Gao Jie, He Han-qing, Shen Ji-chuan, Huang Zhi-yong, Ma Hui-lai, Luo Shu-ying, Chen En-fu
Chinese Field Epidemiology Training Program (CFETP), Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2010 Oct;31(10):1163-5.
On July 6, 2010, the parents of a patient with confirmed measles reported several suspected measles patients with fever and rash in their village. An investigation was carried out to verify and understand the cause of the outbreak.
Several suspected cases had an onset of fever and rash in this and other neighboring villages during June 1 to August 3, 2010. A confirmed case was a suspected case with measles-specific IgM identified in the serum. We conducted door-to-door visits and searched the Chinese Center for Disease Control and Prevention Information System to identify cases, also conducted a retrospective cohort study among migrant children aged 8 months-14 years to identify risk factors related to measles.
We identified 19 measles cases (17 confirmed case, 2 suspected cases) in the village, and all of them were migrants. Children aged 1-2 years had the highest attack rate (13%). The primary case-patient had onset on the day she arrived in this village (June 4, 2010). Caretakers from an unlicensed private clinic were providing service in the village but did not report the outbreak to the public health authority. The outbreak was identified only after receiving a report from the parents of one of the patients, by that time the outbreak had lasted for one month. The measles vaccine coverage rate was 81% among the 315 migrant children aged 8 months-14 years. Among the 61 unvaccinated children, those who reportedly being contacted a measles patient had a higher attack rate (14/16, 88%) than those who did not (2/45, 4.4%) (Relative risk = 20, Fisher's exact 95% confidence interval: 5.7-94).
The low measles vaccine coverage among migrant children and lack of measures taken on the incident, timely isolation diagnosis/reporting by the caretakers from the unlicensed private clinic etc. had contributed to this prolonged outbreak. Measures need to be taken to improve the immunization services for migrant populations and to enhance measles surveillance programs in the area.
2010年7月6日，一名确诊麻疹患者的家长报告称其所在村庄有几例疑似麻疹患者出现发热和皮疹症状。开展了一项调查以核实并了解此次疫情的起因。
2010年6月1日至8月3日期间，在这个村庄及其他邻近村庄有几例疑似病例出现发热和皮疹症状。确诊病例为血清中检测出麻疹特异性IgM的疑似病例。我们进行了逐户走访，并在中国疾病预防控制中心信息系统中搜索以确定病例，还对8个月至14岁的流动儿童进行了回顾性队列研究，以确定与麻疹相关的危险因素。
我们在该村庄确定了19例麻疹病例（17例确诊病例，2例疑似病例），所有病例均为流动儿童。1至2岁儿童的发病率最高（13%）。首例病例患者于抵达该村庄当天（2010年6月4日）发病。一家无证私人诊所的护理人员在该村庄提供服务，但未向公共卫生当局报告此次疫情。仅在收到其中一名患者家长的报告后才发现此次疫情，此时疫情已持续了一个月。在315名8个月至14岁的流动儿童中，麻疹疫苗接种率为81%。在61名未接种疫苗的儿童中，据报告接触过麻疹患者的儿童发病率（14/16，88%）高于未接触过的儿童（2/45，4.4%）（相对风险=20，Fisher精确检验95%置信区间：5.7 - 94）。
流动儿童麻疹疫苗接种率低以及对该事件未采取措施、无证私人诊所的护理人员未及时隔离诊断/报告等因素导致了此次疫情的长期蔓延。需要采取措施改善针对流动人群的免疫服务，并加强该地区的麻疹监测项目。
