铜川市流行性乙型脑炎发病特征分析

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目的了解铜川市乙脑发病特征及人群抗体水平,为有效防控乙脑提供科学依据。方法采用描述流行病学方法,对铜川市乙脑病例进行统计分析,并在铜川市宜君县随机抽取健康人群采集静脉血检测乙脑中和抗体。结果铜川市1960-2012年共报告乙脑病例649例,死亡59例,年均发病率为2.07/10万,死亡率为0.19/10万,病死率为9.09%。发病呈明显的季节特点,近年来职业分布上以农民、民工为多,15岁以上人群病例占总病例数的93.10%,年龄别发病率以60岁以上人群最高;共采集健康人群血样216对,乙脑流行季节前,健康人群中和抗体阳性率24.07%,抗体几何平均滴度(GMT)1∶3.04;流行季节后,健康人群乙脑中和抗体阳性率为26.39%,抗体几何平均滴度(GMT)1∶3.29,流行季节前后中和抗体阳性率和抗体几何平均滴度差异均无统计学意义。结论乙脑疫苗接种是铜川市预防乙脑最有效的途径,铜川市健康人群乙脑抗体水平主要受疫苗接种影响。在做好适龄儿童免疫接种的同时,对成人也应开展乙脑疫苗强化免疫,建立整个人群的免疫屏障。 Objective To understand the etiopathogenisis of JE in Tongchuan City and the level of human antibody in order to provide a scientific basis for the effective prevention and control of JE. Methods Descriptive epidemiological methods were used to analyze the epidemic of JE in Tongchuan City. The healthy volunteers were randomly selected from Yi Jun County, Tongchuan City to collect the venous blood for the detection of JE neutralizing antibodies. Results From 1960 to 2012, a total of 649 JE cases were reported in Tongchuan City, 59 of them died. The average annual incidence rate was 2.07 / 100,000. The mortality rate was 0.19 / 100,000 and the case fatality rate was 9.09%. The incidence was obvious seasonal characteristics. In recent years occupational distribution to peasants, migrant workers, more than 15 years of age cases accounted for 93.10% of the total number of cases, age-related morbidity to 60 years of age the highest population; a total of 216 healthy blood samples were collected , The positive rate of neutralizing antibody in healthy population was 24.07% and the geometric mean antibody titer (GMT) was 1: 3.04 before the epidemic of JE. The positive rate of JE antibody in healthy population was 26.39% after the epidemic season, and the geometric mean antibody drop (GMT) 1: 3.29, the prevalence of neutralizing antibody before and after the epidemic season and antibody geometric mean titer had no statistical significance. Conclusion JE vaccination is the most effective way to prevent JE in Tongchuan City. The JE antibody level in healthy population of Tongchuan City is mainly affected by the vaccination. While doing a good job of immunization of children of the same age, we should also carry out the JE vaccine strengthening immunity to adults and establish an immunological barrier to the entire population.
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