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Article(id=1241771806172975145, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241771801366299468, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202406356, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1719072000000, receivedDateStr=2024-06-23, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773991069596, onlineDateStr=2026-03-20, pubDate=1729785600000, pubDateStr=2024-10-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773991069596, onlineIssueDateStr=2026-03-20, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773991069596, creator=13701087609, updateTime=1773991069596, updator=13701087609, issue=Issue{id=1241771801366299468, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='20', pageStart='3649', pageEnd='3840', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773991068450, creator=13701087609, updateTime=1773991676896, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241774353457681403, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241771801366299468, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241774353457681404, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241771801366299468, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3677, endPage=3681, ext={EN=ArticleExt(id=1241771806487547956, articleId=1241771806172975145, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Epidemic characteristics analysis of breakthrough cases of varicella in Shapingba,Chongqing, 2019-2023, columnId=null, journalTitle=Modern Preventive Medicine, columnName=null, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the epidemic characteristics of breakthrough cases of varicella in Shapingba District, Chongqing, and provide reference for the prevention and control of the varicella epidemic in the area.

Methods

Collect information on varicella cases and their vaccination in Shapingba District from 2019 to 2023, Use descriptive epidemiological methods to analyze the epidemiological characteristics of varicella breakthrough cases, and use linear regression to analyze the relationship between breakthrough cases and age at the time of vaccination and the time interval between vaccination and onset of disease.

Results

From 2019 to 2023, there were a total of 802 breakthrough cases of varicella in Shapingba District, Chongqing, accounting for 14.87% of the total number of varicella cases. The majority of cases were vaccinated with one dose of varicella (648 cases, accounting for 80.80%), and the differences in composition among different years were statistically significant (χ2=16.400,P<0.005); The epidemic has a bimodal distribution, from October to December and May to July each year. The least cases are in winter (142 cases, accounting for 11.68%), and the most cases are in spring (198 cases, accounting for 17.32%). The composition differences between different seasons are statistically significant (χ2=16.348, P<0.001); The breakthrough cases of chickenpox are mainly male, with the highest incidence among primary school students aged 6～10, and the differences in composition are statistically significant (χ2=877.420, P<0.001); The time interval from the first dose of chickenpox vaccine to the onset of breakthrough cases was 46 days to 17 years, with a median \[M(P25,P75)\] of 7 years (4 years, 10 years). The median time interval between scattered children, primary school students, and middle school students was 3 years (2 years,4 years), 8 years (6 years, 9 years), and 12 years (11 years,14 years), respectively, with statistical significance (H=497.280, P<0.001); There is a negative correlation between age at the time of first dose vaccination and the interval between onset of the disease in breakthrough cases, with a correlation coefficient of r=-0.230 (t=-6.693, P<0.001).

Conclusion

Breakthrough cases of varicella in Shapingba, Chongqing are mainly concentrated in primary school students during the start of the school season, with an interval of 7 years between onset. It is necessary to further strengthen the prevention and control of the varicella epidemic in primary schools, further improve the vaccination rate of children with varicella vaccines, and recommend receiving two doses of vaccines before starting primary school to reduce the risk of breakthrough cases.

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目的

分析重庆沙坪坝区水痘突破病例的流行特征，为做好该区的水痘疫情防控提供参考。

方法

收集2019—2023年现住地为沙坪坝区的水痘病例信息及其水痘疫苗接种信息，使用描述流行病学方法分析水痘突破病例的流行特征，使用线性回归分析突破病例与疫苗接种时年龄及疫苗接种至发病的时间间隔的相关关系。

结果

重庆沙坪坝区2019—2023年沙坪坝区共发生水痘突破病例802例，占水痘病例总数的14.87%，以接种1剂水痘的病例为主（648例，占80.80%），各年份构成差异有统计学意义（χ2=16.400，P<0.005）；疫情呈双峰分布，为每年的10月至12月和5月至7月，冬季最少（142例，占11.68%），春季最多（198例，占17.32%），不同季节的构成差异有统计学意义（χ2=16.348，P<0.001）；水痘突破病例以男性为主、6～10岁的小学生最多，构成差异均有统计学意义（χ2=877.420，P<0.001）；突破病例首剂水痘疫苗接种至发病的时间间隔为46天～17年，中位数[M(P25，P75)]为7年（4年，10年），散居儿童、小学生和中学生的间隔时间间隔中位数分别为3年（2年，4年）、8年（6年，9年）和12年（11年，14年），差异有统计学意义（H=497.280，P<0.001）；突破病例首剂接种时年龄与发病时间间隔呈负相关，相关系数r=-0.230（t=-6.693，P<0.001）。

