Epidemiological characteristics and trend prediction of varicella in Fujian Province from 2014 to 2018
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摘要:
目的 了解2014-2018年福建省水痘疫情流行情况并进行发病预测,为调整水痘防控策略提供依据。 方法 收集福建省2014-2018年中国传染病报告信息管理系统的水痘病例资料及突发公共卫生事件管理信息系统的水痘突发事件报告资料,进行统计描述和分析。 结果 福建省2014-2018年累计报告58 934例水痘病例,年均发病率30.65/10万,2014-2018年水痘发病率呈上升趋势(F=20.055, P=0.021)。水痘发病季节性明显,呈“双峰分布”,5-6月及11月至次年1月为发病高峰;发病人群主要集中在<15岁儿童,占总病例数的66.28%;男性水痘年均发病率(32.68/10万)高于女性(28.57/10万)(χ2=52.895, P < 0.001);职业以学生为主,占45.75%。同期共报告水痘突发公共卫生事件183起,波及208 809人,平均罹患率为2.08%,事件发生地主要在小学(71.04%)。通过自回归移动平均(autoregressive integrated moving average, ARIMA)模型预测出2019年11月及12月的病例数分别为3 834例、5 369例,均超过2018年发病人数。 结论 福建省水痘疫情呈上升态势。应加强水痘疫情的防控工作,尤其应在高发季节加强重点人群(<15岁儿童)和重点机构(小学)的防控措施。 Abstract:Objective To analyse the epidemiological characteristics and to predict the cases of varicella in Fujian Province in 2014-2018. This would provide a scientific evidence for varicella prevention and control strategies. Methods Varicella case data was collected from China Infectious Disease Report Information Management System. Varicella emergency report data was collected from Public Health Emergency Management Information System. ArcGIS 10.2 and R 3.4.3 software were used to perform statistical description and analysis. Results A total of 58 934 cases of varicella were reported in Fujian Province from 2014 to 2018. The average annual incidence was 30.65/100 000, with a rising trend from 2014 to 2018(F=20.055, P=0.021); The incidence of varicella was significantly seasonal with a bimodal distribution. The incidence peak was from May to June and from November to January in the following year. The majority of the patients were children under 15 years old, accounting for 66.28% of the total cases. The average annual incidence of varicella in males (32.68/100 000) was higher than that in females (28.57/100 000)(χ2=52.895, P < 0.001); The main occupation of patients were students, accounting for 45.75%. 183 public health emergencies of varicella involving 208 809 people were reported during the same period. The average attack rate was 2.08% and mainly occurred in primary schools, accounting for 71.04%. According to the autoregressive integrated moving average (ARIMA) model, the number of varicella cases in November and December in 2019 were predicted to be 3 834 and 5 369, respectively, both of them exceeded the number of cases in the same month in 2018. Conclusions The varicella epidemic situation is on the rise in Fujian Province. Therefore, the prevention and control strategies should be strengthened, especially for the key groups (children under 15 years old) and in the key institutions (primary schools) during the peak incidence seasons. -
Key words:
- Varicella /
- Epidemiological characteristics /
- Outbreak /
- Prediction
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表 1 2014-2018年福建省各地区水痘突发事件报告情况[n(%)]a
Table 1. Report on varicella emergencies in various regions of Fujian Province from 2014 to 2018[n(%)]a
