Measles Epidemic Trend And A Case-control Study On Dissemination Factors In Changzhou

Background: It have made significant achievements on comprehensive measures ofreduction measles in China, measles outbreaks decline significantly, but there are stillsome areas sustained transmission of measles virus, Especially for small-month-old andadult measles susceptibility is still inconclusive, such as infection and transmissiondynamics of measles in the role of technical problems such as elimination of measles.Purpose: To investigate susceptibility factors of measles in the different agegroups, and explore the possible immunization measures for adults and adjustment forthe measles immunization early age and the impact on the incidence of small age, etc.,to provide reliable support for the theory and practice, on the current process ofeliminating measles epidemic situation and the emergence of measles control strategies,so as to reduce measles morbidity and mortality.Methods: According to the "national measles surveillance program" requirement,to investigate laboratory-confirmed cases of measles citywide within2009~2013the,In accordance with the ratio of1:2, in the same villages which the cases of measles isnow living (communities), and then choose two matched controls, and investigate theincidence of cases and controls with treatment conditions, the possible exposure history,residence and travel history, history of measles disease history and vaccination history,health services situation, socio-demographic and economic information and othercontent of household. We used Epidata database software to handle all data, andanalyzed the data by using Statistical Package SAS9.1. According to research purposes,we analyzed the data for cases and controls by using univariate and multivariatemethods, chart was completed by using Microsoft Excel2003.Results:Within nine years from2004to2012, the average annual incidence rate inthe top three were20.50/0.1million,13.94/0.1million,13.20/0.1million in Tianning,Zhonglou, Wujin District, these areas are more economically active regions, the floating population migration often. Within nine years,"three peaks" phenomenon occured,these were0-1years old,5-10years old, and more than20years old, but the incidenceratio show a downward trend for every age group in2009~2012, compared with theprevious five years.1year old age group accounted for the four-year incidence of29.67%of the total cases,15years old age group for four years incidence of47.69%ofthe total incidence. From2004to2012cases were mainly concentrated in the DiasporaChildren (1475cases,42.67%) and students (445cases, accounting for12.87%), theworkers ranks third (376cases,10.88%). From2004to2012,1603cases were residentpopulation (household in the county of residence), accounting for47.44%,1855caseswere mobile population (domicile is not in the county of residence), accounting for54.90%. Measles cases in unvaccinated dominated (65.61%).Case-control studies show that parental care, migrants, mothers with measlesdisease history,7to21days before the onset of measles exposure history and hospitalpatient exposure history is risk factors of measles for <8-month-old infant. For8monthsto14years old person, univariate analysis showed that the first child, positive attitudeof parents for measles vaccination and vaccination history were protective factors ofmeasles, with the increase in the number of measles vaccination, the risk of disease isreduced, middle and high school education or less for father, and the beginning of highschool education or less for mother, migrants,7to21days prior to the onset of measlesexposure history and hospital patient exposure history are risk factors for measles.Multivariate analysis showed that parents positive attitude on vaccination, measlesvaccination history are protective factors of measles for8months to14years oldsubjects, floating population,7to21days before the onset of the hospital exposurehistory and less vaccination are risk factors for measles. For>14years old subjects,univariate analysis showed that the floating population,7to21days prior to the onset ofmeasles exposure history and hospital patient exposure history are risk factors ofmeasles; multivariate analysis showed that floating population,7to21days before theonset of hospital exposure history are risk factors of measles.Conclusions:2009and2010, the effect of measles immunization is significant.Poor management for source of infection, the new susceptible subjects, and lack ofawareness of parents on measles vaccination are important factor of measles. Conducthigh-quality routine immunization and measles supplementary immunization activities, in particular to strengthen management of the floating population vaccination, increasemeasles vaccination rates for susceptible populations against measles, health educationto raise parents’ awareness and knowledge of self-protection, strengthen the source ofinfection the management is an effective means to eliminate measles.