| Background & ObjectiveMeasles, rubella and mumps are three common kinds of acute respiratory communicable diseases. They are highly contagious and often outbreak in populous places such as day-care centers, schools and military camps which cause heavy economic burden to the society and the families. With the implementation of national immunization programme activities and Expanded programme on immunization (EPI), the incidence and mortality of meals had ever evidently descended and many countries are stepping into the stage to eliminate it. It will be the third disease to be eradicated following smallpox and polio. China has also established the measles elimination programme in 2012. However, it takes time for Quzhou city to make a smooth transition from controlling the disease to eliminating it. The immunization prevention for rubella and mumps were later, compared to that of the measles. Although some nations have successfully gotten rid of the two diseases, they are still out of control in many countries, especially in the developing countries. The epidemic situation in China is rigorous and annually about 40,000 cases of congenital rubella syndromes(CRS) took place. The epidemiological data in Zhejiang province indicated that report incidence rate of mumps was 47.79 per 10,0000 persons. Of Zhejiang province infectious disease outbreaks,20% was mumps. Measles and rubella have similar clinic manifestation hard to be clinically differentiated, therefore, the incidence of rubella makes it difficult to control and monitor the measles. The meals and mumps have been directly reported through internet in Quzhou City since 2004 which showed the annul incidence of measles reached 10.08 per 100,000 persons and mumps 44.30 per 100,000 persons with an increasing epidemic trend. They often outbreak in the populous places such as day-care center, schools and military camps and cause a heavy burden to the society and families. This article analyzed the epidemiological features of measles, rubella and mumps Quzhou City in recent years in to explore the control strategy so as to provide scientific evidence for future prevention.Materials & MethodsCases data was obtained from China legal infectious disease reported system, which was renamed recently as China information system for diseases control and prevention, China emergency public reporting system and China measles surveillance system. Population data was obtained from Statistic Bureau of Quzhou City. Cases data was coded according to the county, and the statistical analysis was finished in Excel 2000 and SPSS 10.0 for Windows. Dispose and analyze the data of measles, rubella and mumps epidemic situation in Quzhou City applying the Muster and Circular distribution methods. Analyze the three distribution of diseases and public health by descriptive epidemiology, control measures were researched according to common epidemiological characteristics of these three kinds of diseases.Results1,Measles epidemiological characteristicsReported cases of measles totaled up to 5098 between 1985 and 2009 in Quzhou city,4 death cases occurred. The average incidence rate was 8.62 per 100,000 annually, the mortality was 6.76%o. The highest incidence was 40.95 per 100,000 in 1992 or 1993, about 950 cases was reported, then the incidence was declined quickly and continued to show slight fluctuations serrated. Kaihua county had the highest incidence and Longyou county had the lowest incidence among all areas. The incidence presented the certain seasonal variation as the majority of cases occurred during April and June. The high-prevalence ages were under 15 years, the proportion of the cases aged under 1 year increased. As for the occuptation, the cases were mainly students and preschool children.2,Rubella epidemiological characteristicsReported cases of rubella totaled up to 2379 between 2004 and 2009 in Quzhou city, no death occurred. The average incidence rate was 16.08 per 100,000 annually. Kecheng district had the highest incidence and Jiangshan city had the lowest incidence among all areas. The incidence presented the visible seasonal variation as the majority of cases occurred during April and June. The high-prevalence ages were 10-19 years, the proportion of the main cases did not changed significantly.Of the total female cases, 50% was child-bearing age. As for the occuptation, the cases were mainly students.3,Mumps epidemiological characteristicsReported cases of mumps totaled up to 6553 between 2004 and 2009 in Quzhou city, no death occurred. The average incidence rate was 44.30 per 100,000 annually. In recent years, the incidence had been in high. Kecheng district had the highest incidence and Jiangshan city had the lowest incidence among all areas. The incidence presented the certain seasonal variation as the majority of cases occurred during April and June. The high-prevalence ages were 5-14 years, the proportion of the main cases did not changed significantly. As for the occuptation, the cases were mainly students.4,The muster and circular distribution methods By the Muster methods, the M of measles and mumps were 0.45 and 0.41 respectly, which showed the certain seasonal variation. The M of rubella was 0.74, which showed the visible seasonal variation. The peak incidence of measles was May 1, the most cases occurred during February 17 and July 12. The peak incidence of rubella was April 26, the most cases occurred during March 13 and June 10. The peak incidence of mumps was May 19, the most cases occurred during March 3 and August 4.5,Time-related public health information116 pieces of time-related public health information was reported between 2004 and 2009 in Quzhou city, Including 28 pieces of mumps,11 pieces of rubella and 7 pieces of measles. The attack rate of mumps, rubella and measles was respectively 6.38%,4.55% and 0.68%. In report area, the first was Kaihua county, the second was Kecheng district. Most events focused on March to July, especially April. The first place occurred in township primary school, the second was township middle school.6,Measles surveillance informationThere were reported 643 case of measles between 2005 and 2009 in China information system for diseases control and prevention,602 cases were brought into China measles surveillance system, the survey rate in 48 hour was 90.36%, the sampling rate of serum was 79.47%. Of the 367 cases,31.06% was immunized with measles vaccine,36.78% was not and 32.15% was unknown. The routine immunization rate of measles was 98.36% and the catch-up vaccination rate was 98.29% between 2006 and 2008. Under 1 year old and 7-14 years old were immunizated relatively lower.ConclusionsThe incidence of measles has been effectively controlled in Quzhou by the popularity of measles vaccine, but it is difficult to reach the level of elimination. Among the female cases with rubella, about 50% was women of child-bearing age which indicates the severe situation of CRS in Quzhou city. Mumps is a serious public hygiene problem because of high incidence and outbreak rate. It is acute to make the three diseases in control state. Because of the similar epidemiological characteristics, such as epidemic season which was significantly delayed, the peak incidence which were April to June, especially before and after May 1, the most ccupation which was student, the epidemic areas which were mobile population centers and the areas of weak immunization, MMR vaccine should be added into the routine immunization. Furthermore, other immunization suggestions are as follows:1)carrying out two-doses immunization schedule, the first vaccination at 8 months ald and revaccination between 18 and 24 months old, strengthening surveillance.2) strengthening publicity and education, conducting catch-up vaccination foucused on women of child-bearing age, preschool children, students and floating population,3)improving immunization work quality,4)strengthening disease surveillance and laboratory net. |
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