地区 2014年 2015年 2016年 2017年 2018年 合计 厦门 6(35.29) 7(25.00) 7(31.82) 19(32.76) 16(27.59) 55(30.05) 漳州 4(23.53) 7(25.00) 3(13.64) 15(25.86) 5(8.62) 34(18.58) 三明 4(23.53) 3(10.71) 2(9.09) 10(17.24) 9(15.52) 28(15.30) 龙岩 2(11.76) 5(17.86) 3(13.64) 6(10.34) 8(13.79) 24(13.11) 福州 0(0.00) 1(3.57) 0(0.00) 3(5.17) 11(18.97) 15(8.20) 宁德 1(5.88) 4(14.29) 1(4.55) 2(3.45) 6(10.34) 14(7.65) 南平 0(0.00) 0(0.00) 3(13.64) 1(1.72) 1(1.72) 5(2.73) 莆田 0(0.00) 1(3.57) 2(9.09) 1(1.72) 0(0.00) 4(2.19) 泉州 0(0.00) 0(0.00) 0(0.00) 1(1.72) 2(3.45) 3(1.64) 平潭 0(0.00) 0(0.00) 1(4.55) 0(0.00) 0(0.00) 1(0.55) 合计 17(100.00) 28(100.00) 22(100.00) 58(100.00) 58(100.00) 183(100.00) 注:a括号外为水痘突发事件报告数,括号内为构成比。 表 2 2014-2018年福建省水痘突发事件报告发生地分布情况[n(%)]
Table 2. Report on the distribution of varicella emergencies in Fujian Province from 2014 to 2018 [n(%)]
事件发生地 农村 城市 合计 小学 60(32.79) 70(38.25) 130(71.04) 幼儿园 16(8.74) 7(3.83) 23(12.57) 其他学校 -a -a 30(16.39) 合计 -a -a 183(100.00) 注:a调查时其他学校的农村和城市分类数据未统计。 表 3 福建省2019年1-12月份水痘发病数预测情况
Table 3. Prediction of the incidence of varicella in Fujian Province from January to December 2019
月份(月) 预测值(例) 实际值(例) 相对误差(%) (80% CI)值 (95% CI)值 1 2 733 2 581 -5.56 (2 171,3 441) (1 922,3 887) 2 1 414 1 137 -19.59 (1 051,1 904) (898,2 228) 3 1 765 1 057 -40.11 (1 292,2 411) (1 096,2 844) 4 1 967 1 295 -34.16 (1 430,2 705) (1 208,3 202) 5 2 744 1 666 -39.29 (1 975,3 811) (1 660,4 535) 6 2 655 1 932 -27.23 (1 885,3 740) (1 572,4 484) 7 2 073 - - (1 451,2 963) (1 201,3 580) 8 1 400 - - (967,2 027) (795,2 465) 9 1 333 - - (910,1 952) (744,2 389) 10 2 086 - - (1 409,3 090) (1 144,3 804) 11 3 834 - - (2 560,5 743) (2 067,7 111) 12 5 369 - - (3 546,8 130) (2 847,10 126) -
[1] Gershon AA, Gershon MD, Breuer J, et al. Advances in the understanding of the pathogenesis and epidemiology of herpes zoster [J]. J ClinVirol, 2010, 48(S1):S2-S7. DOI: 10.1016/s1386-6532(10)70002-0. [2] 王美红, 晁慧, 王波纹, 等.在校大学生水痘142例临床分析[J].中国病原生物学杂志, 2009, 4(7):537-559. DOI: 10.13350/j.cjpb.2009.07.017.Wang MH, Chao H, Wang WB, et al. Clinical analysis of 142 cases of chickenpox among undergraduates [J]. Journal of Pathogen Biology, 2009, 4(7):537-559. DOI: 10.13350/j.cjpb.2009.07.017. [3] 随海田, 李锦成, 王淼, 等. 2005-2015年中国水痘流行病学特征[J].中国疫苗和免疫, 2019, 25(2):155-159.Sui HT, Li JC, Wang M, et al. Varicella epidemiology in China, 2005-2015 [J]. Chin J Vaccin Immuno, 2019, 25(2):155-159. [4] 周爱庆, 潘铭, 马永法. 2013-2017年盐城市盐都区水痘流行特征和疫苗接种[J].中国校医, 2018, 32(11):846-848. http://www.cnki.com.cn/Article/CJFDTotal-XIYI201811022.htmZhou AQ, Pan M, Ma YF. Epidemiological characteristics and vaccination status of varicella in Yandu District, Yancheng City, 2013-2017 [J]. Chin J School Doctor, 2018, 32(11):846-848. http://www.cnki.com.cn/Article/CJFDTotal-XIYI201811022.htm [5] 吴德平, 许建雄, 傅传喜, 等.广州市2006~2012年水痘流行病学特征分析[J].中国疫苗和免疫, 2014, 20(5):450-453. http://www.cnki.com.cn/Article/CJFDTotal-ZGJM201405022.htmWu DP, Xu JX, Fu CX, et al. Epidemiological Characteristics of Varicella in Guangzhou, 2006-2012 [J]. Chin J Vaccin Immuno, 2014, 20(5):450-453. http://www.cnki.com.cn/Article/CJFDTotal-ZGJM201405022.htm [6] 郑庆鸣, 曾华堂, 王铁强, 等.深圳市一起学校水痘暴发的现场流行病学调查[J].