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Article(id=1324050686152933716, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202512166, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1765468800000, receivedDateStr=2025-12-12, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793607883251, onlineDateStr=2026-11-02, pubDate=1778342400000, pubDateStr=2026-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793607883251, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793607883251, creator=13701087609, updateTime=1793607883251, updator=13701087609, issue=Issue{id=1324050669933572771, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='9', pageStart='1537', pageEnd='1728', issueExtLink='null', onlineDate='null', pubDate='1778342400000', pubDateStr='2026-05-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793607879384, creator='13701087609', updateTime=1793670100562, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324311644528050975, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324311644528050976, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050669933572771, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1564, endPage=1568, ext={EN=ArticleExt(id=1324050690716336470, articleId=1324050686152933716, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Epidemiological characteristics and predominant pathogenic bacterial groups of meningococcal meningitis in Anhui Province from 2006 to 2024, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the epidemic characteristics and predominant pathogenic bacterial groups of meningococcal meningitis in Anhui Province from 2006 to 2024, and to provide a basis for the prevention and control of meningococcal meningitis and the adjustment of immunization strategies.

Methods

Data on the incidence of meningococcal disease and pathogen detection in Anhui Province from 2006 to 2024 were collected through the Chinese Disease Prevention and Control Information System. Descriptive epidemiological methods were used to analyze the epidemiological characteristics and bacterial distribution of meningococcal disease. The Joinpoint software was used to analyze the incidence from 2006 to 2024.

Results

From 2006 to 2024, a total of 1 014 cases of meningococcal meningitis were reported in Anhui Province, with an average annual incidence rate of 0.09 per 100 000. Joinpoint regression analysis showed that the incidence of meningococcal meningitis overall decreased from 2006 to 2024 [average annual percent change (AAPC) =-27.66%, P<0.001], with a significant decrease in the number of cases from 2008 to 2015 [annual percent change (APC) =-45.36%, P<0.001]. The top three reporting regions with the average annual incidence rate were Hefei City (0.34 per 100 000), Bengbu City (0.17 per 100 000), and Huainan City (0.12 per 100 000). The cases were mainly concentrated from November to the following April, accounting for 89% of the total. The male-to-female ratio was 1.43 (597/417); the age group with the highest incidence was 15-19 years old (26.53%), 10-14 years old (24.46%), and the 0-4 age group (15.48%); the occupation was mainly students (55.23%). From 2006 to 2024, a total of 170 cases of bacterial surveillance were reported in Anhui Province. The bacterial strain changes showed a trend of a decrease in the proportion of C strain and an increase in the proportion of B strain year by year. In terms of age distribution, the 0-4 age group was mainly dominated by the B strain (43.75%), while the 10-19 age group was mainly dominated by the W135 strain, A strain, and C strain with diversified high incidence.

Conclusion

The incidence of meningococcal disease in Anhui Province is currently at a low level. The peak incidence ages are concentrated in the 10-19 years old and 0-4 years old groups. The predominant strain is Group B. The prevention and control of meningococcal disease faces new challenges. It is recommended to provide an additional dose of meningococcal vaccine for adolescents aged 10-19 years old.

, authors=Ying SU, Yu CHAI, Xia CHEN, Fan-ya MENG, Peng-bo CHENG, Bin-bing WANG, authorsList=Ying SU, Yu CHAI, Xia CHEN, Fan-ya MENG, Peng-bo CHENG, Bin-bing WANG, authorCompany=null, correspAuthors=Bin-bing WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324050717631185251, articleId=1324050686152933716, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=安徽省2006—2024年流行性脑脊髓膜炎流行特征及主要致病菌群特征分析, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的

了解安徽省2006—2024年流行性脑脊髓膜炎（流脑）流行特征和主要致病菌群，为流脑防控工作和免疫策略调整提供依据。

方法

通过中国疾病预防控制信息系统收集2006—2024年安徽省流脑发病资料和病原学检测资料，采用描述性流行病学方法分析流脑发病的流行病学特征和菌群分布情况；采用Joinpoint软件对2006—2024年的发病情况进行分析。

