论文部分内容阅读
目的对一起发生在小学的流行性腮腺炎(流腮)爆发疫情开展流行病学调查,评估疫情防控措施和含腮腺炎成分疫苗(Mumps-containing Vaccine,MuCV)保护效果。方法在发生流腮爆发的湖北省某镇中心小学开展回顾性队列调查,由所有学生的家长自填问卷并收集儿童预防接种证,以搜索病例、核实每名儿童既往流腮患病史和MuCV免疫史信息。采取二代罹患率法测算疫苗保护效果。结果向全校890名学生发放问卷,应答率为99.9%(889/890),搜索到90例流腮病人,其中89例为学生、1例为教师,全校学生罹患率为10.0%(89/890)。首例病例2015年3月9日发病,最后1例6月16日发病,其中,高年级(4~6年级)学生罹患率(5.2%)低于低年级(1~3年级)(13.9%)(P<0.001)。估算接种≥1剂MuCV保护效果为56.5%(95%CI:20.3%~76.2%),接种1剂MuCV后≤3年、4~5年和≥6年的保护效果分别为71.9%(95%CI:27.9%~89.1%)、61.0%(95%CI:19.0%~81.3%)、37.3%(95%CI:-83.0%~78.5%)。结论本起疫情发生和持续蔓延与在校学生MuCV接种率低、接种1剂疫苗保护效果不理想、采取的控制措施不足以阻断流腮病毒持续传播有关。建议在提高适龄儿童MuCV覆盖率的同时,应尽早考虑论证实施2剂MuCV常规免疫程序。
Objective To carry out an epidemiological investigation on the outbreak of mumps (mumps) in primary schools together to evaluate the prevention and control measures and the protective effect of Mumps-containing Vaccine (MuCV) vaccine. METHODS: A retrospective cohort study was conducted in a town center elementary school in Hubei Province where flow bursts broke out. Parents of all students self-completed the questionnaire and collected child vaccination certificates to search for cases and verify past history of each child’s gout and MuCV Immunization history information. Take the second generation attack rate method to measure the vaccine protection effect. Results A questionnaire was sent to 890 students in the whole school. The response rate was 99.9% (889/890). 90 mumps patients were found, of whom 89 were students and 1 was teacher. The attack rate was 10.0% (89/890 ). The first case was onset on March 9, 2015 and the last case was on June 16, in which the prevalence of high school students (grades 4-6) was lower (5.2%) than that of lower grades (grade 1-3) (13.9% ) (P <0.001). MuCV protection was 56.5% (95% CI: 20.3% -76.2%) when vaccinated with ≥1 dose, and was less than 3 years after vaccination with 1 dose of MuCV, 71.9% (95% CI: 27.9% -89.1%), 61.0% (95% CI: 19.0% -81.3%) and 37.3% (95% CI: -83.0% -78.5%). CONCLUSIONS: The vaccination coverage of MuCV was low and the protective effect of one vaccine was unsatisfactory. The control measures taken were not enough to prevent the continuous transmission of mumps virus. Proposed to improve coverage of MuCV school-age children should consider as early as possible to demonstrate the implementation of two routine MuCV immunization program.