Abstract: Objective To investigate the epidemic tendency of Japanese encephalitis(JE) in Kaijiang county, Sichuan province using the information of epidemiology in 2006, so as to provide basic information for JE prevention and control. Methods All of the 31 cases of JE in Kaijing county were interviewed individually by questionnaire on epidemiology and vaccine inoculation rate in 2006. The blood serum of the JE cases in early stage was collected, that of 9 years old healthy children were collected in May, and that of pigs were collected in each 10 days from June to July. All blood serums were tested by ELISA method. Results The total reported cases of JE were 31 in 2006, with incidence rate of 5.49/100 000. The incidence rate in flat area (6.98 per 100 000) was higher than that of hilly area (2.61 per 100 000) (χ²=4.41,P<0.05), the cases were intravenous drip distributed. There were more cases in the last ten days of July and the first 10 days of August, with incidence rate of 54.84% and of 29.03%, respectively. The results showed that boy incidence was more than that of girl (2.88∶1). The patients who were under 3 years old accounted for 70.97% of total. 60.00% of the total cases lived in unsanitary conditions, although 86.67% of them using mosquito net at night. The knowing rate of JE cases guarders on JE prevention and control knowledge was only 13.33%, the immunized ones with JE vaccine accounting for 6.45%, the sequelae rate of JE cases for 19.35%(6/31). About 4783.74 Yuan RMB were needed for each case in clinic and in hospital averagely. JE vaccine immunization rate of the 1-7 years old children accounting for 46.74% (79/169). On clinical, the light and the medium were respectively 41.94% and 38.71%. The positive rate of serum antibody in 2-9 years old healthy children was 63.77%(88/138), of which that of 2 years old children (33.33%) was lower than that of 3-9 years old children, but the difference was of no statistics significance (χ²=11.14,P>0.05). The peak of antibody positive rate of pigs was in the second 10 days of June, and the difference of antibody positive rate in every 10 days in June and July was of no statistics significance (χ²=6.30,P>0.05). The clinical serum diagnosed rate of JE cases was 80.64%(25/31). Conclusion Strengthening propaganda of JE prevention and control knowledge in rural area, increasing JE vaccine immunization rate of children under 7 years old, successfully prevention and control vector mosquitoes for JE will be a good strategy of JE prevention and control in Kaijiang county.

摘要： 目的 探讨2006年开江县流行性乙型脑炎(乙脑)疫情动态及发病趋势,为防制提供科学依据。方法 对2006年发生的31例乙脑病例进行流行病学个案调查及乙脑疫苗接种率抽样调查,采集病人早期血清,5月抽取9岁以下健康儿童血清,6-7月各旬分别抽取猪血清。血清检测方法采用ELISA。结果 全年发生乙脑病例31例,发病率为5.49/10万。平坝浅丘地区发病率6.98/10万,显著高于山区深丘地区的2.61/10万(χ²=4.41,P<0.05),病例呈高度散发点状分布。7月下旬和8月上旬发病最多,分别占54.84%和29.03%;男性发病多于女性,男女之比为2.88∶1;3岁以下儿童发病数占70.97%。居住环境卫生差和极差的占60.00%,蚊帐使用率为86.67%,患儿监护人乙脑防治知识知晓率为13.33%,31例患者中有乙脑疫苗接种史的占6.45%,后遗症发生率为19.35%(6/31),平均每例门诊和住院医药费等直接经济损失4783.74元,1～7岁儿童乙脑疫苗接种率为46.74%(79/169),临床上以轻型和普通型为主,分别占41.94%及38.71%。2～9岁健康儿童抗体阳性率为63.77%(88/138),2岁年龄组抗体阳性率为33.33%,低于其他各年龄组,但差异无统计学意义(χ²=11.14,P>0.05)。猪乙脑抗体阳性率高峰在6月中旬,6-7月各旬抗体阳性率之间差异无统计学意义(χ²=6.30,P>0.05)。临床病例血清学确诊率为80.64%(25/31)。结论 加强农村地区乙脑防治知识的宣传,提高7岁以下儿童乙脑疫苗接种率和覆盖率,做好防蚊、灭蚊,是开江县控制乙脑发生和流行的关键措施。

关键词: 流行性乙型脑炎, 流行病学, 监测