常州市2006～2015年麻疹流行病学及临床特征分析
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摘要
目的探讨本地区麻疹的流行病学特征及临床特点,为预防和控制麻疹提供依据。方法回顾性分析2006～2015年我科收治的631例麻疹患者的临床资料。结果 2008年以后本地区麻疹流行强度减弱,流行季节主要集中冬春季,发病年龄主要集中在<8个月～<4岁和20～<30岁;发病人群以外来流动人口和散居儿童为主;209例(33.1%)患者发病前有麻疹接触史,接种过麻疹疫苗者85例(13.5%);所有患者均有发热,均出现皮疹,体温峰值>39℃患者536例(84.9%);麻疹患者出现不同程度的肝损害和心肌损害,麻疹病毒抗体IgM阳性率高;治疗以抗病毒及对症、支持为主,所有患者均治愈出院,未出现死亡病例。结论近年本地区麻疹的发病强度、年龄分布、临床特征等方面均出现一些新变化,加强免疫接种,积极隔离及治疗患者,对控制和消除麻疹具有重要意义。
Objective To explore the epidemiological and clinical characteristics of measles in this area, and to provide evidence for the prevention and control of measles. Methods The clinical data of 631 patients with measles admitted to our department from 2006 to 2015 were retrospectively analyzed. Results After 2008, the epidemic intensity of measles in this area decreased, and the epidemic season mainly concentrated in winter and spring, the onset age of measles mainly concentrated in <8 months to 4 years old and 20 to 30 years old. Morbidity population and diaspora children are the main groups of the patients. 209 cases(33.1%) had a history of measles exposure before onset, and 85 cases(13.5%) had been vaccinated against measles. All patients had fever and rash, 536 patients(84.9%) had peak body temperature >39℃. Measles patients had different degrees of liver damage and myocardial damage, and the positive rate of measles virus antibody IgM was high. Antiviral therapy, symptomatic treatment and support were the main treatment. All patients were cured and discharged without death. Conclusion In recent years, there have been some new changes in the intensity, age distribution and clinical characteristics of measles in this region. Strengthening immunization, active isolation and treatment of patients are of great significance in controlling and eliminating measles.
Objective To explore the epidemiological and clinical characteristics of measles in this area, and to provide evidence for the prevention and control of measles. Methods The clinical data of 631 patients with measles admitted to our department from 2006 to 2015 were retrospectively analyzed. Results After 2008, the epidemic intensity of measles in this area decreased, and the epidemic season mainly concentrated in winter and spring, the onset age of measles mainly concentrated in <8 months to 4 years old and 20 to 30 years old. Morbidity population and diaspora children are the main groups of the patients. 209 cases(33.1%) had a history of measles exposure before onset, and 85 cases(13.5%) had been vaccinated against measles. All patients had fever and rash, 536 patients(84.9%) had peak body temperature >39℃. Measles patients had different degrees of liver damage and myocardial damage, and the positive rate of measles virus antibody IgM was high. Antiviral therapy, symptomatic treatment and support were the main treatment. All patients were cured and discharged without death. Conclusion In recent years, there have been some new changes in the intensity, age distribution and clinical characteristics of measles in this region. Strengthening immunization, active isolation and treatment of patients are of great significance in controlling and eliminating measles.
引文
[1]龚震宇,龚训良.2000~2015年全球麻疹消除的进展趋势[J].疾病监测,2017,32(3):263-264.
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[4]张秀山,吴义城,钱全,等.2005~2013年我国麻疹流行病学分析[J].军事医学,2015,39(5):360-363.
[5]Gans H,Yasukawa L,Rinki M,et al.Immune responses to measles and mumps vaccination of infants at 6,9,and 12months[J].J Infect Dis,2001,184(7):817-826.
[6]Kumar ML,Johnson CE,Chui LW,et al.Immune response to measles vaccine in 6-month-old infants of measles seronegative mothers[J].Vaccine,1998,16(20):2047-2051.