结果

2006—2024年安徽省共报告流脑1 014例，年均报告发病率0.09/10万。Joinpoint回归分析显示，2006—2024年流脑发病整体呈下降趋势（平均年变化百分比=-27.66%，P<0.001），其中2008—2015年发病数下降显著（年变化百分比=-45.36%，P<0.001）。报告年均发病率前三位的地区分别为合肥市（0.34/10万）、蚌埠市（0.17/10万）和淮南市（0.12/10万）。发病主要集中在11月—次年4月，占总数的89%。男女性别比为1.43（597/417）；发病年龄主要集中在15～19岁（26.53%）、10～14岁（24.46%）和0～4岁（15.48%）；职业以学生为主，占55.23%。2006—2024年安徽省共报告170例菌群监测病例，菌群变迁呈现出C群占比减少，B群逐年上升的趋势。年龄分布上，0～4岁组主要以B群为主（43.75%），10～19岁组则以W135群、A群和C群多元化高发为主。

结论

安徽省流脑发病目前处于低水平，发病年龄集中在10～19岁和0～4岁两个高峰，流行菌株以B群为主，流脑防控面临新挑战，建议针对10～19岁青少年开展1剂次流脑疫苗加强免疫。

, authors=苏颖, 柴瑜, 陈霞, 孟凡亚, 程鹏博, 王斌冰, authorsList=苏颖, 柴瑜, 陈霞, 孟凡亚, 程鹏博, 王斌冰, authorCompany=null, correspAuthors=王斌冰, authorNote=

苏颖（1982—），女，硕士，副主任医师，研究方向：疫苗可预防疾病控制

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王斌冰，E-mail：
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(In Chinese), articleTitle=Research progress on immunogenicity evaluation of serogroup B meningococcal vaccine, refAbstract=null)], funds=[Fund(id=1324050766658404761, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050686152933716, awardId=CSJP035, language=CN, fundingSource=长三角免疫规划领军人才研究项目(CSJP035), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324050720529449316, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050686152933716, xref=null, ext=[AuthorCompanyExt(id=1324050720588169573, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050686152933716, companyId=1324050720529449316, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Institute of Immunization Program, Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui 230601, China), AuthorCompanyExt(id=1324050720604946790, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050686152933716, companyId=1324050720529449316, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=安徽省疾病预防控制中心免疫规划所，安徽 合肥 230601)])], figs=[ArticleFig(id=1324050754109047181, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050686152933716, language=EN, label=Figure 1, caption=Reported incidence and mortality of meningococcal meningitis in Anhui Province, 2006—2024, figureFileSmall=mNBYNROE6M8eGFzNRAlDaA==, figureFileBig=UHfAbjLrBPGqFg1ahsxCkg==, tableContent=null), ArticleFig(id=1324050754931130766, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050686152933716, language=CN, label=图1, caption=安徽省2006—2024年流脑报告发病和死亡情况, figureFileSmall=mNBYNROE6M8eGFzNRAlDaA==, figureFileBig=UHfAbjLrBPGqFg1ahsxCkg==, tableContent=null), ArticleFig(id=1324050757506433423, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050686152933716, language=EN, label=Figure 2, caption=Time distribution of reported meningococcal meningitis cases in Anhui Province, 2006—2024, figureFileSmall=6Xe0uEZILuZJFI9IVBNkTQ==, figureFileBig=sFTQUMI++kzOYED6pSqMsw==, tableContent=null), ArticleFig(id=1324050758253019536, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050686152933716, language=CN, label=图2, caption=安徽省2006—2024年流脑报告发病时间分布, figureFileSmall=6Xe0uEZILuZJFI9IVBNkTQ==, figureFileBig=sFTQUMI++kzOYED6pSqMsw==, tableContent=null), ArticleFig(id=1324050758697615761, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050686152933716, language=EN, label=Figure 3, caption=Age distribution of meningococcal meningitis cases in Anhui Province, 2006—2024, figureFileSmall=tRgz3FLzNjDRjZvuwLgddg==, figureFileBig=I0IaglIpf2PYZkGFzZhdIg==, tableContent=null), ArticleFig(id=1324050759129629074, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050686152933716, language=CN, label=图3, caption=安徽省2006—2024年流脑病例年龄分布, figureFileSmall=tRgz3FLzNjDRjZvuwLgddg==, figureFileBig=I0IaglIpf2PYZkGFzZhdIg==, tableContent=null), ArticleFig(id=1324050759582613907, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050686152933716, language=EN, label=Figure 4, caption=Changes in the predominant pathogenic bacteria groups in Anhui Province, 2006—2024, figureFileSmall=ORzNs9hAn4l7Dj08CiGKuQ==, figureFileBig=w5sqSGoYgQM82tKSCL5zbw==, tableContent=null), ArticleFig(id=1324050761662988692, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050686152933716, language=CN, label=图4, caption=安徽省2006—2024年主要致病菌群变迁情况, figureFileSmall=ORzNs9hAn4l7Dj08CiGKuQ==, figureFileBig=w5sqSGoYgQM82tKSCL5zbw==, tableContent=null), ArticleFig(id=1324050762866753941, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050686152933716, language=EN, label=Table 1, caption=