结论

重庆沙坪坝水痘突破病例集中在开学季、以小学生为主，发病时间间隔为7年，应进一步强化小学水痘疫情防控，进一步提升儿童的水痘疫苗的接种率，并建议在上小学前接种2剂疫苗，降低突破病例发生的风险。

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段清浩，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=tFGYKIMBtNgskq58J0nAdQ==, magXml=JglpgBU99cwoqVXcU8fRNA==, pdfUrl=null, pdf=odKmPZ+FWBVnpK7GwiaA6A==, pdfFileSize=578929, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=RLgYdHbrvOF8X9zP1zXeBQ==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=FjbDSuXtvFyritguZBO5Ag==, mapNumber=null, authorCompany=null, fund=null, authors=

杨连建（1981—），男，硕士，副主任医师，研究方向：传染病与突发公共卫生事件监测及防控

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杨连建（1981—），男，硕士，副主任医师，研究方向：传染病与突发公共卫生事件监测及防控

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杨连建（1981—），男，硕士，副主任医师，研究方向：传染病与突发公共卫生事件监测及防控

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Practical Preventive Medicine, 2021, 28(6): 728-730. （in Chinese), articleTitle=Epidemiological characteristics of breakthrough cases in 35 public health emergencies of chickenpox in Lianyungang City, refAbstract=null), Reference(id=1241771820525884097, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806172975145, doi=null, pmid=null, pmcid=null, year=2019, volume=46, issue=14, pageStart=2518, pageEnd=2521, url=null, language=null, rfNumber=[19], rfOrder=36, authorNames=沈艳, 邱海岩, 邵海枫, journalName=现代预防医学, refType=null, unstructuredReference=沈艳，邱海岩，邵海枫，等．2016—2017年张家港市水痘突发公共卫生事件流行病学特征分析[J]．现代预防医学，2019，46（14）：2518-2521．, articleTitle=2016—2017年张家港市水痘突发公共卫生事件流行病学特征分析, refAbstract=null), Reference(id=1241771820668490443, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806172975145, doi=null, pmid=null, pmcid=null, year=2019, volume=46, issue=14, pageStart=2518, pageEnd=2521, url=null, language=null, rfNumber=[19], rfOrder=37, authorNames=Shen Y, Qiu HY, Shao HF, journalName=Modern Preventive Medicine, refType=null, unstructuredReference=Shen Y, Qiu HY, Shao HF, et al. Analysis of epidemiological characteristics of varicella sudden public health events in Zhangjiagang between 2016 and 2017[J]. Modern Preventive Medicine, 2019, 46(14): 2518-2521.（in Chinese), articleTitle=Analysis of epidemiological characteristics of varicella sudden public health events in Zhangjiagang between 2016 and 2017, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1241771807716479088, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806172975145, xref=null, ext=[AuthorCompanyExt(id=1241771807724867697, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806172975145, companyId=1241771807716479088, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Shapingba District Center for Disease Control and Prevention, Chongqing 400038, China), AuthorCompanyExt(id=1241771807733256307, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806172975145, companyId=1241771807716479088, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=重庆市沙坪坝区疾病预防控制中心，重庆 400038)])], figs=[ArticleFig(id=1241771811147419876, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806172975145, language=EN, label=Fig.1, caption=Monthly distribution of varicella breakthrough cases in Shapingba,Chongqing from 2019 to 2023, figureFileSmall=+LfYL//7TtfFH9cFsFXN0w==, figureFileBig=RLgYdHbrvOF8X9zP1zXeBQ==, tableContent=null), ArticleFig(id=1241771811264860394, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806172975145, language=CN, label=图1, caption=重庆沙坪坝2019—2023年水痘突破病例月分布情况, figureFileSmall=+LfYL//7TtfFH9cFsFXN0w==, figureFileBig=RLgYdHbrvOF8X9zP1zXeBQ==, tableContent=null), ArticleFig(id=1241771811508130038, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806172975145, language=EN, label=Fig.2, caption=Time interval between breakthrough cases of varicella and vaccination in Shapingba,Chongqing from 2019 to 2023, figureFileSmall=1E10vPRGMF2pp9OKqYklyg==, figureFileBig=ulolaOqO3lzzkK7oCvGwOA==, tableContent=null), ArticleFig(id=1241771811671707903, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806172975145, language=CN, label=图2, caption=重庆沙坪坝2019—2023年水痘突破病例与疫苗接种时间间隔情况

