廣州市2007年麻疹流行相關影響因素分析

Investigation on Epidemic Factors of Measles in Guangzhou, 2007

作者：云雪霞；許建雄；梁建華；譚慧峰

機構：廣州市疾病預防控制中心

【摘要】　目的　調查分析當前影響廣州市麻疹發病及流行的相關因素, 為麻疹的防制提供新的依據。方法　利用廣州市制定的《疑似麻疹病例個案補充調查表》對2007年3～9月廣州市12個區(縣級市) 1 562例麻疹病例個案調查資料進行分析, 重點通過對其病例前3 周的相關情況進行調查詢問, 包括臨床表現、近期免疫情況、免疫空白漏種原因、接觸史、發病前去醫院就診情況、本地居住時間等, 深入探討影響廣州市麻疹發病的主要因素。結果　并發癥的出現與否與發熱的程度沒有明顯關系(χ2 = 51175 4, P > 0105) ; 約4193% (77 /1 562) 的病例在麻疹發病的一個最長潛伏期內(病前3 周內) 曾接種過麻疹相關的疫苗, 其中接種麻疹單苗病例占47140%; 分析免疫空白病例漏種的主要原因前幾位依次為: 因病不能接種(42% ) 、不知道需要接種(2418% ) 等; 約8164% (13 /1 562) 的病例病前3周曾與麻疹病人有過接觸, 有30147% (476 /1 562) 的病例病前3 周曾去醫院就診, 48178% (762 /1 562) 的病例病前3 周曾乘坐不同的交通工具外出; 173 例3 周內遷來廣州的病例中, 來廣州后1 周內發病的占72125%(125 /173) , 其中2 例來穗途中即發病。結論　麻疹疫苗的接種與麻疹發病的關系是今后研究的一個方向; 因各種原因漏種麻疹疫苗、曾與麻疹病例接觸、暴露于醫院感染的機會、外出及流動人口進入均是麻疹發病的重要的影響因素, 也是今后麻疹控制的重點。

【Abstract】　Objective　To investigate the epidemic characteristics and influence factors of measles in Guangzhou and to offer new evidence for measles prevention and control.　Methods　The Supplementary Questionnaire of Suspect Measles Cases was used in 1562 cases from 12 districts of Guangzhou city from March to September. The main factors influencing prevalence of measles were analyzed through investigation of clinical manifestation, immune status, contact history, outpatient visit history, blank immunization history, and so on.　Results　No correlation was found between febrility and complications (χ² = 5.175 4, P = 0.159). Of the 1562 reported measles cases, 77 (4.93%) had been inoculated with vaccines of measles. The main reasons for subjects having blank immunization history were: cannot be inoculated with vaccines because of illness, and not aware of measles vaccine inoculation. There were 8.64% ( 135 /1562 ) of the cases who had contacted with measles cases, 30.47% (476 /1562) of the cases who had outpatient visit history three weeks before measles onset and 48.78% (762 /1562) of the cases who had gone out 3 weeks before sick. Of 173 cases migrated to Guangzhou within recent 3 weeks, 125 (72.25% ) cases fell ill in 1 week after migration and 2 fell ill on the way.　Conclusion　Relationship between inoculation of measles vaccine and measles onset needs further study. Blank immunization history, touching with measles cases, exposure to hospital infection, out going and migration were all important influencing factors of measles prevalence, and there of the targets of the measles control.

【關鍵詞】　麻疹；流行因素；計劃免疫

【Key words】　Measles; Epidemic Factor; Planned immunity

中文刊名： 中國預防醫學雜志, 2009年 07期

中圖分類號：R51111　　　文獻標識碼：A　　　文章編號：1009 - 6639 ( 2009) 07 - 0592 - 03