2013—2022年上海浦东新区麻疹和风疹疑似病例的检测结果分析  

Analysis of the suspected cases of measles and rubella in Pudong New Area of Shanghai,2013‒2022

作　　者：王筱 张爱华[1,2] 傅慧琴 杨玉颖 崔晓娴[3] 郝莉鹏 周艳秋 潘丽峰 WANG Xiao;ZHANG Aihua;FU Huiqin;YANG Yuying;CUI Xiaoxian;HAO Lipeng;ZHOU Yanqiu;PAN Lifeng(Shanghai Pudong New Area Center for Disease Control and Prevention,Shanghai 200136,China;Fudan University Pudong Institute of Preventive Medicine,Shanghai 200136,China;Shanghai Municipal Center for Disease Control and Prevention,Shanghai China)

机构地区：[1]上海市浦东新区疾病预防控制中心,上海200136 [2]复旦大学浦东预防医学研究院,上海200136 [3]上海市疾病预防控制中心,上海200336

出　　处：《上海预防医学》2024年第6期534-539,共6页Shanghai Journal of Preventive Medicine

基　　金：上海市浦东新区卫生健康委员会公共卫生高原学科病原微生物检验基金项目(PWYggy2021-01)。

摘　　要：【目的】了解2013—2022年上海市浦东新区麻疹、风疹的流行特征,为适时调整消除麻疹、控制风疹的策略提供数据支持。【方法】采用酶联免疫吸附法检测疑似病例血清标本的麻疹和风疹IgM抗体,采用逆转录-聚合酶链反应法扩增麻疹病毒N基因C末端630个核苷酸序列并测序,构建亲缘关系树。【结果】1529例麻疹疑似病例中麻疹IgM抗体阳性率为33.55%(513/1529),3—5月份阳性率(20.73%)最高,集中在0~岁(63.16%,96/152)和20~岁(45.61%,161/353)人群。风疹IgM抗体阳性率为6.80%(104/1529),10~20岁(27.27%,18/66)人群居多。男性的麻疹和风疹IgM抗体阳性率高于女性(P<0.05),出疹4~28 d麻疹和风疹IgM检出率高于3 d内血清采集时间(P<0.05)。2020—2022年的麻疹和风疹IgM抗体阳性率明显低于2013—2019年。分离得到的麻疹毒株中2株为输入性D8基因型毒株,其余均为本土型H1a基因亚型。【结论】上海市浦东新区的麻疹和风疹IgM抗体阳性率明显降低,麻疹IgM抗体阳性率集中在0~岁和20~岁年龄段,风疹IgM抗体阳性率集中在10~岁年龄段。应继续加强适龄儿童接种相关疫苗,对暴露风险大的年龄段人群进行查漏补种和加强免疫,加强输入性麻疹病例的监测、内防外控,达到消除麻疹、控制风疹的目标。[Objective]To analyze the epidemic characteristics of measles and rubella in Pudong New Area of Shanghai from 2013 to 2022,and to provide data support for the elimination of measles and rubella.[Methods]Enzyme linked immunosorbent assay was used to detect IgM antibodies in serum samples.The sequence of 630 nucleotides at the C-terminal of N gene of measles virus was amplified by reverse transcription-polymerase chain reaction and the phylogenic tree was constructed.[Results]A total of 1529 suspected cases of measles were detected from 2013 to 2022,among which the positive rate of measles IgM antibody was 33.55%(513/1529).The highest positive rate(20.73%)was from March to May,and the positive rate of rubella IgM antibody was 6.80%(104/1529).The positive rate of both IgM was higher in males than that in females(P<0.05).The IgM against measles was mainly detected in 0‒years old(63.16%,96/152)and 20‒years old(45.61%,161/353).The IgM against rubella was mainly detected in 10‒20 years old(27.27%,18/66).The IgM antibody could be detected more easily from 4 to 28 days after eruption,and the IgM antibody positive rate of measles/rubella from 2020 to 2022 was significantly lower than previous years(2013‒2019).There were 2 D8 genotype strains,and the rest were H1a gene subtypes.[Conclusion]The positive rate of IgM antibodies against measles/rubella in Pudong New Area of Shanghai decreased significantly.People aged 0‒years and 20‒years old are more susceptible to measles,and rubella is concentrated in 10‒years old.It is necessary to strengthen the vaccination of school-age children,in order to achieve the goal of eliminating measles.The age group with high risk of exposure should be checked for vaccination status to ensure the enhanced immunization,and the surveillance of imported measles cases should be strengthened.

关 键 词：麻疹 风疹 亲缘性分析 消除 

分 类 号：R181.36[医药卫生—流行病学]