Analysis of the annual variation trend of meningococcal meningitis in Anhui Province, 2006—2024

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）AAPC/APC（%，95%CI）P值
总体-27.66（-36.33～-25.41）<0.001
2006—2008-3.79（-19.10～11.40）0.433
2008—2015-45.36（-54.35～-42.41）<0.001
2015—20242.61（-15.00～36.26）0.719
), ArticleFig(id=1324050763357487510, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050686152933716, language=CN, label=表1, caption=

安徽省2006—2024年流脑总体发病年度变化趋势分析

, figureFileSmall=null, figureFileBig=null, tableContent=
年份（年）AAPC/APC（%，95%CI）P值
总体-27.66（-36.33～-25.41）<0.001
2006—2008-3.79（-19.10～11.40）0.433
2008—2015-45.36（-54.35～-42.41）<0.001
2015—20242.61（-15.00～36.26）0.719
), ArticleFig(id=1324050764146016663, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050686152933716, language=EN, label=Table 2, caption=

Age distribution of predominant pathogenic bacterial groups in Anhui Province, 2006-2024 ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄组（岁）C群A群B群W135群未分群
0～412（11.88）5（22.73）7（43.75）1（14.29）9（37.50）
5～917（16.83）3（13.64）3（18.75）0（0.00）3（12.50）
10～1424（23.76）6（27.27）1（6.25）3（42.86）5（20.83）
15～1927（26.73）5（22.73）3（18.75）2（28.57）4（16.67）
20～2411（10.89）2（9.09）0（0.00）0（0.00）2（8.33）
≥2510（9.90）1（4.55）2（12.50）1（14.29）1（4.17）
合计101（100.00）22（100.00）16（100.00）7（100.00）24（100.00）
), ArticleFig(id=1324050764687081880, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050686152933716, language=CN, label=表2, caption=

安徽省2006-2024年主要致病菌群年龄分布［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄组（岁）C群A群B群W135群未分群
0～412（11.88）5（22.73）7（43.75）1（14.29）9（37.50）
5～917（16.83）3（13.64）3（18.75）0（0.00）3（12.50）
10～1424（23.76）6（27.27）1（6.25）3（42.86）5（20.83）
15～1927（26.73）5（22.73）3（18.75）2（28.57）4（16.67）
20～2411（10.89）2（9.09）0（0.00）0（0.00）2（8.33）
≥2510（9.90）1（4.55）2（12.50）1（14.29）1（4.17）
合计101（100.00）22（100.00）16（100.00）7（100.00）24（100.00）
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安徽省2006—2024年流行性脑脊髓膜炎流行特征及主要致病菌群特征分析
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苏颖 , 柴瑜 , 陈霞 , 孟凡亚 , 程鹏博 , 王斌冰
现代预防医学 | 流行病与统计方法 2026,53(9): 1564-1568
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现代预防医学 |流行病与统计方法 2026 , 53 (9) : 1564 -1568
安徽省2006—2024年流行性脑脊髓膜炎流行特征及主要致病菌群特征分析
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苏颖, 柴瑜, 陈霞, 孟凡亚, 程鹏博, 王斌冰
作者信息
  • 安徽省疾病预防控制中心免疫规划所，安徽 合肥 230601
通讯作者:
王斌冰，E-mail：
作者简介:

苏颖（1982—），女，硕士，副主任医师，研究方向：疫苗可预防疾病控制

Epidemiological characteristics and predominant pathogenic bacterial groups of meningococcal meningitis in Anhui Province from 2006 to 2024
Ying SU, Yu CHAI, Xia CHEN, Fan-ya MENG, Peng-bo CHENG, Bin-bing WANG
Affiliations
  • Institute of Immunization Program, Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui 230601, China
出版时间: 2026-05-10 doi: 10.20043/j.cnki.MPM.202512166
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摘要
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目的

