中国福建省流行性腮腺炎暴发特点调查。

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2024-10-04 DOI:10.1016/j.vaccine.2024.126415

Ruihong Wu , Zhifei Chen , Xiuhui Yang , Yahong Chen , Danhong Chen , Hairong Zhang , Yong Zhou , Weiyi Pan , Dong Li

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引用次数: 0

摘要

目的：确定 2017 年至 2022 年期间福建省流行性腮腺炎暴发的具体情况和潜在原因：确定2017年至2022年期间福建省流行性腮腺炎暴发的具体情况和潜在原因：对中国国家应报传染病报告系统（NNCDRS）在5年观察期内报告的流行性腮腺炎病例按年度和年龄进行调查，以发现疾病随时间传播的同质性。如果可能出现特定的年龄峰值，我们将通过分析以暴发形式出现的流行性腮腺炎病例的群体特征来调查这些数字。这些特征包括人口统计（年龄和性别）、临床症状、地点和时间识别以及疫苗接种情况。关于疫苗接种情况，假设表现为暴发且出现在青壮年中的病例的疫苗接种覆盖率较低，且接种疫苗的时间较长：观察期间报告的流行性腮腺炎病例总数为 15 294 例，每年的发病率从 3.2/10 万到 8.0/10 万不等。在较大年龄组中，疾病的传播按年份和年龄（9 至 15 岁）表现为 20 次暴发，占 710 例，均发生在 2017 年至 2019 年期间。此后，这些疫情在该年龄组消失。群体特征表明，所有疫情都发生在学校环境中，中位年龄为 13 岁（6 至 19 岁）。82.7%的患者腮腺肿大。爆发持续时间的中位数为 28 天，从 14 天到 74 天不等。只有 27.6% 的病例至少接种过一剂腮腺炎病毒疫苗，在这些接种过疫苗的人中，94.9% 的人在接种疫苗 5 年后又患上了腮腺炎。2019 年后疫情大幅减少的原因可能是 COVID 期间采取的公共卫生措施和/或 2008 年（免费接种 1 剂疫苗）和 2020 年（接种 2 剂疫苗）对幼儿实施的新疫苗接种政策降低了病毒的传播率：2017-2019年期间在青壮年中观察到的流行性腮腺炎暴发导致了疾病高峰，这表明可能与疫苗接种覆盖率不理想以及接种疫苗间隔时间过长有关。由于这些疾病高峰自 2020 年以来已经消失，因此建议密切监测青壮年中的新疫情，以便为该年龄组启动新的疫苗接种策略。

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Investigating the characteristics of mumps outbreaks in Fujian Province, China

Objectives

Identifying the specifics and potential causes of mumps outbreaks in the Fujian Province during the period of 2017 to 2022.

Methods

Mumps cases reported by the National Notifiable Communicable Disease Report System (NNCDRS) in China during the observation period of the 5 years were investigated annually and by age to detect homogeneity of the spread of the disease over time. If specific age-peaks may appear, we investigated those figures by analysing group characteristics in mumps cases presented as outbreaks. Those characteristics include demography (age and sex), clinical symptoms, place and time identification, and vaccination status. Regarding the latter, it was hypothesized that cases manifesting an outbreaks and appearing in young adults should have a low vaccination coverage, and a long-lasting period since they received their vaccine.

Results

The total number of mumps cases reported during the observation period was 15,294, leading to incidence rates ranging from 3.2/100,000 to 8.0/100,000 per year. In the older age-group the disease spread by year and age (9 to 15y old) manifested 20 outbreaks accounting for 710 cases, all happening during 2017 to 2019. Thereafter those outbreaks disappeared in that age-group. The group characteristics specified that all the outbreaks happened in school settings, with a median age of 13y (range 6 to 19y). Parotid gland enlargement was observed in 82.7 %. The median duration of the outbreaks was 28 days, varying from 14 to 74 days. Only 27.6 % of the cases received at least one dose of the MuCV vaccine, and among these vaccinated individuals, 94.9 % developed mumps more than 5 years after vaccination. The dramatic reduction in outbreaks after 2019 could be explained by the public health measures taken during the COVID period and/or the new vaccination policy implemented in 2008 (free vaccination, 1 dose) and 2020 (2 doses) of young children causing therefore a lower rate of circulation of the virus.

Conclusion

Mumps outbreaks observed in young adults during 2017–2019 causing a disease peak, indicated a potential link to unsatisfactory vaccination coverage with prolonged interval since receiving the vaccine. As those disease peaks disappeared since 2020, close monitoring for new outbreaks in young adults is recommended that may initiate a new vaccination strategy for that age-group.

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

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