云南省一起成人麻疹暴发的调查分析和控制效果评价

发布时间：2018-02-26 12:23

本文关键词： 麻疹成人暴发应急接种　出处：《中国疫苗和免疫》2017年02期 　论文类型：期刊论文

【摘要】：目的分析云南省德钦县1起成人麻疹暴发的原因,评价防控措施的效果。方法对疑似麻疹患者进行个案调查,收集病例血清和咽拭子/尿液标本,开展血清学和病原学检测。在全县范围内开展发热和/或出疹病例的主动搜索,采用回顾性队列研究分析引起暴发的主要因素。在首例病例报告4天后开展20-40岁人群含麻疹成分疫苗(MCV)应急免疫,并评价免疫后麻疹抗体水平。结果在42例麻疹暴发病例中,来自毗邻地区就诊病例23例,德钦本地病例19例。89.47%的德钦本地病例为20-40岁成人。病例的9株麻疹病毒分离株经鉴定为H1a基因型。在搜索的发热和/或出疹病例中,有明确病例接触史者中麻疹发病比例(10.1%,16/158)高于无病例接触史者(0.3%,3/1 209),且75%(12/16)的有明确病例接触者为医院暴露。德钦县20-40岁人群累计应急接种MCV 10 596人,接种后人群麻疹IgG抗体阳性率为100%,几何平均滴度为1∶1 452.87,疫情得到有效控制。结论本起成人暴发主要为易感人群的累积和院内感染引起。尽早开展以应急接种为主的综合防控措施可以迅速控制疫情。
[Abstract]:Objective to analyze the causes of an adult measles outbreak in Deqin County, Yunnan Province, and to evaluate the effect of prevention and control measures. Methods the suspected measles patients were investigated and the serum and throat swabs / urine samples were collected. Carry out serological and etiological tests. Active search for fever and / or rash cases throughout the county, A retrospective cohort study was used to analyze the main factors leading to the outbreak. Four days after the first case was reported, emergency immunization with measles vaccine (MCV) was carried out in the population aged 20-40 years, and the level of measles antibody after immunization was evaluated. Results in 42 cases of measles outbreak, Of the 23 cases from adjacent regions, 19 cases were Dachin local cases. 89.47% of Dachin local cases were adults aged 20-40 years. Nine isolates of measles virus were identified as H1a genotypes. In the search for fever and / or rash cases, The incidence rate of measles in those with a definite history of case contact was 10.1 / 158) higher than that of those with no history of contact with a case of 0.33 / 1 209, and 75 / 12 / 16) of those who had definite case contacts were exposed to hospital exposure. In Deqin County, 10 596 people aged 20 to 40 were vaccinated in an emergency emergency response. The positive rate of measles IgG antibody and geometric average titer were 1: 1 452.87 and 1: 1 452.87, respectively. Conclusion the adult outbreak is mainly caused by the accumulation of susceptible population and nosocomial infection. Comprehensive prevention and control measures can quickly control the epidemic.
【作者单位】：云南省疾病预防控制中心;
【分类号】：R181.3;R511.1

【相似文献】