了解安徽省2006—2024年流行性脑脊髓膜炎（流脑）流行特征和主要致病菌群，为流脑防控工作和免疫策略调整提供依据。

方法

通过中国疾病预防控制信息系统收集2006—2024年安徽省流脑发病资料和病原学检测资料，采用描述性流行病学方法分析流脑发病的流行病学特征和菌群分布情况；采用Joinpoint软件对2006—2024年的发病情况进行分析。

结果

2006—2024年安徽省共报告流脑1 014例，年均报告发病率0.09/10万。Joinpoint回归分析显示，2006—2024年流脑发病整体呈下降趋势（平均年变化百分比=-27.66%，P<0.001），其中2008—2015年发病数下降显著（年变化百分比=-45.36%，P<0.001）。报告年均发病率前三位的地区分别为合肥市（0.34/10万）、蚌埠市（0.17/10万）和淮南市（0.12/10万）。发病主要集中在11月—次年4月，占总数的89%。男女性别比为1.43（597/417）；发病年龄主要集中在15～19岁（26.53%）、10～14岁（24.46%）和0～4岁（15.48%）；职业以学生为主，占55.23%。2006—2024年安徽省共报告170例菌群监测病例，菌群变迁呈现出C群占比减少，B群逐年上升的趋势。年龄分布上，0～4岁组主要以B群为主（43.75%），10～19岁组则以W135群、A群和C群多元化高发为主。

结论

安徽省流脑发病目前处于低水平，发病年龄集中在10～19岁和0～4岁两个高峰，流行菌株以B群为主，流脑防控面临新挑战，建议针对10～19岁青少年开展1剂次流脑疫苗加强免疫。

流行性脑脊髓膜炎  /  流行特征  /  致病菌群
Objective

To understand the epidemic characteristics and predominant pathogenic bacterial groups of meningococcal meningitis in Anhui Province from 2006 to 2024, and to provide a basis for the prevention and control of meningococcal meningitis and the adjustment of immunization strategies.

Methods

Data on the incidence of meningococcal disease and pathogen detection in Anhui Province from 2006 to 2024 were collected through the Chinese Disease Prevention and Control Information System. Descriptive epidemiological methods were used to analyze the epidemiological characteristics and bacterial distribution of meningococcal disease. The Joinpoint software was used to analyze the incidence from 2006 to 2024.

Results

From 2006 to 2024, a total of 1 014 cases of meningococcal meningitis were reported in Anhui Province, with an average annual incidence rate of 0.09 per 100 000. Joinpoint regression analysis showed that the incidence of meningococcal meningitis overall decreased from 2006 to 2024 [average annual percent change (AAPC) =-27.66%, P<0.001], with a significant decrease in the number of cases from 2008 to 2015 [annual percent change (APC) =-45.36%, P<0.001]. The top three reporting regions with the average annual incidence rate were Hefei City (0.34 per 100 000), Bengbu City (0.17 per 100 000), and Huainan City (0.12 per 100 000). The cases were mainly concentrated from November to the following April, accounting for 89% of the total. The male-to-female ratio was 1.43 (597/417); the age group with the highest incidence was 15-19 years old (26.53%), 10-14 years old (24.46%), and the 0-4 age group (15.48%); the occupation was mainly students (55.23%). From 2006 to 2024, a total of 170 cases of bacterial surveillance were reported in Anhui Province. The bacterial strain changes showed a trend of a decrease in the proportion of C strain and an increase in the proportion of B strain year by year. In terms of age distribution, the 0-4 age group was mainly dominated by the B strain (43.75%), while the 10-19 age group was mainly dominated by the W135 strain, A strain, and C strain with diversified high incidence.

Conclusion

The incidence of meningococcal disease in Anhui Province is currently at a low level. The peak incidence ages are concentrated in the 10-19 years old and 0-4 years old groups. The predominant strain is Group B. The prevention and control of meningococcal disease faces new challenges. It is recommended to provide an additional dose of meningococcal vaccine for adolescents aged 10-19 years old.

