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目的探讨少数民族地区成人麻疹爆发原因,以控制爆发。方法对2008年9～10月发生在云南省大理州云龙县的一起成人麻疹爆发开展流行病学调查,用酶联免疫吸附试验检测麻疹IgM抗体,并运用病毒学和分子生物学技术从病原学上明确病因及病毒来源,同时结合血清流行病学探讨其发病原因和流行因素。结果全县爆发总罹患率18.11/10万(37/204465),发病年龄主要集中在≥16岁占97.29%(36/37),30～50岁占全部病例数91.89%(34/37);其中<8月龄1例占2.70%(1/37),>50岁1例占2.70%(1/37);全部为彝族,男女性别比为1∶4。麻疹病毒分离鉴定为H1 a亚型。结论该次麻疹爆发是一起典型具有麻疹流行病学特征的成人麻疹爆发,与易感人群聚集和其它内外环境等流行因素有关,适时开展大年龄组儿童的强化免疫,完善成人免疫策略加强麻疹监测是控制爆发的关键。
Objective To investigate the causes of adult measles outbreak in ethnic minority areas in order to control the outbreak. Methods An epidemiological investigation of an adult measles outbreak occurred in Yunlong County, Dali Prefecture, Yunnan Province from September to October in 2008 was carried out. The measles IgM antibody was detected by enzyme-linked immunosorbent assay (ELISA), and the virulence and molecular biology techniques were used to analyze the etiology On a clear cause and source of virus, combined with serum epidemiology to explore its causes and prevalence factors. Results The total incidence of outbreak in the whole county was 18.11 / 100000 (37/204465). The age of onset mainly concentrated in 97.29% (36/37) ≥16 years old and 91.89% (34/37) in 30 ~ 50 years old. One case of <8 months old accounted for 2.70% (1/37), one case of> 50 years old accounted for 2.70% (1/37); all were Yi nationality, male to female ratio was 1: 4. Measles virus was identified as H1 subtype. Conclusion The outbreak of measles was a typical outbreak of adult measles with the epidemiological characteristics of measles. It was related to epidemic factors such as susceptible population accumulation and other internal and external environments. The timely implementation of intensive immunization in children of large age group and improvement of adult immunization strategies strengthened measles surveillance Is the key to control the outbreak.