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Study on the Measles Epidemic Change and the Current Immunity Situation of Population in Jiading District

Author: ShiGuoZheng
Tutor: XuZuo；ZhongPeiSong
School: Fudan University
Course: Public Health
Keywords: Measles Epidemic Measles vaccine Vaccination rates Antibody positive rate Serum antibody levels
CLC: R181.8
Type: Master's thesis
Year: 2009
Downloads: 65
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Abstract

The first part of Jiading District, 1953 to 2007, the incidence of measles purpose to understand the epidemiological characteristics of measles outbreaks Jiading District, Jiading District, population-depth understanding of measles immunization status, effective prevention and control of measles to provide basic information. Methods to collect and analyze the Jiading District 1953 measles outbreak descriptive epidemiological analysis, focusing on the 1992 to 2007 measles outbreak reports and monitoring data. The results from 1953 to 2007: Jiading District registration measles cases reported a total of 50,594 cases. The incidence of measles from 1953 to 1965 continued at a high level, the average incidence rate of 884.84/10 million peak in 1959, more than 3000/100 000. Since 1966, the level of incidence declined rapidly from 1966 to 1981 the average annual incidence rate of 114.08/10 million, but the incidence in the fluctuations in state, by a big margin, a small peak in 1980, reached 606.30/10 million , followed by rapid decline, from 1982 to 1991 the average annual incidence rate of 0.62/100 000. 1992 to 2007: confirmed cases of measles, 503 cases, including 104 cases (20.7%) of cases of the local population, the incidence rate of 1.31/10 million cases of foreign population in 399 cases (79.3%), the incidence rate was 9.59/10 million. Epidemic on the rise, in sporadic foreign population incidence is always higher than the local population. A positive correlation between the measles total number of cases and the number of foreign population. The cases of the local population is mainly concentrated in adults over the age of 20 and 0 to 8-month-old infants, accounting for 83.65%; cases of foreign population is mainly concentrated in the August to 7-year-old children and adults over the age of 20, accounting for 72.43%. Locals mouth the highest incidence of 0 ~-year-old baby group reached 60.70/10 million, 20 - year-old group ranked second. Conclusion Since the use of the measles vaccine in 1965, Jiading District, an outbreak of measles generally get better control. The rebound in the 1992 epidemic, the age of onset tends to be \The native population is the focus and difficulty of Jiading District, measles control efforts. The second part of Jiading District, measles vaccination Objective To Jiading District local children and foreign children measles vaccination, to analyze the relationship between the incidence of measles vaccination. Collected in 2003 to investigate the vaccination rate and capacity proportional probability sampling (Probability Proportionate to Size Sampling PPS) method, selected local and foreign August to 210 4-year-old children, investigate measles vaccination. The results in 2003, Jiading District, local children measles vaccine investigation vaccination rate is higher than the native population. Jiading District in 2007 August to 4-year-old children measles MV1 (the beginning of the measles vaccine free vaccination) survey coverage was 98.33%, MV2 (measles vaccine revaccination) survey coverage was 94.41%, in each age group of local children MV1, MV2 vaccination rates and qualified vaccination rates were higher than the same age group of foreign children. The MV1 average vaccination-month-old local children to 8.44, 9.23 alien children. The The MV1, MV2 qualified the vaccination rate local children were 92.38% and 82.91%, 81.43% and 59.59% of foreign children. Local and foreign children the MV1 qualified inoculation rate difference was statistically significant, inoculated with MV and MMR (MMR vaccine) constitute significant than the difference between. The unvaccinated reason is premature inoculation (71.43%) and are not aware of the vaccination sites (28.57%). The conclusion local children and foreign children to measles vaccination is not balanced, the local Children's Vaccination foreign children immune barrier needs to be strengthened further. Should further strengthen publicity and education, and the timely implementation of the vaccination, good leak replant, eliminate immune blank. The third part of Jiading District, the healthy crowd measles antibody levels Objective To my area crowd measles serum antibody levels to explore the link between the measles antibody levels and incidence of different groups of people, to carry out measles immunization prevention efforts targeted focus groups. The general population of the method: select, Malu Town, Jiading District, many foreign population. Using cluster sampling method, in school, the enterprise in accordance with the principle of a workshop in the same class, the decimation of the local population and foreign population study; 8 - month-old group based on the sample size in the same vaccination clinics order continuous extraction treatment time . Pregnant women: the order in accordance with the length of stay in Jiading District Maternal and Child Health Hospital the continuous extraction October 10, 2007, the health of pregnant women in the hospital. Serum the sample IgG antibodies using the indirect method of enzyme-linked immunosorbent assay (ELISA) for detection. Result the general population: a total of 375 valid object of study, the local population of 188 people, 187 of the native population. Measles antibody positive rate was 89.60%, the positive rate of the local population and foreign population difference was not statistically significant. Each age group 8-month-old baby group measles antibody positive rate was the lowest, to 20-year-old, low positive rate of 30 to 40-year-old group. Antibody negative clear vaccination history proportion of 61.54%, 33.33% twice and over vaccination history. 8-month-old baby the sampling object inoculation time at intervals of not more than 10 days after the first dose positive rate of only 11.11%. The number of different inoculant crowd antibody positive rate difference was statistically significant, positive rate increased with the increase in the number of inoculant. Antibody positive subjects, the local population of antibody geometric mean titer (GMT) is lower than the native population, the difference was statistically significant; the antibody titers differences among age groups was statistically significant, the age group of 3 to a maximum of 1489.29 age are on a downward trend, but a sudden increase in the 30 to 40 age group. Pregnant women: 400 cases of pregnant women to extract a total of 395 maternal serum samples, including 197 local pregnant women and 198 foreign pregnant women. The survey shows that pregnant women measles antibody positive rate was 92.15%, 28.86% antibody negative and low level of protection (1:200). The local population of pregnant women, measles antibodies higher than the native population of pregnant women. Lower than the native population of pregnant women in the antibody-positive pregnant women, the local population of pregnant women antibody geometric mean titers (GMT). Conclusion Jiading District 8-month-old infants and adults over the age of 20 measles susceptible populations, especially the 8-month-old infant in the vaccine and the implementation of the body to produce immune response after vaccination, measles virus is quite susceptible, should strengthen such Protection of the population. Immunological failure circumstances, to further improve the quality of vaccination. Maternal measles antibody level of protection should be increased to reduce infant morbidity before vaccination. Part IV Summary and policy recommendations conclusion Jiading District measles the general activity rebounded in recent years. The age of onset tends to be \Maternal measles antibody level of protection is not high. Local children and foreign children inoculated unbalanced immune barrier needs to be further strengthened. The foreign population control and elimination of measles in the important and difficult Jiading District. The policy recommendations emphasis on measles control and elimination of work. Strengthen measles surveillance report management and timely disposal of the epidemic. Further development of the study of women of childbearing age before marriage are vaccinated against measles. Vigorously strengthen publicity and education. Strengthen the vaccination clinics standardized construction specification to carry out vaccination, strengthening quality control. Strengthen the foreign population management, to improve immunization policy enforcement effect.

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CLC: > Medicine, health > Preventive Medicine,Health > Epidemiology and Prevention of Disease > Epidemiology of the basic theory and methods > Outbreak management
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