Meningococcal meningitis  /  Epidemiological characteristics  /  Pathogenic bacterial strains
苏颖, 柴瑜, 陈霞, 孟凡亚, 程鹏博, 王斌冰. 安徽省2006—2024年流行性脑脊髓膜炎流行特征及主要致病菌群特征分析. 现代预防医学, 2026 , 53 (9) : 1564 -1568 . DOI: 10.20043/j.cnki.MPM.202512166
Ying SU, Yu CHAI, Xia CHEN, Fan-ya MENG, Peng-bo CHENG, Bin-bing WANG. Epidemiological characteristics and predominant pathogenic bacterial groups of meningococcal meningitis in Anhui Province from 2006 to 2024[J]. Modern Preventive Medicine, 2026 , 53 (9) : 1564 -1568 . DOI: 10.20043/j.cnki.MPM.202512166
正文
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流行性脑脊髓膜炎（简称“流脑”）是由脑膜炎奈瑟菌（Neisseria meningitidis，Nm）侵入人体引起的一种急性化脓性脑膜炎，该疾病以发病急促，传染性较强，病死率较高[1]为特点。根据荚膜多糖不同，目前已知Nm可分为包括A群、B群、C群、Y群、X群和W135群在内的12个血清群。因不同国家、不同地区、不同时段流行的血清群不同，流脑的流行特征也在不断发生变化。
安徽省历史上流脑高发，主要以A群（98%以上）为主，自2003年在池州市青阳县首次出现C群流脑聚集性疫情[2]，流行菌群从A群转为C群。本文分析2006—2024年安徽省流脑发病的流行病学特征和主要致病菌群，为安徽省流脑防控工作和后续免疫策略的调整完善提供依据支持。
1　资料与方法
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1.1　资料来源
流脑的发病和人口学数据均从中国疾病预防控制信息系统中获取，按照发病日期2006—2024年、现住址为安徽省查询，并导出临床诊断病例和确诊病例数据；实验室确诊病例Nm血清群检测资料来源于中国疾病预防控制信息系统子系统——流脑监测报告管理系统。
1.2　流脑病例定义
2006年1月1日—2009年6月14日报告的病例按照《流行性脑脊髓膜炎诊断标准和处理原则》[3]（GB16884—1997）定义，2009年6月15日—2019年6月30日报告的病例按照《流行性脑脊髓膜炎诊断标准》[4]（WS 295—2008）定义，2019年7月1日—2024年12月31日报告的病例按照《流行性脑脊髓膜炎诊断》[5]（WS 295—2019）定义。三版标准对于流脑病例的定义在病原、传播途径、高发人群与季节以及主要临床表现等方面保持一致；而在病例诊断流程的描述方面WS 295—2019版较前两版更为清晰。
1.3　病原学检测
按照《全国流行性脑脊髓膜炎监测方案》要求，各县区疾控中心采集流脑疑似病例的脑脊液、血液、瘀点瘀斑组织液标本送至市级疾控中心实验室，采用传统细菌学方法和荧光定量核酸检测（real-time PCR检测）方法，对Nm进行菌种分群和鉴定。阳性标本在48 h内送至省级疾控中心流脑网络实验室进行复核鉴定。
1.4　统计分析
采用excel 13.0收集整理相关数据制图并统计分析。本研究中因2017和2021年安徽省无流脑病例报告，发病率为0，为解决对数转换无意义的问题，对所有年份的病例数统一加0.5进行修正，再计算修正发病率。修正后2006—2024年的发病数据采用Joinpoint软件进行分析，分别计算年变化百分比（annual percent change, APC）和平均年变化百分比（average annual percent change，AAPC）及其95%置信区间（confidence interval, CI）。为保证本研究的趋势结论具有稳健型，同步分析对所有年份病例数统一加1进行修正后的趋势变化。检验水准α=0.05。
2　结果
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2.1　流脑总体发病