中华流行病学杂志, 2013, 34(9):906-910. DOI: 10.3760/cma.j.issn.0254-6450.2013.09.011.Zheng QM, Zeng HT, Wang TQ, et al. Field epidemiological study on a varicella outbreak among schoolchildren in Shenzhen [J]. Chin J Epidemiol, 2013, 34(9):906-910. DOI: 10.3760/cma.j.issn.0254-6450.2013.09.011. [7] 庞红, 王晨, 江燕, 等.学校水痘暴发中水痘疫苗保护率的比较[J].中国生物制品学杂志, 2015, 28(1):68-71. DOI: 10.13200/j.cnki.cjb.000730.Pang H, Wang C, Jiang Y, et al. Comparison of varicella vaccine effectiveness during outbreak in a primary school [J]. Chin J Biologicals, 2015, 28(1):68-71. DOI: 10.13200/j.cnki.cjb.000730. [8] 麦冰, 陈抒豪, 黄劲梅, 等.水痘疫苗在学校暴发疫情中保护效果的回顾性队列研究[J].微生物学免疫学进展, 2013, 41(1):20-22. DOI: 10.3969/j.issn.1005-5673.2013.01.005.Mai B, Chen SH, Huang JM, et al. A retrospective cohort study on the effetiveness of varicella vaccine against varicella outbreak in school [J]. Prog in Microbiol Immunol, 2013, 41(1):20-22. DOI: 10.3969/j.issn.1005-5673.2013.01.005. [9] 王长双, 路明霞, 马雅婷, 等.河南省2008-2012年学校及托幼机构水痘突发公共卫生事件流行病学特征分析[J].中国儿童保健杂志, 2014, 22(1):74-76.Wang CS, Lu MX, Ma YT, et al. Analysis of epidemiological characteristics of varicella public health emergencies at schools and childcare facilities of Henan province, 2008-2012 [J]. Chin J Child Health Care, 2014, 22(1):74-76. [10] 赫欣, 刘畅, 崔明辰, 等.河南省健康人群水痘-带状疱疹病毒抗体水平调查[J].中国公共卫生, 2015, 31(10):1301-1303. DOI: 10.11847/zgggws2015-31-10-19.He X, Liu C, Cui MC, et al. Serum level of varicella-zoster virus antibody among healthy residents in Henan province [J]. Chin J Public Health, 2015, 31(10):1301-1303. DOI: 10.11847/zgggws2015-31-10-19. [11] 董彦宏, 时念民, 李丽, 等.北京市朝阳区健康人群水痘-带状疱疹病毒抗体水平调查[J].中国生物制品学杂志, 2017, 30(5):509-513. DOI: 10.13200/j.cnki.cjb.001736.Dong YH, Shi NM, Li L, et al. Investigation on varicella-zoster virus antibody level in healthy population in Chaoyang District, Beijing City, China [J]. Chin J Biologicals, 2017, 30(5):509-513. DOI: 10.13200/j.cnki.cjb.001736. [12] 范仁锋, 张吉凯, 汤妍, 等.水痘及其疫苗的研究进展[J].华南预防医学, 2016, 42(4):390-395. DOI: 10.13217/j.scjpm.2016.0390.Fan RF, Zhang JK, Tang Y, et al. Advances in the study of chicken pox and its vaccine [J]. South China J Prev Med, 2016, 42(4):390-395. DOI: 10.13217/j.scjpm.2016.0390. [13] 李玺琨, 高晓丽, 李岩, 等. 2016年哈尔滨市1~19岁健康人群水痘血清流行病学调查[J].中国当代儿科杂志, 2019, 21(3):203-207. DOI: 10.7499/j.issn.1008-8830.2019.03.003.Li XK, Gao XL, Li Y, et al. Seroepidemiology of varicella among the healthy population aged 1-19 years in Harbin, China [J]. Chin J Contemp Pediatr, 2019, 21(3):203-207. DOI: 10.7499/j.issn.1008-8830.2019.03.003. [14] 潘兴强, 马瑞, 方挺, 等.不同流行强度的2331例水痘突破病例流行病学研究[J].中国预防医学杂志, 2017, 18(7):490-492. DOI: 10.16506/j.1009-6639.2017.07.003.Pan XQ, Ma R, Fang T, et al. Epidemiological study on 2 331 breakthrough varicella cases with different epidemic intensity [J]. Chin Prev Med, 2017, 18(7):490-492. DOI: 10.16506/j.1009-6639.2017.07.003. [15] 随海田, 姚建有, 林权惠, 等.福建省漳浦县2015年一起小学水痘暴发的现场调查[J].中国疫苗和免疫, 2016, 12(6):642-615. http://www.cnki.com.cn/Article/CJFDTotal-ZGJM201606009.htmSui HT, Yao JY, Lin QH, et al. Field investigation of a varicella outbreak in a primary school of Zhangpu County, Fujian Province, 2015 [J]. Chin J Vaccin Immuno, 2016, 12(6):642-615. http://www.cnki.com.cn/Article/CJFDTotal-ZGJM201606009.htm