新疆维吾尔自治区昌吉市某幼儿园1起水痘暴发的流行病学调查  

A varicella outbreak in a kindergarten of Changji district,Xinjiang Uygur Autonomous Region

作　　者：沙吾拉西·热加甫 关静[1,2] 玛合木提江·库尔班 邓晟[1] 马会来[2] 艾尔肯·吾布力[1,2] 马超[3] Shawulaxi Rejiafu;Guan Jing;Mahemutijiang Kuerban;Deng Sheng;Ma Huilai;Aierken Wubuli;Ma Chao(Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi 830011, Xinjiang, China;Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China;Department of National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China)

机构地区：[1]新疆维吾尔自治区疾病预防控制中心,新疆乌鲁木齐830011 [2]中国疾病预防控制中心现场流行病学培训项目,北京100050 [3]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》2018年第3期323-327,共5页Chinese Journal of Vaccines and Immunization

摘　　要：目的分析2017年新疆昌吉市某幼儿园1起水痘暴发特征,估算水痘疫苗（Varicella vaccine,Var V）在暴发中的保护效果（Vaccine effectiveness,VE）。方法通过病例主动搜索,对该幼儿园水痘患者进行个案调查和描述流行病学分析。采取回顾性队列研究方法估算Var V的VE。结果该幼儿园暴发共发生水痘病例19例,罹患率为8.33%,暴发持续22d,波及7个班级。第1代病例（3例）于3月9-11日发病,第2代病例（16例）于3月21日-4月1日发病。男、女罹患率分别为7.69%（9/117）、9.01%（10/111）。全园儿童Var V（均为1剂次）接种率为82.02%。有、无Var V免疫史病例中,皮疹数量〈50个者分别占87.50%（7/8）、18.18%（2/11）。估算Var V的VE为86%（95%CI：62%-95%）。结论幼儿园儿童1剂次Var V接种率高仍可能发生水痘暴发;建议加强幼儿园水痘监测和及时处置,实施2剂次Var V免疫程序。Objective To analyze a varicella outbreak in a kindergarten of Changji city in Xinjiang in2017,and to estimate vaccine effectiveness（ VE） of varicella vaccine（ Var V）. Methods We used an active search to identify varicella cases in the kindergarten for investigation and descriptive epidemiological analysis. We used a retrospective cohort study to estimate Var V VE. Results Nineteen varicella cases occurred during the kindergarten outbreak,for an attack rate of 8. 33%; the outbreak lasted 22 days and involved 7 classes. Three first-generation cases occurred during March 9-11,and 16 secondgeneration cases occurred from March 21 to April 1. Attack rates among males and females were 7. 69%（ 9/117） and 9. 01%（ 10/111）,respectively. The 1-dose varicella vaccination coverage level among kindergarten children was 82. 02%. The percent of vaccinated cases with fewer than 50 lesions was87. 50%（ 7/8）,compared with 18. 18%（ 2/11） of unvaccinated cases with 50 or fewer lesions. The estimated Var V VE was 86%（ 95% CI： 62%-95%）. Conclusions Varicella outbreaks may occur in kindergartens-even in those with high,1-dose Var V coverage. Varicella was milder among vaccinated cases. We suggest strengthening varicella surveillance and rapid response in kindergartens,and we recommend 2 doses of Var V for routine childhood immunization.

关 键 词：水痘 暴发 水痘疫苗 疫苗效果 

分 类 号：R186[医药卫生—流行病学]