2021年南充市某学校水痘暴发疫情流行病学和疫苗保护效果调查  

Epidemiology of varicella outbreak in a school in Nanchong City and investigation on protective effect of vaccine in 2021

作　　者：周文娟 漆琪[2] 刘宇[2] 车双双 邵丹 李锐 ZHOU Wen-juan;QI Qi;LIU Yu;CHE Shuang-shuang;SHAO Dan;LI Rui(Jiangyou City Center for Disease Control and Prevention,Mianyang City 621000,Sichuan Province,China;Sichuan Provincial Center for Disease Control and Prevention,Chengdu City 610041,Sichuan Province,China;Nanchong City Center for Disease Control and Prevention,Nanchong City 637000,Sichuan Province,China;Yaan City Center for Disease Control and Prevention,Yaan City 625000,Sichuan Province,China;Xichong County Center for Disease Control,Nanchong City 637000,Sichuan Province,China.)

机构地区：[1]江油市疾病预防控制中心,四川绵阳621000 [2]四川省疾病预防控制中心,成都610041 [3]南充市疾病预防控制中心,四川南充637000 [4]雅安市疾病预防控制中心,四川雅安625000 [5]西充县疾控中心,四川南充637000

出　　处：《寄生虫病与感染性疾病》2022年第2期103-108,共6页Parasitoses and Infectious Diseases

基　　金：四川省现场流行病学培训项目第四期。

摘　　要：目的 了解南充市某学校一起水痘暴发疫情的流行病学特征及水痘疫苗在本次水痘暴发疫情中的保护效果。方法 采用疑似病例筛查表及《水痘流行病学调查表》于2021年对南充市某学校一起水痘暴发疫情病例进行调查,采用问卷调查发病班级。采用描述性流行病学方法分析水痘流行病学特征和疫苗保护效果。结果 2021-04-08/06-20期间,南充市某学校共报告26例水痘病例,罹患率为4.2‰;经Fisher确切概率法分析,七年级发病班级间罹患率差异有统计学意义(P<0.01)。其中,七年级6班罹患率最高;病例年龄为10~15岁,15岁年龄组罹患率最高。对7年级275名学生纳入疫苗保护效果分析,第一剂次接种率为47.63%,第二剂次接种率为12%;有水痘疫苗接种史的学生患水痘的风险是未接种者的0.93倍(95%CI:0.43~2),水痘疫苗效力为7%(95%CI:0%~57%);对病例≥3例的班级进一步分析,七年级6班疫苗接种水痘疫苗的学生患水痘的风险是未接种者的0.84倍(95%CI:0.40~1.77),疫苗保护效力为16%(95%CI:0%~60%);水痘疫苗接种2剂次的学生患水痘的风险是接种1剂次的0.65倍(95%CI:0.15~2.9),水痘疫苗效力为35%(95%CI:0%~85%)。结论 本次疫情为首例病例潜伏期末及发病后在校正常学习、生活,加之集中发病班级教室空气流通不畅,引发本起水痘暴发疫情。其感染来源可能为班级学生在教室、食堂及校园内其他场所和校外通过接触感染传播水痘-带状疱疹病毒。建议在接种1剂次水痘疫苗的情况下,提高水痘疫苗2剂次接种率。Objective To understand the epidemiological characteristics of an outbreak of chickenpox in a school in Nanchong city, and to understand the protective effect of Varicella vaccine in this outbreak of Varicella. Methods Cases were investigated by using the Suspected Case Screening Form and the Epidemiological Investigation Form of varicella, questionnaires were used to investigate the disease-onset classes. Descriptive epidemiological methods were used to analyze the epidemiological characteristics of varicella and the protective effect of the vaccine. Results During2021-04-08/06-20, a total of 26 cases of varicella were reported in a school of Nanchong city.with a prevalence rate of 4.2‰. Analyzed by Fisher′s exact probability method, there was statistically significant difference in the incidence rate among the seventh grade onset classes(P<0.01).Class 6,Grade 7 had the highest incidence. The age of case was 10 to 15 years old,and the 15-year-old age group had the highest attack rate. Analysis of the protective effect of 275 students in grade 7 included in the vaccine,the vaccination rate of the first dose was 47.63%,and that of the second dose was 12%. The risk of varicella in vaccinated students was 0.93 times higher than that in unvaccinated students(95% CI: 0.43 to 2), efficacy of varicella vaccine 7%(95% CI: 0% ~57%). Classes with ≥3 cases were further analyzed,in the Class 6 Grade 7,the risk of varicella in vaccinated students was 0.84 times higher than that in unvaccinated students(95%CI:0.40-1.77)and vaccine protective efficacy 16%(95% CI: 0%-60%). Students who received two doses of varicella vaccine had 0.65 times the risk of developing varicella compared with those who received one dose(95% CI: 0.15 to 2.9), efficacy of varicella vaccine 35%(95% CI: 0% ~85%).Conclusions This is the first case which outbreaks at the end of the incubation period and onset of normal school learning, life. Besides, the air circulation in the classrooms of the intensively affected class is not smooth,this caused an ou

关 键 词：学校暴发 水痘 疫苗 保护效果 

分 类 号：R511.5[医药卫生—内科学]