注：A为不同性别的时间间隔情况；B为不同人群的时间间隔情况

, figureFileSmall=1E10vPRGMF2pp9OKqYklyg==, figureFileBig=ulolaOqO3lzzkK7oCvGwOA==, tableContent=null), ArticleFig(id=1241771811856257298, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806172975145, language=EN, label=Table 1, caption=

Incidence of breakthrough cases of varicella in Shapingba,Chongqing from 2019 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
年份病例总数及构成
[n(%)]		突破病例数及构成
[n(%)]		突破病例在总病例数中的构成（%）
2019年1 716（31.82）228（28.43）13.29
2020年798（14.80）111（13.84）13.91
2021年1 159（21.49）159（19.83）13.72
2022年797（14.78）136（16.96）17.06
2023年922（17.10）168（20.95）18.22
合计5 392（100.00）802（100.00）14.87
), ArticleFig(id=1241771811965309212, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806172975145, language=CN, label=表1, caption=

重庆沙坪坝2019—2023年水痘突破病例发病情况

, figureFileSmall=null, figureFileBig=null, tableContent=
年份病例总数及构成
[n(%)]		突破病例数及构成
[n(%)]		突破病例在总病例数中的构成（%）
2019年1 716（31.82）228（28.43）13.29
2020年798（14.80）111（13.84）13.91
2021年1 159（21.49）159（19.83）13.72
2022年797（14.78）136（16.96）17.06
2023年922（17.10）168（20.95）18.22
合计5 392（100.00）802（100.00）14.87
), ArticleFig(id=1241771812208578848, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806172975145, language=EN, label=Table 2, caption=

Epidemiological distribution of breakthrough cases of chickenpoxricella in Shapingba,Chongqing from 2019 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
项目水痘病例数突破病例数χ2P值
性别
男2 8914688.281<0.005
女2 501334
年龄（岁）
≤5800235877.420<0.001
6～10800303
11～151 165232
≥162 62732
人群分类
散居儿童42669903.590<0.001
幼托儿童455193
小学生982341
中学生1 456194
大学生6793
其它1 3042
城乡
城区3 2344701.3020.521
结合1 656260
农村50272
季节
春季1 14319816.348<0.001
夏季1 255182
秋季1 779280
冬季1 215142
), ArticleFig(id=1241771812451848491, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241771806172975145, language=CN, label=表2, caption=

重庆沙坪坝2019—2023年水痘突破病例流行病学分布情况

, figureFileSmall=null, figureFileBig=null, tableContent=
项目水痘病例数突破病例数χ2P值
性别
男2 8914688.281<0.005
女2 501334
年龄（岁）
≤5800235877.420<0.001
6～10800303
11～151 165232
≥162 62732
人群分类
散居儿童42669903.590<0.001
幼托儿童455193
小学生982341
中学生1 456194
大学生6793
其它1 3042
城乡
城区3 2344701.3020.521
结合1 656260
农村50272
季节
春季1 14319816.348<0.001
夏季1 255182
秋季1 779280
冬季1 215142
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重庆沙坪坝区2019—2023年水痘突破病例的流行特征分析
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杨连建 , 杨长绢 , 段清浩
现代预防医学 | 流行病与统计方法 2024,51(20): 3677-3681
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现代预防医学 | 流行病与统计方法 2024, 51(20): 3677-3681
重庆沙坪坝区2019—2023年水痘突破病例的流行特征分析
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杨连建, 杨长绢, 段清浩
作者信息
  • 重庆市沙坪坝区疾病预防控制中心，重庆 400038

    • 杨连建（1981—），男，硕士，副主任医师，研究方向：传染病与突发公共卫生事件监测及防控

通讯作者:

