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目的分析山东省1993～2006年麻疹发病年龄变化,为调整免疫和监测策略,实现消除麻疹目标提供依据。方法利用法定传染病报告系统和麻疹监测系统报告的数据,对山东省不同时期麻疹发病年龄特征进行描述性流行病学分析。结果1993～2006年各年麻疹年龄别发病率均以<7岁人群最高,其中<1岁人群近年来增加显著,由1993～1998年的7.68/10万增加到2005～2006年的77/10万;≥15岁人群发病率有逐渐上升趋势,1993～1998、1999～2004、2005～2006年,≥15岁人群发病率分别为0.26/10万、0.31/10万、1.96/10万。1～14岁病例分别占76.63%、57.53%、29.64%,构成比呈减少趋势,而<1岁病例构成明显上升,2005、2006年分别占19.65%、26.77%。爆发病例1993～1998年主要以学龄前和学龄儿童为主,2002年后较大规模的爆发多为成人,流动务工人群麻疹爆发是经济发展较快地区成人麻疹爆发的主要人群。1999～2004年人群抗体监测显示,15～19岁、20～39岁麻疹IgG抗体几何平均滴度低于其他年龄组,分别为1∶465.20和1∶426.51。结论山东省麻疹发病年龄由儿童为主逐渐向大年龄和未到免疫年龄人群转移,成人麻疹,特别是流动务工人员麻疹病例的增加给消除麻疹带来挑战,因此要达到消除麻疹目标,除要做好儿童常规免疫外,加强成人特别是流动人口麻疹监测和免疫具有重要意义。
Objective To analyze the changing age of measles in Shandong Province from 1993 to 2006, and to provide the basis for adjusting immunization and surveillance strategies and eliminating measles targets. Methods Using the reported data of the legal infectious disease reporting system and the measles monitoring system, the descriptive epidemiological characteristics of measles age at different periods in Shandong Province were analyzed. Results The age-specific incidence of measles in each year from 1993 to 2006 was the highest among those <7 years of age, of whom <1 year-old population increased significantly in recent years from 7.68 / 100000 in 1993-1998 to 77/10 in 2005-2006 The incidence of ≥15-year-olds has a gradual upward trend. The incidence rates of ≥15-year-olds from 1993 to 1998, from 1999 to 2004 and from 2005 to 2006 were 0.26 / 100000, 0.31 / 100000 and 1.96 / 100000 respectively. The cases of 1 ~ 14 years old accounted for 76.63%, 57.53% and 29.64%, respectively. The constituent ratio showed a decreasing trend, while the cases of <1 year old increased significantly, accounting for 19.65% and 26.77% respectively in 2005 and 2006. The outbreak cases were mainly preschool and school-age children from 1993 to 1998. The larger-scale outbreaks in 2002 were mostly adults. The outbreak of measles in migrant workers was the major population of adult measles outbreaks in economically developed areas. From 1999 to 2004, population antibody surveillance showed that the geometric mean titers of measles IgG antibodies between 15-19 years old and 20-39 years old were lower than other age groups, which were 1: 465.20 and 1: 426.51, respectively. Conclusion The onset age of measles in Shandong Province is gradually shifting from children to large age and not reaching immunization age. The increase of measles cases, especially the migrant workers’ measles cases, poses a challenge to eliminating measles. Therefore, to eliminate the measles target, In addition to routine immunization of children, it is of great significance to strengthen measles surveillance and immunization of adults, especially migrants.