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目的探讨麻疹暴发流行的形式、原因及三间分布情况,以更好地指导麻疹防制工作。方法对麻疹病人作流行病学调查,并采其急性期血清用ELISA法作麻疹病毒IgM抗体测定;按照有关规定对麻疹病例作诊断分类。结果东海县2006年1~5月份共报告麻疹203例,罹患率为17.74/10万,暴发流行17起,有22个乡级单位的101个自然村、街道小区发病;不足免疫月龄的发病构成及年龄组发病率均最高分别占40.39%和1 183.09/10万,大年龄发病占17.74%,各年龄组间性别发病率差异无统计学意义(P>0.05);有麻疹疫苗免疫史的发病占25.13%,无免疫史的占16.75%,免疫史不详的占17.74%,不足免疫月龄的占40.39%;有1针、2针免疫史的麻疹发病危险性分别是有2针以上免疫史的33倍和17倍;麻疹病人IgM抗体阳性率71.43%,各年龄组间差异无统计学意义(P>0.05);首例病人为输入性的在校学生;教师及医务人员有发病。结论流行形式以多点暴发、局灶性发病为主,同时又有广泛的散发性,波及面达全县范围;无麻疹免疫史包括不足免疫月龄,是麻疹的好发人群,但存在明显的发病年龄后移现象;今后要切实加强麻疹免疫覆盖率与加强免疫的成功率;适当调整免疫月龄及成人特别是育龄期女性的麻疹加强免疫。
Objective To explore the forms, causes and distribution of measles outbreak in order to better guide the prevention and control of measles. Methods Epidemiological survey of measles patients was carried out. The serums from the acute phase were collected for the detection of measles virus IgM by ELISA. The measles cases were classified according to the relevant regulations. Results A total of 203 measles cases were reported from January to May 2006 in Donghai County, with an attack rate of 17.74 / lakh and 17 outbreaks. There were 101 natural villages with 22 township-level units and sub-district communities. The incidence of insufficient immunization age (40.39% and 1 183.09 / 100 000 respectively), and the incidence of major age was 17.74%. There was no significant difference in the incidence of gender among all age groups (P> 0.05). The incidence of measles vaccine immunization Accounting for 25.13%, non-immune history accounted for 16.75%, unknown history of immunization accounted for 17.74%, less than 40.39% of immunization month age; 1 needle, 2 needle immunization history of measles risk of onset are more than 2 needle immunization history 33 times and 17 times respectively. The positive rate of IgM antibody in measles patients was 71.43%. There was no significant difference among all age groups (P> 0.05). The first patient was an in-school student. The teachers and medical staff had the disease. Conclusions The epidemic pattern is characterized by multiple outbreaks and focal morbidity but also widespread sporadic spread across the county. The history of non-measles immunization, including insufficient immunization months, is a predominant population of measles with obvious manifestations Of the incidence of post-gradual migration phenomenon; in the future we must earnestly strengthen the coverage of measles immunization and the success rate of strengthening immunization; appropriate adjustment of immune age and adult, especially women of childbearing age to strengthen the immune.