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[目的]调查分析北京市城区高水痘疫苗覆盖率幼儿园发生的水痘暴发疫情。[方法]对2007年北京市朝阳区100%水痘疫苗覆盖率幼儿园水痘暴发疫情进行流行病学分析。[结果]①9例病例中3例皮损为中度,其余都是轻度,分布在两个班、两个楼层,班级罹患率存在统计学上的差异。②暴露群体的疫苗覆盖率为100%,接种时年龄的中位数为15个月,接种后免疫间隔的中位数为49个月。9名患儿的免疫间隔集中在3～4年,免疫间隔≥4年者发生水痘的概率是免疫间隔﹤4年者的2倍。③暴露班级的抗体检测结果:4名学生水痘IgM抗体阳性,46名学生水痘IgG抗体阳性。病例的IgG抗体全部为阳性,抗体含量均值为(2000.00±509.09)mIU/ml,IgM抗体有4人为阳性,抗体含量均值(13.28±24.31)U/ml。[结论]①虽然突破性水痘的临床症状轻微,但仍具有传染性。②100%的疫苗覆盖率,未能预防水痘的暴发。③在高疫苗接种率群体,除预防接种外,隔离和排查也是疫情控制中非常有效的防控措施。④单剂接种国产减毒水痘活疫苗的免疫保护期到底有多长、是否应该开展2剂接种是需要继续研究的问题。
[Objective] To investigate and analyze the outbreak of chickenpox in kindergarten with coverage of high chickenpox in Beijing city. [Method] The epidemiology of chickenpox outbreak in kindergarten with 100% chickenpox vaccine coverage in Chaoyang District in 2007 was analyzed. [Results] ① The lesions in 3 of 9 cases were moderate and the others were mild. There were statistically significant differences in the attack rates of the two classes and the two floors. (2) The vaccination coverage of the exposed groups was 100%, the median age at vaccination was 15 months, and the median immunization interval after vaccination was 49 months. Nine children with immunization intervals of 3 to 4 years, immunization interval ≥ 4 years, the probability of occurrence of chickenpox immunosuppression <4 years, 2 times. ③ exposure class antibody test results: 4 students were positive for chickenpox IgM antibodies, 46 students were positive for chickenpox IgG antibodies. All the cases were positive for IgG antibody. The average antibody level was (2000.00 ± 509.09) mIU / ml. There were 4 positive IgM antibodies with antibody mean (13.28 ± 24.31) U / ml. [Conclusion] ① Although the clinical symptoms of breakthrough chicken pox are slight, they are still contagious. ② 100% vaccine coverage, failed to prevent the outbreak of chickenpox. ③ In the high vaccination rate group, in addition to vaccination, isolation and investigation is also a very effective prevention and control measures in epidemic control. ④ single-dose inoculation of live attenuated varicella vaccine in the end how long the immune protection, whether it should be carried out 2 vaccination is the need to continue to study the issue.