2015—2018年西安市百日咳流行特征分析  

Epidemiological characteristics of Bordetella pertussis in Xi’an from 2015 to 2018

作　　者：张娟胜 林晨 刘莹[1] 李芳[1] 王小强[1] 韩锐郡[1] 王增国[1] 彭雁[1] 营思思 ZHANG Juan-sheng;LIN Chen;LIU Ying;LI Fang;WANG Xiao-qiang;HAN Rui-jun;WANG Zeng-guo;PENG Yan;YING Si-si(Xi'an Center for Disease Control and Prevention,Xi'an,Shaanxi 710054,China;不详)

机构地区：[1]西安市疾病预防控制中心,陕西西安710054 [2]上海市浦东新区疾病预防控制中心,复旦大学浦东预防医学研究院,上海200136

出　　处：《现代预防医学》2022年第8期1361-1364,共4页Modern Preventive Medicine

基　　金：西安市科技计划项目[201805101YX9SF35(2)];西安卫健委卫生科研人才培训项目(J201801016)。

摘　　要：目的 分析西安市2015—2018年百日咳流行病学特征,为预防和控制百日咳传播提供参考。方法 采用描述流行病学方法,对中国疾病预防控制信息系统中2015—2018年期间西安市百日咳报告病例和此期间西安市百日咳哨点监测病例的数据进行统计学分析。结果 西安市2015—2018年共报告百日咳确诊病例1 635例,发病率分别为3.97/10万、4.11/10万、4.85/10万和5.28/10万,发病有逐年上升趋势(χ^(2)_(趋势)=21.719,P<0.001);高发季为3—8月(2015—2018年分别占该年度总发病数的75.73%、66.76%、78.97%和80.27%);以3~6月龄发病比例最高(2015—2018年分别占该年度总发病数的50.58%、48.60%、48.36%和41.22%);未全程接种疫苗患儿所占比例最大(2015—2018年分别为36.26%、23.74%、42.76%和33.73%),未到接种年龄就发病所占比例有逐年升高趋势(χ^(2)_(趋势)=10.302,P=0.001),无免疫史患儿比例呈逐年降低趋势(χ^(2)_(趋势)=36.088,P<0.001);3种实验室检测方法中荧光PCR的检出率最高(40.12%);传播模式除了散发病例,出现了家庭聚集现象,且所有流行病学相关病例均被漏诊或误诊。结论 西安市近年来百日咳发病率有明显上升趋势,<6月龄婴儿为主要发病人群,百日咳的日常监测仍有待加强,且其家庭聚集式传播现象值得关注。Objective To analyze the epidemiological characteristics of pertussis cases in Xi’an from 2015 to 2018 and provide reference for the prevention and control of pertussis. Methods Descriptive epidemiological method was used to analyze the cases of pertussis from national statutory disease reporting system and the data of sentinel surveillance in Xi ’an from 2015 to 2018. Results A total of 1 635 confirmed cases of pertussis were reported in Xi’an from 2015 to 2018, with incidence rates of 3.97/100 000, 4.11/100 000, 4.85/100 000, and 5.28/100 000, respectively, with an increasing trend in incidence year by year(χ^(2)trend=21.719, P<0.001);the high incidence season was March-August(75.73%, 66.76%, 78.97% and80.27% of the total incidence in 2015-2018, respectively);the highest proportion of incidence was from 3 to 6 months of age(50.58%, 48.60%, 48.36% and 41.22% of the total incidence in 2015-2018, respectively). The proportion of children who were not fully vaccinated was the highest(36.26%, 23.74%, 42.76%, and 33.73% from 2015 to 2018, respectively), and the proportion of children who had the disease before the age of vaccination tended to increase each year(χ^(2)trend=10.302, P =0.001), while the proportion of children without immunization history tended to decrease each year. The proportion of children with no immunization history tended to decrease year by year(χ^(2)trend=36.088, P<0.001);the detection rate of fluorescent PCR was the highest among the three laboratory tests(40.12%);the mode of transmission, in addition to disseminated cases,showed family aggregation, and all epidemiologically related cases were missed or misdiagnosed. Conclusion The incidence of pertussis in Xi’an has been increasing significantly in recent years, with infants <6 months of age as the main incidence group. Daily surveillance of pertussis still needs to be strengthened, and its family aggregation transmission phenomenon is of concern.

关 键 词：百日咳 流行病学特征 疫苗接种 家庭聚集性 

分 类 号：R516.6[医药卫生—内科学] R181.3[医药卫生—临床医学]