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为了掌握河北省 1999年麻疹流行病学特点 ,对 1999年麻疹监测系统病例报告及运转情况进行了分析 ,全年共报告麻疹疑似病例 5 40例 ,临床诊断 2 80例 ,实验室确诊 12 4例 ,实验室排除 136例。 40 4例麻疹分布在全省 11个市的 6 0个县 (市、区 ,下同 ) ,占总县数的 34 9% ,报告≥ 10例的县有 10个 ,占报告县数的 16 7%。 10个县共报告麻疹 2 44例 ,占病例总数的6 0 4% ,最多 1个县报告麻疹 49例 ,具有广泛分散又相对集中的特点。全年均有发病 ,3～ 5月为高发。病例男性多于女性 ,15岁以下儿童共发病 2 86例 ,占 70 8%。学龄前儿童和小学生为重点发病对象。 5 0 2 %病例有明确免疫史。病例临床症状以轻型为主 ,但 82 3 %的 15岁以下儿童病例合并以肺炎为主的并发症。针对病例的地域分布特征 ,提出 2 0 0 0年应在保定、沧州市开展针对 15岁以下儿童的麻疹疫苗初始强化免疫。分析相关年龄麻疹病例的免疫史 ,说明我省的常规免疫工作仍存在一些问题 ,要着重提高麻疹疫苗接种的及时性和接种质量。针对目前麻疹病例临床诊断标准灵敏度高、特异度低的特点 ,要加大病例的血清学诊断力度 ,针对监测系统存在的病例漏报、迟报问题 ,要通过增加人员培训和加强管理来逐步解决
In order to grasp the epidemiological characteristics of measles in 1999 in Hebei Province, the case report and operation status of measles monitoring system in 1999 were analyzed. A total of 540 cases of suspected measles cases, 280 cases of clinical diagnosis, 12 4 cases of laboratory diagnosis The laboratory excluded 136 cases. 40 4 cases of measles were distributed in 60 counties (cities and districts, the same below) of 11 cities in the province, accounting for 34.9% of the total number of counties, and 10 counties reporting ≥ 10 cases, accounting for 16 7%. A total of 444 measles cases were reported in 10 counties, accounting for 60.4% of the total number of cases. A maximum of 49 measles cases were reported in one county, with widespread and relatively concentrated characteristics. The incidence all year round, 3 to 5 for the high incidence. There were more cases of males than females, and 2 86 cases of children under 15 years old accounted for 70.8%. Preschool children and pupils as the focus of the disease. Fifty-two percent of cases had a clear history of immunization. The clinical symptoms were light, but 82.3% of children under 15 combined with pneumonia. According to the geographical distribution of the cases, it is proposed that the initial boost of measles vaccine against children under 15 should be carried out in Baoding and Cangzhou in 2000. Analysis of immunization history of measles cases of related age shows that there are still some problems in routine immunization work in our province. Emphasis should be placed on improving the timeliness and vaccination quality of measles vaccination. For the current clinical diagnostic criteria for measles cases with high sensitivity and low specificity, it is necessary to intensify the serological diagnosis of cases and to address the problems of underreporting and late reporting in the surveillance system and to gradually solve this problem by increasing personnel training and strengthening management