论文部分内容阅读
目的了解浙江省2005年麻疹爆发疫情的流行因素,总结控制工作中的经验。方法描述流行病学分析浙江省麻疹流行近况;流行病学分析麻疹的流行因素,包括人群免疫状况、感染方式、传染源管理、麻疹病毒基因型和麻疹疫苗(MV)保护效力,对免疫干预措施效果进行评价。结果流动儿童MV接种率低于常住儿童,儿童家长文化程度低,对免疫规划缺乏了解,是限制需方主动获得免疫服务的原因。流出地未提供免疫服务,流入地卫生人力资源配置不足,是供方未及时对流动儿童提供第1针MV免疫服务的重要原因;不在学校接种MV,后期又无督促机制,严重影响MV第2针接种率。成人发生麻疹主要是由于既往未获得免疫,目前尚不能排除继发性免疫失败的可能。感染麻疹的主要因素为医院暴露、与病例接触、未接种MV。传染源管理目前存在薄弱环节。本次流行的麻疹毒株基因型仍为H1亚型,毒株虽发生了一些变异,但现用MV仍有很好保护效果。结论提高流动儿童MV接种率需要按照全人群比例配置卫生资源,多部门联合,或专门的“流动人口管理单位”管理。按卫生部新免疫程序针对2~6岁儿童开展MV接种,浙江省可通过对入托、入学查验预防接种证确保所有儿童完成全程接种。针对≥15岁成人麻疹的控制,尚需现场证据证明其有效和可行性。减少暴露机会、控制传染源等措施需引起重视。
Objective To understand the epidemic of outbreaks of measles in Zhejiang Province in 2005 and summarize the experience in control work. Methods Epidemiological analysis of epidemiological status of measles epidemic in Zhejiang Province; Epidemiological analysis of epidemiological factors of measles, including population immune status, infection patterns, infection source management, measles virus genotype and measles vaccine (MV) protection efficacy, immunization interventions Effect evaluation. Results The vaccination rate of migrant children was lower than that of the resident children. The low educational level of parents of children and lack of understanding of immunization programs were the reasons that restricted demand-side voluntary immunization services. Inadequate delivery of immune services to outflows and insufficient allocation of human resources to inflow areas is an important reason for the supply of MV vaccination services to migrant children in a timely manner. In the absence of MV vaccination in schools, there is no urgency mechanism in the latter part of the program, which seriously affects MV 2 Needle vaccination rate. Measles in adults is mainly due to the previous lack of immunization, the current failure to rule out the possibility of immune failure. The main factors of measles infection were hospital exposure, contact with the case and no vaccination. There are currently weak links in infection source management. The prevalence of measles strain genotype is still H1 subtype, although the strains of some variation, but the MV is still very good protection. Conclusion To improve the MV vaccination rate of migrant children, we need to allocate health resources, joint multisectoral, or specialized “floating population management units” according to the proportion of the whole population. According to the Ministry of Health new immunization program for children aged 2 to 6 years of MV vaccination, Zhejiang Province, through the admission, admission examination vaccination certificate to ensure that all children to complete the full vaccination. For measles control of ≥15 years of age, evidence is still needed on the spot to prove its effectiveness and feasibility. Measures such as reducing the chance of exposure and controlling the source of infection should be taken seriously.