Seward Jane F, Watson Barbara M, Peterson Carol L, Mascola Laurene, Pelosi Jan W, Zhang John X, Maupin Teresa J, Goldman Gary S, Tabony Laura J, Brodovicz Kimberly G, Jumaan Aisha O, Wharton Melinda
Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, Mailstop E-62, Atlanta, GA 30333, USA.
JAMA. 2002 Feb 6;287(5):606-11. doi: 10.1001/jama.287.5.606.
Before licensure of varicella vaccine in 1995, varicella was a universal childhood disease in the United States, causing 4 million cases, 11,000 hospitalizations, and 100 deaths every year.
To examine population-based disease surveillance data in 3 communities to document the impact of the varicella vaccination program.
DESIGN, SETTING, AND SUBJECTS: Active surveillance for varicella conducted among the populations of Antelope Valley, Calif; Travis County, Tex; and West Philadelphia, Pa; from January 1, 1995, to December 31, 2000. Reporting sites included child care centers, schools, universities, physicians, public health clinics, hospitals, emergency departments, and households.
Trends in number and rate of varicella cases and hospitalizations; varicella vaccine coverage.
From 1995 through 1998, in each surveillance area, the number of verified varicella cases varied from year to year with marked springtime seasonality. In 1999, the number and rates of varicella cases and hospitalizations declined markedly. From 1995 through 2000, in Antelope Valley, Travis County, and West Philadelphia, varicella cases declined 71%, 84%, and 79%, respectively. Cases declined to the greatest extent among children aged 1 to 4 years, but cases declined in all age groups, including infants and adults. In the combined 3 surveillance areas, hospitalizations due to varicella declined from a range of 2.7 to 4.2 per 100,000 population in 1995 through 1998 to 0.6 and 1.5 per 100,000 population in 1999 and 2000, respectively (P =.15). By 2000, vaccine coverage among children aged 19 to 35 months was 82.1%, 73.6%, and 83.8% in Los Angeles County, Texas, and Philadelphia County, respectively.
Varicella disease has declined dramatically in surveillance areas with moderate vaccine coverage. Continued implementation of existing vaccine policies should lead to further reductions of varicella disease in these communities and throughout the United States.
在1995年水痘疫苗获得许可之前，水痘在美国是一种常见的儿童疾病，每年导致400万例病例、11000例住院治疗和100例死亡。
研究3个社区基于人群的疾病监测数据，以记录水痘疫苗接种计划的影响。
设计、地点和研究对象：1995年1月1日至2000年12月31日期间，对加利福尼亚州羚羊谷、得克萨斯州特拉维斯县和宾夕法尼亚州西费城的人群进行水痘主动监测。报告地点包括日托中心、学校、大学、医生、公共卫生诊所、医院、急诊科和家庭。
水痘病例数和发病率以及住院率的趋势；水痘疫苗接种覆盖率。
1995年至1998年，在每个监测地区，确诊的水痘病例数逐年变化，具有明显的春季季节性。1999年，水痘病例数和发病率显著下降。1995年至2000年，在羚羊谷、特拉维斯县和西费城，水痘病例分别下降了71%、84%和79%。1至4岁儿童的病例下降幅度最大，但所有年龄组（包括婴儿和成人）的病例均有所下降。在这3个监测地区的综合数据中，水痘住院率从1995年至1998年每10万人2.7至4.2例，分别降至1999年和2000年的每10万人0.6例和1.5例（P = 0.15）。到2000年，洛杉矶县、得克萨斯州和费城县19至35个月龄儿童的疫苗接种覆盖率分别为82.1%、73.6%和83.8%。
在疫苗接种覆盖率中等的监测地区，水痘疾病显著下降。继续实施现有疫苗政策应会导致这些社区以及整个美国的水痘疾病进一步减少。
