摘要
[目的]分析重庆流行性脑脊髓膜炎的流行特征,了解人群免疫状况,预测发病趋势。[方法]收集重庆市2002～2005年流脑发病疫情报告资料。对2005年的病例及其密切接触者脑脊液、血液进行细菌培养。在2005年按东南西北中随机抽取5个区县作为流脑健康人群监测点,分9个年龄组人群,采集咽拭子及静脉血进行带菌调查及抗体水平检测。[结果]2000～2005年全市报告病例719例,病死率为3.34%,年发病率在0.26～0.57/10万之间波动。2～4月为发病高峰(占57.02%),年龄以小于10岁组为主(506例)。病例血清Nm抗体阳性率为31.25%(5/16),密切接触者阳性率为17.12%(19/111),病例和密切接触者流脑A群和C群抗体的阳性率差异均无统计学意义(χ2=0.54、1.11,P﹥0.05)。2005年5个监测点A群抗体阳性率为22.6%,GMT为1︰1.70;C群抗体阳性率为13.6%,GMT为1︰1.28,A群和C群抗体均阳性为5.70%。各监测点阳性率差异有统计学意义(χ2=104.6,P﹤0.01)。A群抗体水平与是否接种疫苗有关联性。而C群抗体和两群抗体水平与是否接种A+C疫苗接种无关联性。流脑病例样品阳性率为4.44%(2/45),A群和C群为主要流行株,病例密切接触者和健康人群均未检出Nm。[结论]重庆市流脑发病以散发为主,健康人群流脑IgG抗体的阳性率较低,提示大部分人对流脑易感。因此加强流脑监测,提高实验室检测能力和疫苗的有效接种是控制流脑流行的关键。
[Objective] To analyze the epidemic characteristic, understand the situation of population immunity and predict the tendency of epidemic cerebrospinal meningitis. [ Methods] Data were collected from reports of infection diseases in 2000-2005 in Chongqing city. CSF and blood from cases and closing contact persons were collected for bacterial culture of Nm in 2005.Throat swab and blood from healthy people in 5 districts or counties by 9 age groups were collected for investigation and test of germ-carrying and serological. [Results] 719 cases were reported in Chongqing including 24 deaths from 2000 to 2005. Fatality rate was 3.34%. The annual incidence rate fluctuated from 0.26 to 0.57/hundred thousand. The onset peak was between February and April every year （57.02%） . The incidence age was mainly lower than 10 （n = 506） . The positive rate of antibody in blood serum from cases was 31.25% （5/16） and that from closing contact persons was 17.12% （19/111） . The positive rate of group A and C antibody was not different between cases and closing contact persons （X^2= 0.54, 1.11, P 〉 0.05） . The positive rate of group A antibody was 22.6% and GMT was 1 ： 1.70. The positive rate of group C antibody was 13.60% and GMT was 1 ： 1.28. The positive rate of group A and C antibody was 5.70% in 5 monitoring sites in 2005. The positive rate was different in each monitoring site （X^2 = 104.6, P 〈 0.01） . The level of group A antibody was relevant with vaccination, but the level of group C, group A and C antibody was not relevant with vaccination of A＋C. The positive rate of epidemic meningitis cases was 4.44% （2/45）, The epidemic Nm was group A and group C, but no Nm was detected in closing contact persons and healthy people. [Conclusion] The onset of epidemic cerebrospinal meningitis is mainly in Chongqing. The positive rate of IgG antibody in healthy people was lower, which shows many people were vulnerable to epidenfic meningitis. So the key point to control the occurrence and epidemic of epidemic cerebrospinal meningitis is to enhance the serogroup surveillance, improve laboratory test capability and ensure the routine preventive vaccination.
出处
《现代预防医学》
CAS
北大核心
2007年第9期1652-1655,共4页
Modern Preventive Medicine
关键词
流行性脑脊髓膜炎
脑膜炎奈瑟菌
抗体
监测
Epidemic cerebrospinal meningitis
Neisseria meningitides
Antibody
Surveillance