[7]姚婷新,谷芬,廖亦男,等.某院248例麻疹患儿的临床特征[J].中国感染控制杂志,2018,17(5):432-435.
[8]马超,郝利新,苏琪茹,等.中国2014年麻疹流行病学特征分析[J].疾病监测,2015,30(10):818-823.
[9]白杉,穆金萍.2005-2014年沈阳市麻疹流行特征分析[J].现代预防医学,2016,43(2):214-218,222.
[10]许燕,刘元宝,孙翔,等.江苏省2010-2016年麻疹流行病学特征分析[J].江苏预防医学,2017,28(6):662-664.
[11]Ackerman Z1,Flugelman MY,Wax Y,et al.Hepatitis during measles in young adults:possible role of antipyretic drugs[J].Hepatology,1989,10(2):203-206.
[12]梁海涛.小剂量干扰素α治疗儿童麻疹的效果观察[J].中国当代医药,2018,25(35):80-82.
[13]Naim HY.Measles virus:a pathogen, vaccine, and a vector[J].Hum Vaccin Immunother,2015,11(1):21-26.
[14]李海涛,孙静静,谷翠梅.麻疹疑似病例血清麻疹病毒IgM抗体检测结果的分析与报告[J].中国处方药,2016,14(8):135-136.
[15]任博,盛琳君,万钢,等.北京地坛医院2008-2016年麻疹疑似病例IgM抗体检测结果分析[J].国际检验医学杂志,2017,38(20):2889-2891.
[2]WHO.Measles[EB/OL].http://www.who.int/mediacentre/factsheets/fs286/en,2017-08-07.
[3]余文,赵智娴,李立群,等.云南省2006~2015年麻疹流行特征与消除麻疹措施分析[J].中国疫苗和免疫,2016,22(6):632-636.
[4]张秀山,吴义城,钱全,等.2005~2013年我国麻疹流行病学分析[J].军事医学,2015,39(5):360-363.
[5]Gans H,Yasukawa L,Rinki M,et al.Immune responses to measles and mumps vaccination of infants at 6,9,and 12months[J].J Infect Dis,2001,184(7):817-826.
[6]Kumar ML,Johnson CE,Chui LW,et al.Immune response to measles vaccine in 6-month-old infants of measles seronegative mothers[J].Vaccine,1998,16(20):2047-2051.
[7]姚婷新,谷芬,廖亦男,等.某院248例麻疹患儿的临床特征[J].中国感染控制杂志,2018,17(5):432-435.
[8]马超,郝利新,苏琪茹,等.中国2014年麻疹流行病学特征分析[J].疾病监测,2015,30(10):818-823.
[9]白杉,穆金萍.2005-2014年沈阳市麻疹流行特征分析[J].现代预防医学,2016,43(2):214-218,222.
[10]许燕,刘元宝,孙翔,等.江苏省2010-2016年麻疹流行病学特征分析[J].江苏预防医学,2017,28(6):662-664.
[11]Ackerman Z1,Flugelman MY,Wax Y,et al.Hepatitis during measles in young adults:possible role of antipyretic drugs[J].Hepatology,1989,10(2):203-206.
[12]梁海涛.小剂量干扰素α治疗儿童麻疹的效果观察[J].中国当代医药,2018,25(35):80-82.
[13]Naim HY.Measles virus:a pathogen, vaccine, and a vector[J].Hum Vaccin Immunother,2015,11(1):21-26.
[14]李海涛,孙静静,谷翠梅.麻疹疑似病例血清麻疹病毒IgM抗体检测结果的分析与报告[J].中国处方药,2016,14(8):135-136.
[15]任博,盛琳君,万钢,等.北京地坛医院2008-2016年麻疹疑似病例IgM抗体检测结果分析[J].国际检验医学杂志,2017,38(20):2889-2891.