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目的分析海南省2010年麻疹疫苗强化免疫活动中疑似预防接种异常反应(Adverse Events Following Immunization,以下简称AEFI)监测和与处置情况,为今后大型疫苗强化免疫活动或应急免疫活动预防接种异常反应监测工作提供策略依据。方法全省建立疑似病例救治绿色通道,所有疑似病例通过全省AEFI监测系统上报,同时送定点医院免费救治,及时进行调查诊断,采用描述性流行病学方法分析AEFI个案数据,评价处置效果。结果本次强化免疫共监测报告AEFI 573例,报告发生率为7.41/万;一般反应报告发生率为4.70/万,异常反应为1.42/万,偶合症为1.09/万;76.79%AEFI在接种后24h内发生,就诊后24h内报告率达94.07%,报告后48h内调查率达99.65%。86.4%异常反应临床诊断为过敏性皮疹,发生率为1.07/万;其它较严重反应为过敏性紫癜、脓疱疹、热性惊厥、血管性水肿和血小板减少性紫癜,发生率分别为0.03/万、0.03/万、0.02/万、0.01/万和0.01/万。15例严重的AEFI中,异常反应9例,占60%,偶合症4例,不明原因2例;除一例偶合病毒性心肌炎死亡外,其它均治愈或好转。结论强化免疫活动建立敏感的AEFI监测系统、医疗机构绿色救治通道、及时处置AEFI病例非常关键,针对不明原因的、偶合症的病例需进一步实验室诊断准备,才能保证强化免疫工作的顺利开展。
Objective To analyze the surveillance and treatment of suspected adverse immunization (AEFI) in measles vaccine 2010 in Hainan Province, and to monitor the surveillance of abnormal vaccination in large-scale vaccine or emergency vaccination in the future Provide a strategic basis. Methods The province established a green channel for the treatment of suspected cases. All suspected cases were reported by the AEFI monitoring system in the province. Free medical treatment was sent to the designated hospitals for investigation and diagnosis in time. The data of AEFI cases were analyzed by descriptive epidemiology to evaluate the treatment effect. Results A total of 573 AEFI cases were reported with an incidence of 7.41 / million and a generalized response rate of 4.70 / million with an abnormal reaction rate of 1.42 / million with a combined incidence of 1.09 / million. AEFI of 76.79% Within 24 h, the report rate reached 94.07% within 24 hours after treatment and the investigation rate reached 99.65% within 48 hours after the report. 86.4% of the abnormal reactions were clinically diagnosed as allergic rash, the incidence was 1.07 / million; other more serious reactions were allergic purpura, impetigo, febrile seizures, angioedema and thrombocytopenic purpura, the incidence was 0.03 / million , 0.03 / million, 0.02 / million, 0.01 / million and 0.01 / million. Among 15 severe AEFI patients, 9 cases were abnormal reaction, accounting for 60%, 4 cases of coupled disease and 2 cases of unknown cause. All cases were cured or improved except one case of viral myocarditis death. Conclusions It is very important to establish a sensitive AEFI surveillance system, green channel for medical treatment and prompt disposal of AEFI cases in intensive immunization activities. For unknown reasons, cases of complications need further laboratory diagnosis and preparation to ensure the smooth development of intensive immunization.