文章摘要
黎祺,李媛秋,马超,郝利新,王富珍,苏琪茹,安志杰,尹遵栋.2016-2020年中国麻疹暴发疫情流行特征与处置情况分析[J].中华流行病学杂志,,():
2016-2020年中国麻疹暴发疫情流行特征与处置情况分析
Surveillance and response to measles outbreaks in China, 2016-2020
收稿日期:2021-05-20  出版日期:2021-08-19
DOI:10.3760/cma.j.cn112338-20210520-00414
中文关键词: 麻疹;暴发;监测;处置
英文关键词: Measles;Outbreak;Surveillance;Treatment
基金项目:
作者单位E-mail
黎祺 中国疾病预防控制中心免疫规划中心, 北京 100050
湖南省湘西州疾病预防控制中心, 吉首 416000 
 
李媛秋 中国疾病预防控制中心免疫规划中心, 北京 100050  
马超 中国疾病预防控制中心免疫规划中心, 北京 100050 machao@chinacdc.cn 
郝利新 中国疾病预防控制中心免疫规划中心, 北京 100050  
王富珍 中国疾病预防控制中心免疫规划中心, 北京 100050  
苏琪茹 中国疾病预防控制中心免疫规划中心, 北京 100050  
安志杰 中国疾病预防控制中心免疫规划中心, 北京 100050  
尹遵栋 中国疾病预防控制中心免疫规划中心, 北京 100050  
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中文摘要:
      目的 分析2016-2020年中国麻疹暴发疫情流行病学特征、开展的调查及处置措施。方法 整理2016-2020年麻疹监测系统报告的中国31个省份麻疹暴发疫情信息、调查及处置情况,根据麻疹暴发定义在同期麻疹散发病例中侦测疑似麻疹暴发并进行分析。结果 2016-2020年中国报告麻疹暴发疫情344起,共涉及麻疹病例1 886例,暴发首例病例发病距暴发疫情报告时间M范围为4~10.5 d,涉及病例M范围为2~3例,疫情持续天数M范围为8~13 d,2016-2020年每年最长疫情持续时间分别为65、44、28、63、13 d;报告暴发数位于前三的省份为甘肃、北京、山东;在居民小区/村发生共115起,所占比例最高;2016年暴发病例基因型鉴定结果100%为H1基因型,此后H1基因型占比逐年下降,2017年H1基因型所占比例为88.57%(31/35),2018年为85.00%(17/20),2019年为15.79%(3/19),2020年无H1基因型报告,4株均为D8基因型;313起暴发对当地医疗机构开展了病例主动搜索,266起暴发开展了含麻疹成分疫苗接种率调查。2016-2020年中国共发现疑似麻疹暴发919起,涉及麻疹病例4 212例;疑似麻疹暴发位于前三的省份为新疆、甘肃、四川;疑似麻疹暴发场所同样以居民小区/村为主(493起),2016-2018年疑似麻疹暴发的基因型99.50%为H1型,2019-2020年2.44%为H1基因型、95.12%为D8型。结论 麻疹暴发疫情数量、规模和持续时间逐渐下降,社区水平的麻疹暴发不容忽视,本土H1基因型有逐渐被其他基因型替代的趋势。麻疹暴发监测报告的敏感性有待进一步提高,继续提高含麻疹成分疫苗覆盖率、对疫情进行及时有效的处置,是我国消除麻疹工作的重点。
英文摘要:
      Objective To understand the epidemiological characteristics of measles outbreaks in China from 2016 to 2020 and related outbreak investigations and response performances.Methods The information about the incidence of measles outbreaks, the investigation and response of measles outbreaks in 31 provinces from 2016 to 2020 were collected from Measles Surveillance System, and the incidence of suspected measles outbreaks detected through sporadic case finding during the same period according to the measles outbreak definition was analyzed.Results From 2016 to 2020, a total of 344 measles outbreaks were reported nationwide, involving1 886 measles cases. The median of intervals between the first case onsets and reported outbreaks ranged from 4 days to 10.5 days, the median of the numbers of involved cases ranged from 2 to 3, and the median of the duration of the epidemic ranged from 8 to 13 days, and some outbreaks had long durations of 65,44,28,63 and 13 days. The top three provinces with high number of reported outbreaks were Gansu, Beijing and Shandong. Among the reported outbreaks, 115 occurred in communities/villages, accounting for the highest proportion. The genotype identification results indicated that all the outbreaks in 2016 were caused by measles virus H1, and the proportion of the outbreaks caused by measles virus H1 decreased year by year since then, which was 88.57% (31/35) in 2017, 85.00% (17/20) in 2018 and 15.79% (3/19) in 2019 respectively. There was no outbreak caused by measles H1 reported in 2020, the 4 isolates all belonged to genotype D8. Active case findings were conducted in local medical institutions for 313 outbreaks, and measles-containing vaccine coverage surveys were conducted for 266 outbreaks. From 2016 to 2020, a total of 919 suspected measles outbreaks were detected nationwide, involving 4 212 measles cases. The top three provinces with suspected measles outbreaks were Xinjiang, Gansu and Sichuan. The suspected measles outbreaks also mainly occurred in communities/villages (493), and up to 99.50% of the suspected outbreaks were caused by measles virus H1 from 2016 to 2018, and 95.12% and 2.44% of the suspected outbreaks were caused by measles virus D8 and H1 respectively from 2019 to 2020. Conclusions The number, scale and duration of measles outbreaks were gradually decreasing, the measles outbreaks at the community level can not be ignored, and the local H1 genotypes tend to be gradually replaced by other genotypes. Improving the sensitivity of outbreak surveillance, promoting vaccination, expanding the vaccine coverage, timely and effective response to the outbreaks are the focus of measles elimination in China in the future.
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