目的 分析皖西某寄宿制学校水痘暴发原因,并评估水痘疫苗保护效果。方法 制定统一调查问卷和病例定义,对该学校所有学生进行现场调查和描述流行病学分析,采用回顾性队列研究方法评估水痘疫苗保护效果。结果 学校共报告水痘病例40例,罹患率为5.33%(40/750),水痘疫苗接种率为52.74%(279/529),突破病例发生率为3.58%(10/279)。logistic多因素分析结果显示,寄宿制学生的发病风险是走读生的4.62倍(OR=4.62,95%CI:2.142~9.993)。1剂水痘疫苗总保护效果为69.35%(95%CI:35.80%~85.40%),对中重度水痘保护效果为83.84%(95%CI:26.40%-96.50%),接种疫苗5年内保护效果为100%,超过5年保护效果降至63.38%(95%CI:23.10%-82.60%)。结论 本次疫情发生与蔓延与水痘疫苗接种率低、1剂疫苗保护效果不好、寄宿制学生管理不善及病例隔离不规范有关。
Abstract
Objective To analyze the causes of varicella outbreak in a boarding school in western Anhui,and to evaluate the protective effect of varicella vaccine. Methods An on-site survey and descriptive epidemiological analysis on students of the school were conducted by developing a uniform questionnaire and case definition.A retrospective cohort study was used to evaluate the protective effect of varicella vaccine. Results A total of 40 varicella cases were reported in schools,with an attack rate of 5.33% (40/750),a vaccination rate of 52.74% (279/529),and a breakthrough cases rate of 3.58% (10/279).Multivariate Logistic regression analyses showed that the risk of boarding students was 4.62 times higher than that of day students (OR=4.62,95%CI:2.142-9.993).The total protective effect of one-dose varicella vaccine was 69.35% (95%CI:35.804-85.403)within the protective effect on moderate and severe varicella was 83.84% (95%CI:26.403-96.502).The protective effect was 100% within 5 years and the protective effect decreased to 63.38% (95%CI:23.104-82.603) over 5 years. Conclusion The occurrence and spread of this epidemic are related to the low vaccination rate of varicella vaccine,poor protection effect of one-dose varicella vaccine,poor management of boarding students and irregular isolation of cases.
关键词
水痘 /
疫苗接种 /
疫苗保护效果 /
暴发疫情 /
现场流行病学
Key words
Varicella /
Vaccination /
Protective effect of vaccine /
Outbreak /
Field epidemiology
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