安徽省2006—2024年报告流脑病例共计1 014例，其中临床诊断病例845例（83.33%），确诊病例169例（16.67%）；2017和2021年无流脑病例报告。年均发病率0.09/10万；报告死亡病例67例，病死率6.61% 。Joinpoint分析结果显示，2006—2024年发病呈下降趋势，AAPC为27.66%（P<0.001），并根据结果将发病情况分为2006—2008、2008—2015和2015—2024年进行分析。其中2008—2015年发病下降显著，平均每年下降45.36%（P<0.001）。见图1、表1。
2.2　发病特征
2.2.1　地区分布
2006—2024年，全省16个市均有流脑病例报告，发病地区主要集中在江淮之间和淮河以北地区；报告发病率最高的三个市分别为合肥市（0.34/10万）、蚌埠市（0.17/10万）和淮南市（0.12/10万）。
2.2.2　时间分布
2006—2024年安徽省报告流脑病例主要集中在11月—次年4月，病例数为901例，占发病总数的89%，其中发病最高峰出现在3月（231例）、2月（229例）和1月（199例）。4月开始，发病数明显下降，流脑发病进入低发季节。见图2。
2.2.3　人群分布
2006—2024年安徽省报告流脑病例中，男女性别比为1.43（597/417），男性发病率0.10/10万，女性发病率0.07/10万，男性发病率显著高于女性，差异有统计学意义（χ2=26.58，P<0.001）。发病人群主要集中在15～19岁组（269例），占总病例数的26.53%，其次为10～14岁组（248例）和0～4岁组（157例），分别占总病例数的24.46%和15.48%，见图3。职业分布主要为学生（560例），散居儿童（152例）和农民（67例），分别占总病例数的55.23%，14.99%和6.61%。
2.3　主要致病菌群
2006—2024年安徽省共报告170例菌群监测病例，其中C群101例（59.41%），A群22例（12.94%），B群16例（9.41%），W135群7例（4.12%），未分群24例（14.12%）。
2.3.1　致病菌群年变化趋势
2006—2010年，安徽省主要致病菌群以C群为主，占70.16%，其次是A群，占14.52%；2011—2015年，C群仍然是占比最高的致病菌群，为52.63%，但B群占比逐渐上升，为10.53%，且首次出现了W135群；2016—2020年，C群（25.00%）占比持续下降，B群（31.25%）病例所占比例首次超过C群；2021—2024年，B群成为占比最高的主要致病菌群，为63.64%。见图4。
2.3.2　年龄分布
101例C群病例主要分布在15～19岁组（27/101，26.73%）；22例A群病例主要分布在10～14岁组（6/22，27.27%）；16例B群病例主要分布在0～4岁组（7/16，43.75%）；7例W135群病例主要分布在10～14岁组（3/7，42.86%）。见表2。
2.3.3　密切接触者Nm菌群
在患者的密切接触者标本中检出122株Nm，其中C群占86.89%（106/122），A群占4.10%（5/122），B群占7.38%（9/122），W135群占0.82%（1/122），未分群占0.82%（1/122）。
3　讨论
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在流脑疫苗使用之前，安徽省流脑发病出现过三次大流行[2]，分别发生于1957—1959年、1962—1968年、1975—1980年，年均发病率分别为48.71/10万、729.25/10万和321.89/10万，主要流行菌株为A群。上世纪80年代，A群脑膜炎球菌多糖疫苗广泛接种，2002年安徽省流脑发病率降至0.06/10万。2003年本省暴发C群流脑，发病率出现回升。2006—2024年安徽省报告1 014例流脑病例，年均发病率0.09/10万，发病率年均下降27.66%，整体呈下降趋势，与全国整体发病趋势一致[6]。其中，2008—2015年全省发病水平下降显著，与2008年流脑疫苗被纳入国家免疫规划对适龄儿童开展接种，以及2010年安徽省将A群C群流脑结合疫苗（6月龄1剂次、7月龄1剂次）纳入免疫规划、替代A群流脑多糖疫苗（6月龄1剂次、9月龄1剂次）的基础免疫等免疫策略的实施有关。
本研究结果提示，全省流脑发病地区主要集中在江淮之间和淮河以北地区，这与2006年前后C群流脑集中高发于江淮之间[7]，造成江淮之间地区流脑发病陡然增高有关。流脑作为呼吸道传染病，全年各月份虽均有病例报告，高发季节仍集中在每年的11月—次年的4月，与辽宁[8]、郑州[9]等地的季节分布特征一致。人群分布上，男性发病率高于女性，与广东[10]等地结果一致，可能原因是男性激素水平对免疫系统存在一定的抑制作用，且男性社会活动较多，继而被传染几率较大。职业分布以学生为主，占比高达55.23%，与年龄发病高峰集中在15岁组（26.53%）和10岁组（24.46%）相互呼应，结果显示安徽省流脑的发病人群已从传统的0～4岁儿童[11]变为0～4岁儿童和10～19岁青少年，由单峰高发转为双峰高发，符合全国流脑发病年龄趋势变化[6]。原因可能为A群C群流脑多糖疫苗加强免疫后免疫持久性不足3年[12]，且学生群体多为室内集中学习，给Nm的传播提供了机会。北京市在2006年将第2剂次A群C群流脑多糖疫苗接种年龄由6周岁延迟3年至9周岁接种，防控效果显著[13]，值得安徽省学习借鉴。
