宁波市2010-2014年水痘暴发疫情及其突破病例分析

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目的了解宁波市水痘暴发疫情及其突破病例的流行病学特征,为完善水痘防控措施提供依据。方法对2010-2014年宁波市水痘暴发疫情资料进行描述性分析。比较入学前和入学后以及不同学校类型学生水痘突破病例的初次免疫(初免)至发病时间间隔。结果 2010-2014年宁波市累计报告水痘暴发疫情28起,累计报告病例574例,平均发病率为1.98%(574/28 917)。宁波市水痘暴发疫情主要发生在春季(3~5月)和秋季(9~11月),分别占32.14%和45.83%。小学是水痘暴发疫情发生的主要场所,占全部暴发疫情的89.29%(25/28)。农村学校水痘暴发疫情共15起,占53.57%(15/28),平均发病率为2.66%,高于城市学校(1.56%)和城乡结合部学校(1.45%),P均<0.01。水痘突破病例中,入学前(1~2岁)接种水痘疫苗者初免至发病时间间隔[(6.38±2.14)年]长于入学后(≥3岁)接种者[(5.31±2.42)年](t=2.22,P=0.028);城市小学接种水痘疫苗者初免至发病时间间隔[(7.24±1.83)年]长于县镇小学[(6.46±2.00)年]和农村小学[(5.81±2.03)年](F=4.67,P=0.012)。结论应重点加强春秋季小学水痘防控工作,尤其应在农村学校中宣传水痘预防知识,并认真开展第2针水痘疫苗接种工作。 Objective To understand the epidemiological characteristics of varicella outbreaks and breakthrough cases in Ningbo and to provide evidences for the prevention and control of varicella. Methods Descriptive analysis was conducted on the data of outbreaks of chickenpox in Ningbo during 2010-2014. The initial immunization (initial immunization) compared with pre-admission and post-enrollment as well as cases of varicella in different school-type pupils was compared to the onset time interval. Results From 2010 to 2014, a total of 28 cases of chickenpox outbreaks were reported in Ningbo City. A total of 574 cases were reported, with an average incidence rate of 1.98% (574/28 917). The outbreak of chickenpox in Ningbo mainly occurred in spring (March-May) and autumn (September-November), accounting for 32.14% and 45.83% respectively. Primary schools were the major sites for occurrence of chickenpox outbreaks, accounting for 89.29% (25/28) of the total outbreaks. There were 15 outbreaks of chickenpox in rural schools, accounting for 53.57% (15/28) with an average incidence of 2.66%, higher than those in urban schools (1.56%) and urban-rural schools (1.45%) (P <0.01). Among the chickenpox breakthrough cases, pre-admission (1-2 years) pre-immunization time to episodes of varicella vaccine was longer (6.38 ± 2.14 years) than those vaccinated (≥3 years) after vaccination (5.31 ± 2.42 years) t = 2.22, P = 0.028). The duration of primary immunization of chickenpox vaccine in urban primary schools was significantly higher than that of primary school [(6.46 ± 2.00) years) and rural primary school (5.81 ± 2.03) Year] (F = 4.67, P = 0.012). Conclusion The prevention and control of chickenpox in primary and secondary schools in spring and autumn should be emphasized. In particular, knowledge of prevention of chickenpox should be disseminated in rural schools and the second vaccination of chickenpox should be carried out seriously.
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