbreak involved less than 10 cases,27 outbreaks involved 10-24 cases 3 outbreaks involved more than 25 cases,and there were189 breakthrough varicella cases among total 541 cases, accounting for 34.94%. The incidence rate of breakthrough varicella cases was 0.90%. The breakthrough varicella cases mainly concentrated in 4-13year-old age group,and most of patients were children aged 7-13 years old,who were kindergarten and primary school students. There male-to-female ratio was 1.01 ∶1. The peak seasons appeared in spring（March to June）and early winter（October to December）. The cases were reported in every county/city/district,and mainly concentrated in Rudong County,Qidong County and Haian County. The shortest and longest time interval between the onset and vaccination was 65 days and 12 years respectively,with an average of（5.63±2.01） years. The time interval showed a single peak normal distribution（skewness =0.11,P =0.54 〉0.05,kurtosis =2.83,P =0.81 0.05,χ^2 =0.45,P =0.80 〉0.05）.[Conclusion]The proportion of breakthrough varicella cases in outbreaks is high in Nantong City,which indicates that the 1dose of varicella vaccine immunization program may be insufficient,and it is necessary to further analyze and evaluate the vaccine protection effect.

关 键 词：水痘 暴发疫情 水痘突破病例 免疫策略 水痘疫苗 

分 类 号：R181.8[医药卫生—流行病学]