| 高洁,何寒青,沈纪川,黄志勇,马会来,骆淑英,陈恩富.浙江省一起由免疫接种空白导致的流动人口麻疹暴发[J].Chinese journal of Epidemiology,2010,31(10):1163-1165 |
| 浙江省一起由免疫接种空白导致的流动人口麻疹暴发 |
| An outbreak of measles among unvaccinated migrant population in Zhejiang province，from June to August, 2010 |
| Received:August 30, 2010 Revised:June 28, 2012 |
| DOI：10.3760/cma.j.issn.0254-6450.2010.10.020 |
| KeyWord: 麻疹 预防接种 流动人口 |
| English Key Word: Measles Vaccination Migrants |
| FundProject:杭州市科技局重点创新项目(200513231344) |
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| Abstract: |
| 目的 为核实浙江省某村1名麻疹确诊患儿家长报告同村有多名发热、出疹病例，并 调查暴发原因。方法 疑似病例定义为2010年6月1日至8月3日，该村及其所在街道和周围邻村 居民中出现发热伴出疹症状者；确诊病例为疑似病例中血清麻疹IgM抗体阳性者。在伞村范围开 展逐户搜索，通过中国疾病预防控制信息系统搜索该村所在街道及相邻村的麻疹报告病例。对全 村8月龄至14岁流动儿童开展回顾性队列研究。结果 该村共发现19例麻疹病例(17例确诊和2 例疑似)，均为流动人口。罹患率以1-2岁组为最高(13％)。首发病例6月4日抵该村后发病。在非 法私人诊所就医，但未向卫生部门报告疫情，p生部门通过患儿家长报告识别暴发时，疫情已持续1 个月。315名8月龄至14岁流动儿章中，麻疹疫苗接种率为8l％。无麻疹疫苗接种史的61名流动儿 童中，16名有明确病例接触史者发病风险(88％。14／16)高于45名无病例接触史者(4.4％，2／45) (Fisher精确概率法，艘=20。95％CI：5.7～94)。结论 该村流动儿童麻疹疫苗接种率低，非法私人 诊所不按规定对病例进行报告、隔离和医疗诊治，是导致此次疫情暴发的主要原因。 |
| English Abstract: |
| Objective On July 6，20 l 0，the parents of a patient with confirmed measles repoaed several suspected measles patients with fever and rash in their village.An investigation was carried out to verify and understand the cause of the outbreak.Methods Several suspected cases had all onset of fevet and rash in this and other neighboring villages during June l to August 3，20l O.A confirmed case was a suspected case with measles.specific lgM identified in the serum.We conducted door-to.door visits and searched the Chinese Center for Disease Control and Prevention Information System to identify cases，also conducted a retrospective cohog study among migrant children aged 8 months-14 years to identifv risk factors related to measles.Results We identified 19 measles cases (1 7 confirmed case.2 suspected cases)in the village，and all of them were migrants.Children aged 1-2 years had the highest attack rate(13％).The primary case-patient had onset on the day she arrived in this village(June 4.20l 0).Caretakers from an unlicensed private clinic were providing service in the village but did not report the outbreak to the public healtll authority.The outbreak was identifiedonly after receiving a report from the parents of one of the patients.bv that time the outbreak had lasted for one month.The measles vaccine coverage rate was 8 l％among the 3 1 5 migrant children aged 8 months一1 4 years.Among the 6 1 unvaccinated children.those who reportedly being contacted a measles patient had a higher attack rate(14／16，88％)th811 those who did not(2／45，4.4％) (Relative risk=20，Fisher’S exact 95％confidence interval：5.7-94).Conelusion The lOW measles vaccine coverage among migrant children and lack of measures taken on the incident.timely isolmion diagnosis／reporting by the caretakers from the unlicensed private clinic etc.had contributed to this prolonged outbreak.Measures need to be taken to improve the immunization services for migrant populations and to enhance measles surveillance programs in the area. |
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