一起幼儿园水痘暴发及疫苗保护效果分析  

Analysis of a variclla outbreak and vaccine protection effect in a kindergarten

作　　者：朱丽霞[1] 周永超[1] 刘玉梅[1] 周光华[1] 康光鸿 ZHU Lixia;ZHOU Yongchao;LIU Yumei;ZHOU Guanghua;KANG Guanghong(Center of Disease Control and Prevention of Beibei District of Chongqing,Chongqing 400700,China)

机构地区：[1]重庆市北碚区疾病预防控制中心

出　　处：《医学动物防制》2019年第11期1106-1108,共3页Journal of Medical Pest Control

摘　　要：目的分析某幼儿园一起水痘暴发疫情流行特征及疫苗接种保护效果,为控制水痘暴发、完善疫苗接种策略提供依据。方法采用回顾性队列研究方法收集水痘暴发病例信息以及儿童疫苗接种情况,分析暴发流行特征和疫苗保护效率。结果共报告水痘暴发病例24例,分布在5个班,其中大一班病例占50.00%,全园儿童罹患率8.99%(24/267),疫情持续31天。5岁及以上儿童罹患率15.07%,高于4岁及以下儿童的1.65%,差异有统计学意义(χ^2=12.9626,P<0.01)。发现水痘突破病例14例,其中接种年限≥3年的占64.28%。全园儿童中,接种过1剂次疫苗儿童的罹患率7.29%,低于未接种者的15.62%,差异有统计学意义(χ^2=3.9234,P<0.05),疫苗保护效率53.33%。结论1剂次疫苗接种对幼儿园5岁以上儿童保护不充分,在有较高接种率的幼儿园仍可能暴发水痘。建议强化幼儿园水痘疫情监测和早期处置,完善现有接种策略。Objective To analyze the epidemiological characteristics of a varicella outbreak occurred in a kindergarten and to estimate vaccine effictiveness(VE)of varicella vaccine(Var V),so as to provide scientific basis for varicella control and adjustment of immunization strategy.Methods Medical record of cases and Var V history of all the children in the kindergarten were collected.Retrospective cohort study was used to analyze the characters of the outbreak and to estimate VE of Var V.Results A total of 24 cases of varicella outbreak were reported,distributed in 5 classes,among which the cases in the first class accounted for 50.00%,the incidence rate of children in the whole kindergarten was 8.99%(24/267).The outbreak lasted 31 days.The incidence rate of children over 5 years old was 15.07%,which was higher than those under 5 years old(χ^2=12.9626,P<0.01).A total pf 14 varicella breakthrough cases were occurred,64.28%of them with vaccination history for over 3 years.Among the children in the whole school,the incidence rate of children who had received one dose of vaccine was 7.29%,lower than that of those who had not received the vaccine,which was 15.62%.The difference was statistically significant(χ^2=3.9234,P<0.05),and the VE was 53.33%.Conclusion 1-dose Var V is insufficient to protect children over 5 years old in the kindergarten,so outbreaks may even occur in the kindergartens with high 1-dose Var V coverage.It is necessary to reinforce the surveillance to prevent varicella outbreak in kindergarten and early treatment of varicella outbreak in children is recommended before entering primary school.

关 键 词：水痘 暴发 突破病例 疫苗保护率 

分 类 号：R511.5[医药卫生—内科学]