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目的调查一起学校水痘暴发的流行因素,探讨水痘疫苗的保护效率。方法采用1∶1频数匹配病例对照研究方法,即以病例作为病例组,随机选择同班级、同性别,且无水痘患病史的相同数量未发病的健康学生作为对照组。使用自行设计的水痘危险因素调查表,对病例和对照进行问卷调查。结果此次疫情共报告32例水痘病例,总罹患率为0.80%。波及深圳市龙岗区某学校4个班级,其中二年级23例,五年级9例,各班罹患率差异有统计学意义(P<0.05);接种过水痘疫苗的病程时间(中位时间5 d)比未接种过水痘疫苗的病程时间(中位时间10 d)短;经常与其他年级或班级学生玩耍感染水痘的危险性是未与其他年级或班级学生玩耍的10.71倍,接触班里水痘病例的危险性是未接触的41.89倍;水痘疫苗的保护效率为6.76%,95%CI:10.00%～83.51%。接种进口水痘疫苗的罹患率远低于接种国产疫苗的罹患率(P<0.05)。结论这是一起发生在某小学的水痘暴发疫情,经常与其他班级或年级的学生玩耍以及水痘疫苗保护效率欠佳,是此次疫情暴发的危险因素。
Objective To investigate the prevalence of a chickenpox outbreak in school and to explore the protective efficiency of chickenpox vaccines. Methods A 1: 1 frequency matching case-control study was used. The control group consisted of the cases with the same number of non-onset healthy students of the same class, same sex and no chickenpox as the control group. Using a self-designed questionnaire of varicella risk factors, a questionnaire survey of cases and controls was conducted. Results A total of 32 chickenpox cases were reported in this epidemic, with a total attack rate of 0.80%. There were 4 classes in a school in Longgang District of Shenzhen City, including 23 cases in second grade and 9 cases in fifth grade. There was significant difference in the attack rate among classes (P <0.05). The duration of disease duration (median time 5 days ) Was shorter than the duration of the disease without the varicella vaccine (median 10 days). The risk of playing chickenpox frequently with other grade or class pupils was 10.71 times of that of other classes or students who had not been exposed to chickenpox The risk of non-contact was 41.89 times; the protection efficiency of chickenpox vaccine was 6.76%, 95% CI: 10.00% -83.51%. The incidence of vaccination against imported chickenpox vaccines was much lower than that of vaccinated domestic vaccines (P <0.05). Conclusions This is an outbreak of chickenpox occurring in a primary school. Frequent playing with other classes or grades of pupils and the ineffective protection of the varicella vaccine are risk factors for the outbreak.