段清浩，E-mail:
Epidemic characteristics analysis of breakthrough cases of varicella in Shapingba,Chongqing, 2019-2023
Lian-jian YANG, Chang-juan YANG, Qing-hao DUAN
Affiliations
  • Shapingba District Center for Disease Control and Prevention, Chongqing 400038, China
出版时间: 2024-10-25 doi: 10.20043/j.cnki.MPM.202406356
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摘要
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目的

分析重庆沙坪坝区水痘突破病例的流行特征，为做好该区的水痘疫情防控提供参考。

方法

收集2019—2023年现住地为沙坪坝区的水痘病例信息及其水痘疫苗接种信息，使用描述流行病学方法分析水痘突破病例的流行特征，使用线性回归分析突破病例与疫苗接种时年龄及疫苗接种至发病的时间间隔的相关关系。

结果

重庆沙坪坝区2019—2023年沙坪坝区共发生水痘突破病例802例，占水痘病例总数的14.87%，以接种1剂水痘的病例为主（648例，占80.80%），各年份构成差异有统计学意义（χ2=16.400，P<0.005）；疫情呈双峰分布，为每年的10月至12月和5月至7月，冬季最少（142例，占11.68%），春季最多（198例，占17.32%），不同季节的构成差异有统计学意义（χ2=16.348，P<0.001）；水痘突破病例以男性为主、6～10岁的小学生最多，构成差异均有统计学意义（χ2=877.420，P<0.001）；突破病例首剂水痘疫苗接种至发病的时间间隔为46天～17年，中位数[M(P25，P75)]为7年（4年，10年），散居儿童、小学生和中学生的间隔时间间隔中位数分别为3年（2年，4年）、8年（6年，9年）和12年（11年，14年），差异有统计学意义（H=497.280，P<0.001）；突破病例首剂接种时年龄与发病时间间隔呈负相关，相关系数r=-0.230（t=-6.693，P<0.001）。

结论

重庆沙坪坝水痘突破病例集中在开学季、以小学生为主，发病时间间隔为7年，应进一步强化小学水痘疫情防控，进一步提升儿童的水痘疫苗的接种率，并建议在上小学前接种2剂疫苗，降低突破病例发生的风险。

水痘  /  突破病例  /  流行特征
Objective

To analyze the epidemic characteristics of breakthrough cases of varicella in Shapingba District, Chongqing, and provide reference for the prevention and control of the varicella epidemic in the area.

Methods

Collect information on varicella cases and their vaccination in Shapingba District from 2019 to 2023, Use descriptive epidemiological methods to analyze the epidemiological characteristics of varicella breakthrough cases, and use linear regression to analyze the relationship between breakthrough cases and age at the time of vaccination and the time interval between vaccination and onset of disease.

Results

From 2019 to 2023, there were a total of 802 breakthrough cases of varicella in Shapingba District, Chongqing, accounting for 14.87% of the total number of varicella cases. The majority of cases were vaccinated with one dose of varicella (648 cases, accounting for 80.80%), and the differences in composition among different years were statistically significant (χ2=16.400,P<0.005); The epidemic has a bimodal distribution, from October to December and May to July each year. The least cases are in winter (142 cases, accounting for 11.68%), and the most cases are in spring (198 cases, accounting for 17.32%). The composition differences between different seasons are statistically significant (χ2=16.348, P<0.001); The breakthrough cases of chickenpox are mainly male, with the highest incidence among primary school students aged 6～10, and the differences in composition are statistically significant (χ2=877.420, P<0.001); The time interval from the first dose of chickenpox vaccine to the onset of breakthrough cases was 46 days to 17 years, with a median \[M(P25,P75)\] of 7 years (4 years, 10 years). The median time interval between scattered children, primary school students, and middle school students was 3 years (2 years,4 years), 8 years (6 years, 9 years), and 12 years (11 years,14 years), respectively, with statistical significance (H=497.280, P<0.001); There is a negative correlation between age at the time of first dose vaccination and the interval between onset of the disease in breakthrough cases, with a correlation coefficient of r=-0.230 (t=-6.693, P<0.001).

Conclusion

Breakthrough cases of varicella in Shapingba, Chongqing are mainly concentrated in primary school students during the start of the school season, with an interval of 7 years between onset. It is necessary to further strengthen the prevention and control of the varicella epidemic in primary schools, further improve the vaccination rate of children with varicella vaccines, and recommend receiving two doses of vaccines before starting primary school to reduce the risk of breakthrough cases.

