中国2011年麻疹流行病学特征与消除麻疹进展Measles Epidemiology and Progress Towards Measles Elimination in China,2011
马超,郝利新,苏琪茹,马静,张燕,曹雷,罗会明
摘要(Abstract):
目的分析中国(未包括香港、澳门特别行政区和台湾地区,下同)2011年麻疹流行病学特征和采取的措施,为消除麻疹提供参考。方法对全国麻疹发病、麻疹监测系统(Measles Surveillance System,MSS)运转指标及采取的消除麻疹措施进行描述流行病学分析。结果全国2011年麻疹报告发病率为0.74/10万,较2010年下降74.12%,降至历史新低。西藏、新疆、青海、甘肃、陕西省(自治区,下同)报告发病率居全国前5位,新疆、四川、浙江、陕西、甘肃省麻疹病例数居全国前5位,5个省的病例数占全国病例总数的57.61%。年龄别发病率以<5岁儿童最高(8.21/10万),其中尤以<1岁儿童(23.52/10万)和1岁儿童(8.87/10万)最高。≤1岁病例占病例总数的53.90%,≥15岁病例占27.58%。全国2011年共报告疑似麻疹病例34642例,排除麻疹病例报告发病率为1.84/10万,疑似麻疹病例48h内完整调查率93.30%,散发疑似麻疹病例血标本采集率90.37%,血清学检测结果7d内报告率93.85%,62起麻疹爆发中血清学确诊比例为98.39%,采集病原学标本的起数占75.81%。全国共报告223例麻疹病例的病原学标本基因亚型鉴定结果,221例为H1a基因亚型,2例为d11基因型。结论中国预防控制麻疹成效显著,麻疹发病水平降至历史新低,MSS运转质量进一步提高。但要达到消除麻疹目标仍需更大努力,应将提高适龄儿童含麻疹成份疫苗(Measles-containing Vaccine,MCV)及时、全程接种率作为核心的免疫措施,继续做好重点地区MCV的集中查漏补种和麻疹疫情的调查与处置,杜绝二代病例的发生,从而阻断麻疹病毒持续传播,最终实现消除麻疹。
关键词(KeyWords): 麻疹;流行病学特征;消除;进展
基金项目(Foundation):
作者(Author): 马超,郝利新,苏琪茹,马静,张燕,曹雷,罗会明
参考文献(References):
- [1]Chao Ma,Zhijie An,Lixin Hao,et al.,Progress toward measles elimination in the People’s Republic of China,2000-2009[J].J Infect Dis,2011,204(Suppl1):S447-454.
- [2]马超,郝利新,马静,等.中国2010年麻疹流行病学特征与消除麻疹进展[J].中国疫苗和免疫,2011,17(3):242-248.MA Chao,HAO Li-xin,MA Jing,et al.Measles Epidemiology and Progress in Measles Elimination in China,2010[J].Chinese Journal of Vaccine and Immunization,2011,17(3):242-248.
- [3]马超,郝利新,安志杰,等.中国麻疹监测系统的建立和运转情况分析[J].中国疫苗和免疫,2010,16(4):297-303.MA Chao,HAO Li-xin,AN Zhi-jie,et al.Establishment and Performance of Measles Surveillance System in the People’s Republic of China[J].Chinese Journal of Vaccine and Immunization,2010,16(4):297-303.
- [4]WHO.Progress in global measles control,2000-2010[J].WER,2012,87(5):45-52.
- [5]郝利新,马超,马静,等.中国2008~2009年麻疹流行病学特征分析[J].中国疫苗和免疫,2010,16(4):293-296.HAO Li-xin,MA Chao,MA Jing,et al.Analysis on Epidemiological Characteristics of Measles in China from2008to2009[J].Chinese Journal of Vaccine and Immunization,2010,16(4):293-296.
- [6]WHO.Measles vaccines WHO position paper[J].WER,2009,84(35):349-360.
- [7]武文娣,刘大卫,曹雷,等.2005~2007年中国常规免疫报告接种率的估算[J].中国疫苗和免疫,2009,15(4):363-366.WU Wen-di,LIU Da-wei,CAO Lei,et al.Study on the Estimation of Routine Immunization Coverage of China,2005-2007[J].Chinese Journal of Vaccine and Immunization,2009,15(4):363-366.
- [8]李倩,胡昱,陈恩富,等.浙江省含麻疹成分疫苗常规免疫首剂接种率估算与评价[J].疾病监测,2011,26(7):512-515.LI Qian,HU Yu,CHEN En-fu,et al.Evaluation on Estimation of Routine Immunization Coverage of the First Dose of Measles Containing Vaccine in Zhejiang Province[J].Disease Surveillance,2011,26(7):512-515.
- [9]Castillo-Solorzano C C,Matus C R,Flannery B,et al.,The Americas:paving the road toward global measles eradication[J].J Infect Dis,2011,204(Suppl1):S270-278.
- [10]Sniadack DH,Moscoso B,Aguilar R,et al.Measles epidemiology and outbreak response immunization in a rural community in Peru[J].Bull WHO,1999,77(7):545-552.
- [11]Sniadack DH,Mendoza-Aldana J,Jee Youngmee,et al.Progress and challenges for measles elimination by2012in the Western Pacific Region[J].J Infect Dis,2011,204(Suppl1):S439-446.
- [12]黄红玉,张洪明,施素洁.一起外来务工人员麻疹暴发疫情的调查[J].江苏预防医学,2008,19(1):19-20.HUANG Hong-yu,ZHANG Hong-ming,SHI Su-jie.An Measles Outbreak Investigation on Migrant Workers[J].Jiangsu Preventive Medicine,2008,19(1):19-20.
- [13]汪建红,方春福,占炳东.某企业成人麻疹暴发疫情调查[J].浙江预防医学,2011,23(3):36-37.WANG Jian-hong,FANG Chun-fu,ZHAN Bing-dong.An Adult Measles Outbreak Investigation in a Factory[J].Zhejiang Preventive Medicine,2011,23(3):36-37.
- [14]谭洁,单芙香,罗青山,等.一起成人麻疹暴发的调查[J].现代预防医学,2006,33(6):1011.TAN Jie,SHAN Fu-xiang,LUO Qing-shan,et al.An Adult Measles Outbreak Investigation[J].Modern Preventive Medicine,2006,33(6):1011.
- [15]柴光军,王洪波,马平,等.空军某新兵训练队麻疹暴发的流行病学调查[J].解放军预防医学杂志,1994,12(6):491-492.CHAI Guang-jun,WANG Hong-bo,MA Ping,et al.An Epidemiological Investigation on Measles Outbreak in New Airforce Recruits[J].Preventive Medicine of the PRC,1994,12(6):491-492.
- [16]Cairns KL,Perry RT,Ryman TK,et al.Should outbreak response immunization be recommended for measles outbreaks in middle-and low-income countries?An update[J].J Infect Dis,2011,204(Suppl1):S35-46.
- [17]WHO.Reported incidence time series[R].Available at http://www.who.int/immunization_monitoring/data/data_subject/en/index.html.