1950-2021年河南省流行性脑脊髓膜炎流行特征及菌群变迁趋势分析  

Epidemiological characteristics of meningococcal meningitis cases and trend of serogroup switching of Neisseria meningitidis in Henan province,1950-2021

作　　者：姬艳芳[1] 杨凯朝 杜冰会 李致远 张肖肖[1] 李军[1] 史鲁斌 刘倩[1] 孔江南 董蒲梅[1] 张延炀[1] JI Yanfang;YANG Kaichao;DU Binghui;LI Zhiyuan;ZHANG Xiaoxiao;LI Jun;SHI Lubin;LIU Qian;KONG Jiangnan;DONG Pumei;ZHANG Yanyang(Henan Provincial Center for Disease Control and Prevention,Zhengzhou,Henan 450016,China)

机构地区：[1]河南省疾病预防控制中心,河南郑州450016

出　　处：《河南预防医学杂志》2023年第1期7-13,共7页Henan Journal of Preventive Medicine

摘　　要：目的 分析流行性脑脊髓膜炎(流脑)流行特征及菌群变迁趋势,为流脑防控提供参考。方法 收集《河南省疫情资料汇编》和中国疾病预防控制信息系统中1950-2021年河南省报告的流脑病例数据和2006年后的流脑病原学数据,用描述性流行病学方法对其流行特征和菌群变迁趋势进行分析。结果 共报告流脑发病和死亡病例1 140 810例和70 292例,病死率6.16%,年均发病率和死亡率分别为21.14/10万和1.30/10万;共有4个发病高峰,最高为1967年,发病数和发病率分别是358 643例和646.44/10万,其余3个发病高峰为1957、1977和1984年,发病率分别是52.50/10万、179.36/10万和45.38/10万;1985年后发病持续下降,2021年报告3例病例,为有病例报告以来最低水平。流脑自然流行期、疫苗使用初期、自费疫苗使用期和扩大免疫规划期年均发病率分是64.71/10万、15.69/10万、1.02/10万和0.01/10万,疫苗的使用打破了8-10年一次周期性流行的规律,2008年后病例呈高度散发状态。同一时期不同地区间和不同时期不同地区间发病率差异较大,发病率最高的1967年信阳地区为1 393.69/10万,2009年后,驻马店市连续13年、鹤壁市和三门峡市均连续11年无流脑病例报告。扩大免疫规划时期以前高发月份为2-4月,分别占全年病例数的80.98%、86.47%和70.59%;扩大免疫规划时期高发月份为1-3月,占全年病例数的51.67%,季节性流行特征不再明显。2004年后报告病例以<20岁人群为主,占78.58%,<1岁人群和7~19岁人群构成比呈上升趋势。2006-2021年共报告69例经病原学分型的病例,其中2006-2012年以A群为主,占29.17%,2013-2021年以B群和C群为主,分别占46.67%和44.44%,间或有W135群出现。结论 疫苗的使用有效控制了流脑的流行,由周期性高发状态转变为散发为主的低发状态;主导菌群由A群向B群、C群转换。建议继续做好流脑疫苗常规免疫,加强病原学监测,保持监测敏感性,�Objective The epidemiological characteristics of meningococcal meningitis(MM) cases and serogroup switching trend of neisseria meningitidis(Nm) were analyzed to provide reference for the prevention and control of meningitis. Methods MM case data from the Compilation of Epidemic Data in Henan province and National Notifiable Disease Reporting System from Henan from 1950-2021, and etiology data after 2006 were collected, and a descriptive epidemiological analysis was conducted.Results A total of 1 140 810 MM cases and 70 292 deaths were reported in Henan province from 1950-2021, with a case fatality rate of 6.16%, the average annual morbidity and mortality were 21.14/100 000 and 1.30/10 100 000;Four peaks occurred, with the highest in 1967, in which the numbers of cases and the incidence were 358 643 and 646.44/100 000, respectively;the other3 peaks occurred in 1957, 1977 and 1984, with the incidence of 52.50/100 000, 179.36/100 000 and 45.38/100 000;The incidence declined continuously after 1985, and 3 cases were reported in 2021 with the lowest level since the record started. The average annual incidences in natural epidemic period, early stage of vaccine, self-funded period and the period of Expanded Program on Immunization(EPI) were 64.71/100 000, 15.69/100 000, 1.02/100 000 and 0.01/100 000. The use of vaccines broke the periodic trend of 8-10 years, with cases being highly sporadic since 2008. The incidence rate varies greatly with different regions during the same period, and with different regions during the different period;the highest incidence was in Xinyang in1967 with the rate of 1 393.69/100 000;there have been no meningitis cases reported in Zhumadian for 13 years, and for in bot Hebi city and in Sanmenxia city for 11 years. The peak month was February-April before EPI, accounting for 80.98%, 86.47%and 70.59% of the annual total cases, respectively. The peak month during EPI period was January-March, accounting for51.67% of all the cases in the whole year, and the seasonal epidemic characteristics ar

关 键 词：流行性脑脊髓膜炎 流行特征 菌群变迁 

分 类 号：R183.3[医药卫生—流行病学]