Varicella  /  Breakthrough case  /  Epidemiological characteristic
杨连建, 杨长绢, 段清浩. 重庆沙坪坝区2019—2023年水痘突破病例的流行特征分析. 现代预防医学, 2024 , 51 (20) : 3677 -3681 . DOI: 10.20043/j.cnki.MPM.202406356
Lian-jian YANG, Chang-juan YANG, Qing-hao DUAN. Epidemic characteristics analysis of breakthrough cases of varicella in Shapingba,Chongqing, 2019-2023[J]. Modern Preventive Medicine, 2024 , 51 (20) : 3677 -3681 . DOI: 10.20043/j.cnki.MPM.202406356
正文
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水痘是由水痘－带状疱疹病毒（varicella-zostervirus,VZV）感染引起，以发热、皮肤和黏膜组织成批出现周身性红色斑丘疹、疱疹、痂疹为主要临床特征的呼吸道传染病[1]，水痘传播能力强，容易在学校和幼托机构传播蔓延，严重影响学生的学习和学校的教学秩序[2]。接种过水痘疫苗的儿童或罹患过水痘的病例，经过数年后再次感染水痘的情况称为水痘突破病例。研究表明，接种水痘疫苗后，随着时间推移，人体内水痘抗体水平逐步衰减，疫苗保护效果下降，从而导致突破病例的发生[3]。当前通过接种水痘疫苗仍然是预防水痘的最佳防控策略[4]，但既往的研究对疫苗接种与突破病例发生的时间间隔分析仍然不充分，尤其是对接种2剂疫苗突破病例的时间间隔的研究明显不足。为此，本研究以沙坪坝区近5年的水痘疫情监测数据为基础，分析水痘突破病例的流行特征，及其与疫苗接种的相关关系，为进一步优化水痘疫情防控措施提供参考依据。
1　资料与方法
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1.1　资料来源
水痘病例资料来源于中国疾病监测信息报告管理系统2019—2023年现住址为重庆沙坪坝区的水痘病例，病例的水痘疫苗接种信息来源于重庆疫智防控信息系统中的疫苗接种信息。
1.2　判定标准
水痘突破病例指接种水痘疫苗42天后，发生水痘感染的病例[5]；发病间隔时间指接种水痘疫苗后至发生水痘感染的时间间隔（年）[6]；首剂接种年龄指儿童接种第一次水痘疫苗时的年龄（岁）[7]。
1.3　统计分析
使用R 4.2.0进行数据分析，计数资料使用[n（%）]描述，计量资料使用中位数和四分位数间距[M（P25，P75）]描述，不同组别间构成差异比较使用Pearson χ2检验，非正态计量资料两组间比较采用Wilcoxon秩和检验或Kruskal-Wallis秩和检验，采用线性相关分析方法对突破病例水痘疫苗首剂接种至发病的时间间隔进行分析，检验水准为α=0.05。
2　结果
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2.1　总体概况
2019—2023年重庆沙坪坝区共报告水痘病例5 392例，其水痘中突破病例802例，占水痘病例总数的14.87%，其中突破病例中接种1剂水痘的有648例，占水痘病例总数的12.01%，接种2剂的有154例，占2.86%。
2020年突破病例最少，为111例，占突破病例总数的13.84%，2019年最多，为228例，占突破病例总数的28.43%；各年份水痘突破病例数在病例总数中的构成差异有统计学意义（χ2=16.400，P<0.005），详见表1。
2.2　流行特征
2.2.1　时间分布
2019—2023年重庆沙坪坝区水痘突破病例呈双峰分布，分别为每年的10月至12月和5月至7月，10月至12月累计病例数为309例，占突破病例总数的38.53%，5月至7月累计病例数为244例，占30.42%；突破病例以冬季最少142例，占该季度水痘病例总数的11.68%，春季最多198例，占该季度水痘病例总数17.32%。不同季节突破病例在水痘总病例中的构成差异有统计学意义（χ2=16.348，P<0.001），详见图1。
2.2.2　城乡分布
沙坪坝区2019—2023年城区、郊区和农村地区水痘突破病例数及其构成分别为470例、260例和72例，分别占同区域水痘病例总数的14.53%、15.70%和14.34%。不同地区突破病例在水痘总病例中的占比差异无统计学意义（χ2=1.302，P>0.05），详见表2。
2.2.3　人群分布
