本文關(guān)鍵詞： 麻疹 成人 暴發(fā) 應(yīng)急接種　出處：《中國(guó)疫苗和免疫》2017年02期 　論文類(lèi)型：期刊論文

【摘要】：目的分析云南省德欽縣1起成人麻疹暴發(fā)的原因,評(píng)價(jià)防控措施的效果。方法對(duì)疑似麻疹患者進(jìn)行個(gè)案調(diào)查,收集病例血清和咽拭子/尿液標(biāo)本,開(kāi)展血清學(xué)和病原學(xué)檢測(cè)。在全縣范圍內(nèi)開(kāi)展發(fā)熱和/或出疹病例的主動(dòng)搜索,采用回顧性隊(duì)列研究分析引起暴發(fā)的主要因素。在首例病例報(bào)告4天后開(kāi)展20-40歲人群含麻疹成分疫苗(MCV)應(yīng)急免疫,并評(píng)價(jià)免疫后麻疹抗體水平。結(jié)果在42例麻疹暴發(fā)病例中,來(lái)自毗鄰地區(qū)就診病例23例,德欽本地病例19例。89.47%的德欽本地病例為20-40歲成人。病例的9株麻疹病毒分離株經(jīng)鑒定為H1a基因型。在搜索的發(fā)熱和/或出疹病例中,有明確病例接觸史者中麻疹發(fā)病比例(10.1%,16/158)高于無(wú)病例接觸史者(0.3%,3/1 209),且75%(12/16)的有明確病例接觸者為醫(yī)院暴露。德欽縣20-40歲人群累計(jì)應(yīng)急接種MCV 10 596人,接種后人群麻疹I(lǐng)gG抗體陽(yáng)性率為100%,幾何平均滴度為1∶1 452.87,疫情得到有效控制。結(jié)論本起成人暴發(fā)主要為易感人群的累積和院內(nèi)感染引起。盡早開(kāi)展以應(yīng)急接種為主的綜合防控措施可以迅速控制疫情。
[Abstract]:Objective to analyze the causes of an adult measles outbreak in Deqin County, Yunnan Province, and to evaluate the effect of prevention and control measures. Methods the suspected measles patients were investigated and the serum and throat swabs / urine samples were collected. Carry out serological and etiological tests. Active search for fever and / or rash cases throughout the county, A retrospective cohort study was used to analyze the main factors leading to the outbreak. Four days after the first case was reported, emergency immunization with measles vaccine (MCV) was carried out in the population aged 20-40 years, and the level of measles antibody after immunization was evaluated. Results in 42 cases of measles outbreak, Of the 23 cases from adjacent regions, 19 cases were Dachin local cases. 89.47% of Dachin local cases were adults aged 20-40 years. Nine isolates of measles virus were identified as H1a genotypes. In the search for fever and / or rash cases, The incidence rate of measles in those with a definite history of case contact was 10.1 / 158) higher than that of those with no history of contact with a case of 0.33 / 1 209, and 75 / 12 / 16) of those who had definite case contacts were exposed to hospital exposure. In Deqin County, 10 596 people aged 20 to 40 were vaccinated in an emergency emergency response. The positive rate of measles IgG antibody and geometric average titer were 1: 1 452.87 and 1: 1 452.87, respectively. Conclusion the adult outbreak is mainly caused by the accumulation of susceptible population and nosocomial infection. Comprehensive prevention and control measures can quickly control the epidemic.
【作者單位】： 云南省疾病預(yù)防控制中心;
【分類(lèi)號(hào)】：R181.3;R511.1

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