1951-2016年湖南省流行性脑脊髓膜炎流行病学特征及菌群变迁趋势分析  

Epidemiological features of meningococcal meningitis and trend of serogroup switching of Neisseria meningitides strains in Hunan Province,1951-2016

作　　者：戴德芳[1] 李放军[1] 夏昕[1] 张淑君[1] 杨彦华[1] 张红[1] 

机构地区：[1]湖南省疾病预防控制中心,湖南长沙410005

出　　处：《实用预防医学》2017年第12期1440-1442,共3页Practical Preventive Medicine

基　　金：湖南省卫生厅科研基金课题(No.C2013-035)

摘　　要：目的分析湖南省流行性脑脊髓膜炎(流脑)流行病学特征及脑膜炎奈瑟菌(Neisseria meningitidis)菌群分布和变迁趋势,为制定防控策略提供科学依据。方法采用描述流行病学方法,分析湖南省1951-2016年流脑流行病学特征,采用Excel 2007分析2008-2016年监测工作中获得的脑膜炎奈瑟菌株资料。结果湖南省1951-2016年流脑疫情经历了1959年、1967年和1977年3次流行高峰,自上世纪80年代A群多糖疫苗广泛使用后,发病率逐年大幅下降,未再出现暴发流行和周期性流行,实施国家扩大免疫规划后,流脑疫情得到有效控制,近十年,流脑发病率处于历史低位。2008-2013年从流脑病例及病例密切接触者中分离培养出的C群比例明显高于B群和W135群,未检出A群病例,说明C群已经取代了A群,成为湖南省的优势菌株,但是从2014年开始,C群病例呈减少趋势,B群、W135群病例构成比不断增加。结论湖南省流脑发病率维持在较低水平,流脑流行菌群构成正向多元化发展。Objective To analyze the epidemiological characteristics of meningococcal meningitis and the trend of serogroup switching of Neisseria meningitides strains in Hunan Province so as to provide a scientific basis for developing its prevention and control strategies. Methods Descriptive epidemiological method was used to analyze the epidemiological features of meningo- coccal meningitis in Hunan Province from 1951 to 2016. And Excel 2007 was employed to analyze the data relative to Neisseria meningitides strains obtained from the monitoring during 2008-2016. Results Three epidemiological peaks could be seen re- spectively in 1959, 1967 and 1977 in the meningococcal meningitis epidemics in Hunan Province during 1951-2016. The inci- dence rates had been dramatically lowered since the widespread use of meningococcal polysaccharide vaccine （MPV） in the 1980s, and no outbreaks or periodic epidemics occurred. After implementing the national Expanded Programme on Immunization, the epidemic situation of meningococcal meningitis in Hunan Province got effective control. In recent ten years, the prevalence rates were at historic lows. The proportion of Neisseria meningitidis serogroup C strains isolated from meningococcal meningitis cases and the case-close-contacts during 2008-2013 was significantly higher than those of serogroup B and W135 strains, and Neisseria meningitidis serogroup A strain was not detected, suggesting that serogroup C strain had already replaced serogroup A strain and become the priority strain in Hunan Province. However, its priority had been weakened by continuously increasing proportions of serogroup B and W135 strains since 2014. Conclusions The prevalence rate of meningococcal meningitis in Hunan Province has been maintaining a low level. The prevalent strain of Neisseria meningiticles is switching toward a diversification of serogroup.

关 键 词：流行性脑脊髓膜炎 脑膜炎奈瑟菌 流行病学特征 菌群变迁 

分 类 号：R512.3[医药卫生—内科学]