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目的探索新时期麻疹流行的特点和规律。方法收集2007年春季沁源县麻疹暴发流行的传染病报告卡、个案调查和实验室报告资料,进行临床表现、流行病学特征分析。结果沁源县2007年3月15日～4月27日共确诊麻疹93例,罹患率58.59/10万。病例主要集中在沁源二中及其附近3个乡镇,平均年龄17.3岁,男女比例为1:0.7,职业分布以中小学生发病率最高,有免疫史者66例;93例全部有发热和全身皮疹,但发现口腔黏膜斑和退疹后有色素沉着糠麸样脱皮的分别有13例和26例。结论本次疫情为一起带入性麻疹暴发流行,沁源二中防控机制不健全及应对措施不当是疫情扩散的重要原因;常规免疫疏漏、原继发免疫失败是流行的根本原因。应进一步完善传染病防控机制,切实保障冷链正常运转,在继续做好麻疹常规免疫的同时要加强重点人群的加强免疫,传染病疫情公布方式应改进。
Objective To explore the characteristics and laws of the epidemic of measles in the new era. Methods The infectious disease report card, case investigation and laboratory report were collected from the epidemic of measles in Qinyuan County in spring 2007, and the clinical manifestations and epidemiological characteristics were analyzed. Results Qinyuan County, March 15, 2007 to April 27 were diagnosed with 93 cases of measles, the attack rate of 58.59 / 100,000. The cases mainly concentrated in Qinyuan No.2 Middle School and its nearby three townships, with an average age of 17.3 years. The male-female ratio was 1: 0.7. The occupational distribution was highest in primary and secondary school students with 66 cases of immunization history. All 93 cases had fever and systemic The rash, however, found that there were 13 and 26 cases, respectively, of pigmentation and bran-like peeling after oral mucosal plaque and debridement. Conclusions The outbreak was a contagious measles outbreak, the imperfect mechanism of prevention and control of Qinyuan II and improper coping measures were the important reasons for the spread of the epidemic. Conventional immunological omission and failure of the original secondary immunization were the root causes of the epidemic. The mechanism of prevention and control of infectious diseases should be further perfected to ensure the normal operation of the cold chain. While continuing the routine immunization of measles, it is necessary to step up the immunization of key populations, and the ways of publicizing the epidemic situation of infectious diseases should be improved.