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目的了解江西省某小学一起流行性腮腺炎暴发疫情以及接种含腮腺炎成分疫苗的保护效果,为预防和控制学校流行性腮腺炎疫情的暴发流行提供依据。方法采用现况调查和回顾性队列研究,通过面对面访谈、电话调查、查阅接种证的方式,获取人口学、既往史、发病和诊疗情况以及免疫接种信息,描述疫情暴发情况,评估疫苗保护效果。结果 2015年4月18日至7月3日,江西省某学校发生135例流行性腮腺炎病例,小学生罹患率为7.15%(135/1 888)。5月25日至6月8日为此次疫情的发病高峰期,病例主要分布在小学A部教学楼,罹患率为8.86%(115/1 298);男、女生罹患率分别为7.87%(83/1 055)、6.24%(52/833),差异无统计学意义(χ~2=1.851,P=0.174)。7,8岁学生罹患率最高,分别为11.80%(55/466)、11.03%(46/417),不同年龄之间罹患率差异有统计学意义(χ~2=49.425,P<0.01);有明确接种史的学生中,含腮腺炎成分疫苗的接种率为75.33%(684/908)。接种含腮腺炎成分疫苗在此次疫情中具有保护作用(RR=0.57,95%CI=0.39~0.84);接种1剂次疫苗后,疫苗保护率随接种时间延长呈下降趋势(χ_(趋势)~2=8.175,P=0.004),5.5年后失去保护作用(RR=0.76,95%CI=0.50~1.13)。结论此次事件为一起流行性腮腺炎暴发疫情。1剂次腮腺炎疫苗在接种5.5年后失去保护作用,应及时给予第2剂次加强。
Objective To understand the epidemic situation of mumps outbreak in a primary school of Jiangxi Province and the protective effect of the vaccination vaccine containing mumps, so as to provide basis for preventing and controlling outbreak of mumps epidemic in school. Methods The current situation survey and retrospective cohort study were conducted to obtain demographic information, past history, incidence and diagnosis, and immunization information through face-to-face interview, telephone survey and access to vaccination certificates. The outbreak situation was described and the vaccine protection effect was evaluated. Results From April 18 to July 3, 2015, 135 mumps cases occurred in a school in Jiangxi Province. The attack rate among primary school students was 7.15% (135/1 888). From May 25 to June 8, at the peak of the outbreak, the cases mainly distributed in the teaching building of Part A of Primary School, with an attack rate of 8.86% (115/1 298). The prevalence rates of males and females were 7.87% 83/1 055) and 6.24% (52/833) respectively, with no significant difference (χ ~ 2 = 1.851, P = 0.174). The prevalence rates of students aged 7 and 8 years were the highest (11.80% and 11.03%, 46/417, respectively). There was significant difference in the attack rates between different ages (χ ~ 2 = 49.425, P <0.01). Among students with a clear history of vaccination, vaccination with mumps-containing vaccine was 75.33% (684/908). Inoculation with mumps vaccine had a protective effect in this outbreak (RR = 0.57, 95% CI = 0.39-0.84). After vaccination with 1 dose of vaccine, the vaccine protection rate decreased with the prolongation of inoculation time (χ_ (trend) ~ 2 = 8.175, P = 0.004), and lost the protective effect after 5.5 years (RR = 0.76, 95% CI = 0.50-1.13). Conclusions The incident was an outbreak of mumps. 1 dose of mumps vaccine lose protection after 5.5 years of inoculation, should be given the second dose to strengthen.