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目的探讨天津市2004-2008年麻疹发病升高的原因,为防制麻疹提供科学依据。方法利用麻诊监测及调查资料对天津市近年麻疹流行特征、人群抗体、院内感染状况等进行分析。结果近5年来,天津市麻疹发病率从2004年的0.67/10万增至2008的年21.97/10万,发病年龄构成以婴儿和成人为主,占60%~,其中<1岁组麻疹发病率最高;1~6岁麻疹患者流动人口约占50%;2005-2008年,28起麻疹暴发疫情中,13起发生在企业。病例对照研究显示,医院内感染的OR=41.0(95%CI=17.2~97.8),2007年健康人群麻疹抗体阳性率为91.78%,保护率为75%。结论天津市近年来麻疹增高原因主要与接种率低、易感人群积累、继发性免疫失败、医院内感染、流动人口增加有关。
Objective To investigate the causes of the increased incidence of measles in Tianjin from 2004 to 2008 and provide a scientific basis for the prevention of measles. Methods The epidemiological characteristics of measles, population antibody and nosocomial infection in recent years were analyzed by using the information of monitoring and surveys. Results The incidence of measles in Tianjin increased from 0.67 / 100 000 in 2004 to 21.97 / 100 000 in 2008, and the age of onset was mainly infants and adults, accounting for 60% ~, of which measles The highest rate; 1 to 6-year-old migrant measles patients account for about 50%; 2005-2008, 28 outbreaks of measles outbreak, 13 occurred in the enterprise. Case-control studies showed that OR = 41.0 (95% CI = 17.2 ~ 97.8) in nosocomial infections. In 2007, the positive rate of measles antibody in healthy population was 91.78% and the protection rate was 75%. Conclusion The reasons for the increase of measles in Tianjin in recent years are mainly related to the low vaccination rate, the accumulation of susceptible people, the secondary immune failure, the hospital infection and the floating population increase.