贺旭英 马敬仓

[摘要] 目的 分析菏泽市2015年麻疹监测与疫情特点，以期指导菏泽市麻疹监测和疫情应急处理工作，为消除麻疹工作提供基础信息。 方法 对2015年麻疹监测系统（MSS）数据进行描述分析，采用ELISA法、实时荧光RT-PCR法分别检测血清标本麻疹IgM抗体、病毒核酸，对病原学标本进行麻疹病毒分离。 结果 2015年报告麻疹疑似病例（MLI）400例，其中，麻疹236例，发病率为2.87/10万。MLI血清标本、病原学标本采集率分别为86.25%、8.75%，样本及时送达率分别为92.84%、87.50%。病原学标本中，麻疹病毒核酸检出率为65.52%，分离1株麻疹病毒，为H1a型；各县区均有麻疹发病；3岁以下年龄组病例占52.12%，≥20岁年龄组占31.36%；麻疹病例中，无麻疹疫苗接种史者100例，占42.37%。 结论 2015年菏泽市MSS运转正常，麻疹发病率仍不稳定，要重视<8月龄、成人群体的麻疹发病情况，要继续落实以提高麻疹疫苗接种率为重点的技术措施。

[关键词] 麻疹；监测；病毒；控制；实验室

[中图分类号] R511.1 [文献标识码] A [文章编号] 1673-7210（2016）03（c）-0096-04

[Abstract] Objective To analyze the characteristics of measles surveillance and epidemic in Heze City in 2015， in order to guide measles surveillance and emergency handling work， and to provide the basic information for confirming measles elimination. Methods Descriptive analysis was conducted for the data of MSS in 2015. ELISA method and real-time RT-PCR were respectively used to test serum specimens for measles IgM antibody and viral nucleic acid. Measles virus isolation was conducted in the pathogenic samples. Results 400 measles-like illnesses （MLI） were reported in 2015， 236 cases confirmed measles with the incidence （per 100 000） 2.87. The collecting rates of blood serum samples and pathogen specimens of the MLI were 86.25% and 8.75%， and the timely delivery rates were 92.84% and 87.50%. The positive rate of measles virus nucleic acid was 65.52% in the pathogenic samples. 1 strain of measles virus was isolated， type H1a confirmed. There were measles in all counties and districts. The groups aged under 3 year old accounted for 52.12%， and the groups aged 20 years and above accounted for 31.36%. Of all measles cases， there were 100 cases with no measles vaccination history， accounting for 42.37%. Conclusion MSS runs normally in Heze City in 2015， and the incidence of measles is still unstable. The measles situations among the groups aged under 8 months and among the adults should be paid more attention， also should do more efforts to implement the technical measures， among which the key measure is to raise the coverage rate of measles vaccination.

[Key words] Measles； Surveillance； Virus； Control； Laboratory

麻疹是世界衛生组织（world health organization，WHO）重点控制的传染病之一，WHO为控制麻疹等传染病的流行于1974年提出了“扩大免疫规划”，在全世界普遍应用麻疹疫苗以后，其发病和死亡均出现了大幅度下落，2002年WHO美洲区麻疹控制取得重要进展[1-2]。WHO于2012年发布了消除麻疹证实的框架文件，麻疹监测的意义更加重要[3]。近年来，菏泽市麻疹监测系统根据消除麻疹的要求，不断改进工作，落实提高各种监测指标[4-6]。为评估菏泽市2015年麻疹监测系统（measles surveillance system，MSS）监测能力，对2015年数据进行分析报道如下：

1 资料与方法

1.1 一般资料

菏泽市MSS资料来自中国疾病预防控制系统及其麻疹监测信息报告管理系统，为个案调查信息和实验室检测结果形成的数据库。……