目的 分析《上海市水痘疫苗应急接种实施方案(2013年-2014年试行版)》(以下简称《方案》)执行前后,闵行区水痘爆发疫情的变化情况,评价水痘减毒活疫苗应急接种的作用.方法 通过横断面调查收集”中国疾病预防控制信息系统“中报告的闵行区水痘暴发疫情监测的相关资料.《方案》执行前后的观察期分别为2012年1月1日至2013年6月30日和2013年7月1日至2014年12月31日.结果 《方案》执行前,闵行区共报告水痘疫情14起,均上升为爆发疫情,持续时间最长的82天,平均每起疫情持续50.86天(712/14),累计代次2.42代(50.86/21),发病159人,总罹患率为1.26％ (159/12 625),班级罹患率为9.09％ (159/1 750),每起疫情平均发病11.36人(159/14),平均发病班级3.21个(45/14);《方案》执行后,闵行区共报告水痘疫情169起,其中22起上升为爆发疫情,持续时间最长的66天,平均每起疫情持续41.32天(909/22),累计代次1.97代(41.32/21),发病200人,总罹患率1.10％ (200/18 200),班级罹患率为8.38％ (200/2387),每起疫情平均发病9.09人(200/22),平均发病班级2.50 (55/22)个.虽然《方案》执行后,闵行区水痘疫情大幅度增加,但是水痘爆发疫情在水痘疫情中的占比明显下降,总罹患率、班级罹患率,疫情最长持续时间、平均持续时间、累计代次,每起疫情平均发病人数、平均发病班级数等均有不同程度下降,平均持续时间差异有统计学意义(x2=4.06,P＜0.05).结论 高危人群中水痘疫苗应急接种能有效控制疫情蔓延范围,降低续发病例发生的可能性.%Objective To analyze the changes of varicella outbreak in Minhang District before and after practicing "the varicella emergency vaccination implementation program (2013-2014 trial version),Shanghai",and to evaluate the effects of live attenuated vaccine against varicella.Methods We used cross-sectional investigation to collect monitoring data of vaticella outbreak recorded in "China Information System for Disease Control and Prevention".The observation periods before and after the implementation of the program were during 2012-01-01 to 2013-06-30 and during 2013-07-01 to 2014-12-31.Results Before the implementation of the program,14 cases of varicella epidemic were reported in Minhang District.All cases were up to the outbreaks in the epidemic,the longest duration was 82 days,the average duration continued was 50.86 days (912/14),the average cumulative generation was 2.42 generations (50.86/21),the total number of people was 159,the total incidence rate was 1.26％ (159/12 625),the class incidence rate was 9.09％ (159/1 750),the average number of people was 11.36 (159/14),the average number of class was 3.21 (45/14).After the implementation of the program,169 cases of the varicella epidemic were reported in Minhang District,only 22 cases rose to the outbreaks in the epidemic,the longest duration was 66 days,the average duration continued was 41.32 days (909/22),the average cumulative generation was 1.97 generations (41.32/21),the total number of people was 200,the total incidence rate was 1.10％ (200/18 200),the class incidence rate was 8.38％ (200/2 387),the average number of people was 9.09 (200/22),the average number of class was 2.50 (55/22);Although the varicella epidemic in the total outbreaks had significantly increased in Minhang District before and after emergency implementation,but the varicella outbreak in the varicella epidemic significantly decreased,the total incidence rate,the class incidence rate,the longest duration,the average duration,the average cumulative generation,the average number of people and the average number of class had decreased in varying degrees.There is statistical difference between the average duration before and after the implementation (x2 =4.06,P＜0.05).Conclusions Emergency vaccination of varicella vaccine in high risk population can effectively control the spread of epidemic situation and reduce the possibility of secondary transmission.
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