沙坪坝区2019—2023年水痘突破病例以男性为主；以6～10岁的儿童突破病例最多（303例），16岁及以上的青少年最少（32例），不同年龄段突破病例的构成差异有统计学意义（χ2=877.420，P<0.001）；以小学生最多（341例），其他人群最少（2例），不同人群突破病例构成差异有统计学意义（χ2=903.590，P<0.001），详见表2。
2.3　突破病例疫苗接种至发病时间间隔分析
沙坪坝区2019—2023年水痘突破病例自首次接种水痘疫苗后至发病时间间隔为46天～17年，中位数[M（P25，P75）]为7年（4年，10年），其中男生为7年（3年，11年），女生为7年（4年，9年），男女的突破病例发病时间间隔差异无统计学意义（Z=12.260，P>0.05）；散居儿童、小学生和中学生的间隔时间中位数分别为3年（2年，4年）、8年（6年，9年）和12年（11年，14年），不同人群的间隔时间差异有统计学意义（H=497.280，P<0.001），详见图2。154例突破病例的第2剂疫苗接种至发病时间间隔为44天～14年，中位数[M（P25，P75）]为3年（1年，5年），两剂次接种时间间隔为1～12年，中位数[M（P25，P75）]为4年（3年，5年）。
突破病例水痘接种年龄在1～25岁之间，中位数[M（P25，P75）]为1.16岁（1.05岁，1.87岁），突破病例疫苗接种至发病的时间间隔与水痘疫苗首剂接种时的年龄呈显著的负相关，相关系数r=-0.230（t=-6.693，P<0.001）。
3　讨论
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本研究显示，沙坪坝区2019至2023年水痘突破病例802例，占病例总数的14.87%，低于珠海地区的19.146%[8]和重庆永川区的17.54%[9]，这可能与各地统计分析的时间跨度和儿童水痘疫苗接种覆盖率有关。
本研究发现，水痘突破病例中80.80%为接种1剂的儿童，这与诸多研究结论相似[10-12]，水痘突破病例在总病例中的占比从2019年的13.29%上升至2023年的18.22%；突破病例呈明显的双峰分布（每年的10月至12月和5月至7月），这与学校行课时间高度一致，提示学校开学期间是水痘疫情防控的关键时期，与姚广松等研究结果相似[13-15]。本研究发现，水痘突破病例中男生明显高于女生，这与相关研究结果相似[11,16]，可能因为男生较女生更好动，暴露的风险较高所致；突破病例主要以6～10岁的小学生最多，这可能是因为小学易感人群集中，通过同学之间的密切接触导致疫情传播蔓延[4,8]。
本研究显示，水痘突发病例在首剂接种水痘疫苗后至发病时间间隔中位数为7年，明显高于重庆北碚区的研究结果[（3.75±1.37）年][17]，与张嘉陵等的研究结果[（7.48±1.76）年]和沈艳等的研究结果为[（6.62±1.68）年]相近[18-19]。突破病例的发病时间间隔与初免时的年龄呈负相关（P<0.001），表明初次接种年龄越小，突破病例发病时间间隔越长[8]。这提示儿童应当按水痘接种规程尽早接种疫苗，并于接种后7年以内再次接种水痘疫苗强化免疫保护效果，本研究还发现，第2剂疫苗接种至破病例发病时间间隔，以及两剂疫苗接种的时间间隔平均在3～4年，明显低于首剂疫苗接种至发病的平均时间间隔（7年），这提示应尽早开展水痘加强免疫，降低突破病例发生的风险。
综上所述，水痘突破病例在水痘总病例的比例呈逐年上升趋势，接种1剂水痘疫苗不能很好预防水痘病毒的感染发病，学校是突发病例发生的重要场所，与学校行课时段高度吻合，建议各地充分统筹和优化水痘疫苗接种政策，提高2剂次水痘疫苗覆盖率，有效控制水痘突破病例疫情。
文献
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2024年第51卷第20期
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doi: 10.20043/j.cnki.MPM.202406356
  • 接收时间：2024-06-23
  • 首发时间：2026-03-20
  • 出版时间：2024-10-25
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  • 收稿日期：2024-06-23
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    重庆市沙坪坝区疾病预防控制中心，重庆 400038

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段清浩，E-mail:
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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