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目的分析一起山区学校风疹暴发的原因及流行特征,指导防治工作。方法对疫情资料进行描述流行病学分析,用酶联免疫吸附试验检测风疹IgM抗体。结果 2013年5月16~30日,楚雄市八角镇中学和中心小学校发生风疹暴发,累计报告病例43例,均为在校学生,罹患率4.1%(43/1 040);男生罹患率较高,各年龄组罹患率类似;平均潜伏期11d,疫情持续15d,疫情呈中学向小学传播的趋势。43例均接种过麻疹疫苗,但未接种风疹疫苗;所有病例均有发热和出疹,有74.4%伴咳嗽,81.4%伴结膜炎,79.1%伴淋巴结肿大。于发病后1~11d采集血清标本32份,检测结果麻疹IgM抗体均阴性,风疹IgM抗体阳性率100%,风疹IgM抗体平均检出时间为发病后8d。结论风疹疫苗接种率低是疫情产生的根本原因;学生住宿拥挤、通风不良和报告不及时造成了疫情迅速蔓延。
Objective To analyze the causes and epidemic characteristics of the outbreak of rubella in mountainous areas and to guide the prevention and treatment work. Methods Epidemic data were described descriptive epidemiological analysis, and rubella IgM antibody was detected by enzyme-linked immunosorbent assay. Results From May 16 to May 30, 2013, outbreaks of rubella occurred in the middle schools and primary schools in Bajiao Town, Chuxiong City. A total of 43 cases were reported, all of whom were school-based students with an attack rate of 4.1% (43/1 040). The prevalence of boys was high The attack rate was similar in all age groups. The average incubation period was 11 days and the epidemic lasted for 15 days. The epidemic tended to spread to primary schools in secondary schools. Forty-three cases were vaccinated against measles but were not vaccinated against rubella. All cases had fever and rash with 74.4% with cough, 81.4% with conjunctivitis and 79.1% with lymph nodes. Serum samples were collected from 1 to 11 days after onset. The results showed that all measles IgM antibodies were negative, the positive rate of rubella IgM antibody was 100%, and the average detection time of rubella IgM antibody was 8 days after onset. Conclusions Low rates of rubella vaccination are the root causes of the outbreak; student accommodation is overcrowded, poor ventilation and inadequate reporting promptly cause the epidemic to spread rapidly.