一起接种麻疹风疹联合疫苗偶合菌痢暴发的调查  

Investigation of a bacillary dysentery outbreak about measles and rubella combined attenuated live vaccine

作　　者：白尧勇 罗淑信 蒲锋 黄兴勉 陈惠珍 BAI Yaoyong;LUO Shuxin;PU Feng;HUANG Xingmian;CHEN Huizhen(Fengshan County Center for Disease Control and Prevention,Fengshan,Guangxi 547600,China)

机构地区：[1]凤山县疾病预防控制中心,广西凤山547600 [2]凤山县妇幼保健院,广西凤山547600

出　　处：《中国热带医学》2019年第7期700-703,共4页China Tropical Medicine

摘　　要：目的分析一起群体性接种麻疹风疹联合疫苗偶合细菌性痢疾暴发事件,总结处置经验。方法采用现况调查和病例对照研究方法,对接种场所、就诊医院及相关人员进行调查,采集标本检测、收集资料、汇总分析,参考AEFI因果关系评定原则进行诊断等。结果发病64人,罹患率16.75%,疫情波及2所小学、1所幼儿园,临床表现以发热、头痛、腹痛、腹泻、粘液脓血便为主,发病曲线为同源暴发;接种单位和接种人员有资质,疫苗进货渠道正规,有批签发合格证,属省、市、县逐级下发,储存、运输和接种过程均符合要求;接种途径正确、操作规范,接种登记信息完整;同批次疫苗在其他地方接种未出现异常反应,病例对照研究喝生水是危险因素;病人粪便标本检出宋内氏痢疾杆菌,按肠道传染病处置后,疫情很快平息。结论诊断结论为预防接种偶合症,与接种疫苗无关;偶合症是疑似预防接种异常的常见类型,及时报告、快速调查、风险处置、采集有临床意义的标本进行检测,是处置与疫苗接种相关事件的关键。Objective To analyze an outbreak of measles and rubella combined vaccine combined with bacterial dysentery, and to summarize the management experience. Methods The current situation investigation and case control study methods were used to investigate the inoculation sites, hospitals and related personnel, collect samples for testing, collect data, summarize and analyze, and make diagnosis by referring to the AEFI causal relationship assessment principle. Results There were 64 cases and with an incidence of 16.75%, the outbreak affected 2 primary schools and 1 kindergarten. The clinical manifestations were mainly fever, headache, abdominal pain, diarrhea, mucus, pus and blood stool. The incidence curve was homologous outbreak. Vaccinal unit and personnel had qualification, vaccine stock channel was regular, had batch to issue certificate of quality, belonged to province, city, county to issue level by level, stored, carried and vaccinal processed all accord with a requirement;The inoculation way was correct, the operation standard, the inoculation registration information was complete;The same batch of vaccine in other places did not appear abnormal reaction, the case control study drinking raw water was a risk factor;Shigellobacter sonnei was detected in the stool samples of the patients, and the epidemic situation soon subsided after the disposal of intestinal infectious diseases. Conclusion The diagnosis was vaccination coincidence, not vaccination. Coincidental disease is a common type of suspected vaccination abnormality, and timely reporting, rapid investigation, risk communication and collection of clinically significant specimens for testing are the key to handling vaccine-related events.

关 键 词：预防接种 异常反应 偶合症 细菌性痢疾 

分 类 号：R186[医药卫生—流行病学]