病原学监测共报告170例致病菌群，前三位主要致病菌群为C群（59.41%）、A群（12.94%）、B群（9.41%），总体变化趋势除B群逐年上升外，C群、A群、W135群和未分群总体均呈下降趋势。结果显示，不同时间段安徽省流行的Nm菌群亦有不同。2006—2015年C群Nm是安徽省的优势流行菌群，且2012年首次出现W135群Nm[14]，2013年合肥报告一例W135群Nm死亡病例[15]，菌群多元化趋势初显；2016年起，B群Nm占比超过其他菌群，成为当下新的流行菌群，安徽省Nm发生了菌群变迁，与江苏[16]、贵州[17]等省份的菌群变迁趋势相同。菌群变迁的原因与A群C群流脑疫苗纳入免疫规划对适龄儿童开展接种，A群和C群的易感人群大幅度减少，且目前国内尚无B群Nm疫苗使用，人群体内无B群Nm的保护性抗体有关。Nm的年龄分布上，C群主要分布在15～19岁组（26.73%），A群主要分布在10～14岁组（27.27%），B群主要分布在0～4岁组（43.75%），W135群主要分布在10～14岁组（42.86%）。由上可知，小年龄组Nm以B群流行为主，10～19岁组Nm则以W135群，A群和C群多元化流行为主。
本研究存在局限性。研究数据来源于中国疾病预防控制信息系统，因平台升级和跨年度报病等客观原因，可能存在病例漏报、误报和病原学监测结果录入不及时等问题，导致监测菌群数低于实际主要致病菌群数。同时，针对发病数据中个别年份0值发病率的问题，本研究采用病例数加0.5法处理，并用加1法进行验证，两种处理方法均显示同一时间序列变化，提示本研究的趋势结论具有稳健性。该方法虽能解决模型拟和问题，但可能对低发病年份的趋势产生微小影响。
综上所述，安徽省流脑发病目前总体处于历史最低水平，且具有以下两个显著特征：（1）发病年龄由5岁以下单高峰转变为5岁以下和10～19岁双高峰；（2）Nm经历了由C群高发变迁为B群占比逐年增高，且菌群多元化趋势显著。结果提示我们，鉴于当下的流脑防控新形势，应夯实流脑常规监测工作，对学校等高危场所加强监测，提高监测系统敏感性，强化教职工和学校医务人员的流脑防控知识培训，做好学生晨检登记工作。作为社会关注度较高的学生群体，一旦发生病例可能会有舆情，我们更应关注学生群体的流脑发病情况，建议在每年流脑高发季节前的9—10月份开展健康学生带菌率监测工作，并对10～19岁人群实施1剂次流脑疫苗加强免疫，以此掌握本地带菌情况，及时制订适合本地的防控措施，应对可能发生的校园聚集性疫情。在欧美等发达国家，葛兰素史克研发的4CMenB和辉瑞研发的rLP2086等B群流脑疫苗已上市使用，且在儿童和青少年B群Nm发病中已取得较好的保护效果[18-19]。根据相关文献[20]提示，针对当下B群Nm已然成为流行菌群的趋势，我国已有多家疫苗生产企业正在开展不同技术路线的B群流脑疫苗研发工作，待我国B群流脑疫苗上市使用后，可最大程度提供人群的B群Nm免疫保护，减少B群流脑发病。同时，也应加强其他菌群，诸如W135群、Y群病例的监测，根据本省流脑发病新形势适时调整免疫策略，全方位做好防控工作。
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2026年第53卷第9期
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doi: 10.20043/j.cnki.MPM.202512166
  • 接收时间：2025-12-12
  • 首发时间：2026-11-02
  • 出版时间：2026-05-10
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  • 收稿日期：2025-12-12
基金
长三角免疫规划领军人才研究项目(CSJP035)
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    安徽省疾病预防控制中心免疫规划所，安徽 合肥 230601

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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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