摘要
目的分析北京市东城区2013—2023年水痘发病的流行特征及2017—2023年托幼儿童和学生水痘病例水痘疫苗免疫效果,为优化东城区水痘防控措施及水痘疫苗免疫规划策略提供参考。方法收集2013—2023年中国疾病预防控制信息系统报告的东城区水痘病例,对相关资料进行描述流行病学分析;收集2017—2023年北京市免疫规划信息管理系统报告的东城区托幼儿童和学生水痘病例,对水痘疫苗免疫效果进行分析。结果2013—2023年东城区累计报告水痘病例4184例,无死亡病例,年均发病率为44.52/10万。2013—2019年发病率相对平稳,年均发病率为50.72/10万,2019年发病508例,发病率为61.80/10万,发病数和发病率均达到峰值。2020—2023年发病率明显降低,年均发病率为30.72/10万。男性发病率为46.61/10万,高于女性的42.54/10万,差异有统计学意义(χ^(2)=8.757,P=0.003)。<1岁年龄组年均发病率最高,为244.73/10万(140例)。学生、幼托儿童和散居儿童共2131例,占总病例的50.93%,但成人病例占比在2013—2019年、2020—2022年和2023年不断升高。发病呈现比较典型的季节性,除2020年春季发病高峰消失外,其余各年分别在每年的4—6月和10月至次年1月出现发病高峰。2017—2023年托幼儿童和学生水痘病例中接种过水痘疫苗的病例发热风险更低(χ^(2)=4.142,P=0.045),皮疹程度更轻(χ^(2)=9.954,P=0.006);接种过2剂次水痘疫苗的病例比接种过1剂次的发热风险更低(χ^(2)=6.390,P=0.011),皮疹程度更轻(χ^(2)=10.387,P=0.004)。接种1剂次水痘疫苗的病例中,接种时间距发病时间间隔3年以上者,占84.06%(385/458);接种2剂次水痘疫苗的病例中,第2剂接种时间距发病时间间隔3年以上者,占75.74%(128/169)。结论建议学校和托幼机构在发病高峰到来前做好健康宣教,高峰期严格落实各项防控措施;继续维持水痘疫苗高覆盖率,进一步提高2剂次水痘疫苗接种率;将第2剂水痘疫苗接种、成人水痘疫苗接种纳入免费应急接种程序,以有效控制水痘的传播和流行。
Objective To analyze the epidemic characteristics of chickenpox incidence in Dongcheng district of Beijing,from 2013 to 2023 and the immunization effect of chickenpox vaccine on kindergarten children and students with chickenpox from 2017 to 2023,so as to provide references for optimizing chickenpox prevention and control measures and chickenpox vaccine immunization program strategies in Dongcheng district.Methods Chickenpox cases reported in Dongcheng district via the Chinese Disease Prevention and Control Information System from 2013 to 2023 were collected,and descriptive epidemiological analysis was conducted on the relevant data;Cases of chickenpox among kindergarten children and students in Dongcheng district reported by the Beijing Immunization Planning Information Management System from 2017 to 2023 were collected,and the immunization effect of chickenpox vaccine was analyzed.Results A total of 4184 chickenpox cases were reported in Dongcheng district from 2013 to 2023,with no deaths and an average annual incidence rate of 44.52 per 100000 population.From 2013 to 2019,the incidence rate was relatively stable(average annual incidence rate:50.72 per 100000 population).In 2019,both the number of cases(508 cases)and the incidence rate(61.80 per 100000 population)reached the peak.From 2020 to 2023,average annual incidence rate was 30.72 per 100000 population and the incidence rate decreased significantly.The incidence rate in males was higher than that in females,and the difference in incidence rate between different genders was statistically significant(46.61/100000 vs 42.54/100000,χ^(2)=8.757,P=0.003).The average annual incidence rate was the highest in the<1 year-old age group,at 244.73 per 100000 population(140 cases).Students,kindergarten children,and scattered children accounted for 50.93%(2131 cases)of the total cases,but the proportion of adult cases continued to increase in the periods of 2013—2019,2020—2022,and 2023.The incidence showed a typical seasonal pattern.Except that the spring incidence peak disappeared in 2020,the incidence peaks occurred in April—June and October-January of the following year in other years.Among kindergarten children and students with chickenpox from 2017 to 2023,those who had been vaccinated against chickenpox had a lower risk of fever(χ^(2)=4.142,P=0.045)and milder rash(χ^(2)=9.954,P=0.006);Compared with those who received 1 dose of chickenpox vaccine,cases who received 2 doses had a lower risk of fever(χ^(2)=6.390,P=0.011)and milder rash(χ^(2)=10.387,P=0.004).Among cases who received 1 dose of chickenpox vaccine,84.06%(385/458)had an interval of more than 3 years between vaccination and onset;Among cases who received 2 doses of chickenpox vaccine,75.74%(128/169)had an interval of more than 3 years between the second dose vaccination and onset.Conclusions It is recommended that schools and kindergarten institutions conduct health education before the arrival of the incidence peak and strictly implement various prevention and control measures during the peak period;Continue to maintain a high coverage rate of chickenpox vaccine and further increase the vaccination rate of 2 doses of chickenpox vaccine;Include the vaccination of the second dose of chickenpox vaccine and adult chickenpox vaccine into the free emergency vaccination program to effectively control the transmission and prevalence of chickenpox.
作者
白宏伟
汪静
孙昊
刘金萌
BAI Hongwei;WANG Jing;SUN Hao;LIU Jinmeng(Dongcheng District Center for Disease Control and Prevention,Beijing 100009,China)
出处
《首都公共卫生》
2025年第6期398-402,共5页
Capital Journal of Public Health
关键词
水痘
流行病学
水痘疫苗
Chickenpox
Epidemiology
Varicella vaccine
