Article(id=1320438069157802606, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438006813672182, articleNumber=null, orderNo=null, doi=10.11847/zgggws1147102, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1739462400000, receivedDateStr=2025-02-14, revisedDate=1741881600000, revisedDateStr=2025-03-14, acceptedDate=1760630400000, acceptedDateStr=2025-10-17, onlineDate=1792746568239, onlineDateStr=2026-10-23, pubDate=1773072000000, pubDateStr=2026-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792746568239, onlineIssueDateStr=2026-10-23, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792746568239, creator=13701087609, updateTime=1792746568239, updator=13701087609, issue=Issue{id=1320438006813672182, tenantId=1146029695717560320, journalId=1319373219989389464, year='2026', volume='42', issue='3', pageStart='257', pageEnd='384', issueExtLink='null', onlineDate='null', pubDate='1773072000000', pubDateStr='2026-03-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792746553376, creator='13701087609', updateTime=1792748100383, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1320444495519404406, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438006813672182, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1320444495519404407, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438006813672182, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=365, endPage=369, ext={EN=ArticleExt(id=1320438069367517807, articleId=1320438069157802606, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=A measles outbreak in an elementary school in Henan province, 2024: a case report, columnId=1320427692466492070, journalTitle=Chinese Journal of Public Health, columnName=Public Health Field Report, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate and analyze a measles outbreak in an elementary school in Henan province, thereby providing a basis for the prevention and control of measles outbreaks.

Methods

On-site epidemiological investigation and outbreak disposition were carried out for the suspected cases related to this outbreak reported by the China Disease Control and Prevention Information System. Blood and pharyngeal swab specimens were collected from suspected cases and close contacts. Laboratory tests included serological testing, nucleic acid testing, and genotyping for measles virus, and data were analyzed in Excel 2019 software.

Results

An outbreak of measles in an elementary school was reported in May 2024 in Henan province, with three confirmed cases, two of which were sequenced to be of the B3 genotype. The cases showed typical symptoms such as fever and rash. Among the students in the grades where the cases were located, 75.41% (276/366) had a history of immunization with ≥2 doses of measles component-containing vaccine (MCV) and 8.47% (31/366) had no history of immunization with MCV. The outbreak was effectively controlled after taking emergency vaccination, catch-up vaccination after checking for missed cases, and other measures.

Conclusions

The outbreak is caused by a measles virus strain of B3 genotype, and the dense school population and weak immunization barriers are main factors for this outbreak. In the future, efforts should be made to improve the system of school enrollment vaccination certificate verification and catch-up vaccination, increase the coverage of MCV, and build a strong immunization barrier.

, authors=Yingying LIU1, 2, Zhanpei XIAO2, Yanyang ZHANG1, 2, Daxing FENG2, Jun LI2, Xiaoxiao ZHANG2, Yonghao GUO2, Mingxia LU2, Binghui DU2, Lubin SHI2, Mingyu ZHANG2, Yating MA2, Yuting TANG1, 2, authorsList=Yingying LIU, Zhanpei XIAO, Yanyang ZHANG, Daxing FENG, Jun LI, Xiaoxiao ZHANG, Yonghao GUO, Mingxia LU, Binghui DU, Lubin SHI, Mingyu ZHANG, Yating MA, Yuting TANG, authorCompany=null, correspAuthors=Yanyang ZHANG, authorNote=null, correspAuthorsNote=
ZHANG Yanyang, E-mail:
, copyrightStatement=Copyright © 2026 Chinese Journal of Public Health. All rights reserved., 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=1320438069988274802, articleId=1320438069157802606, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=2024年河南省一起小学麻疹暴发疫情调查, columnId=1320427692667818664, journalTitle=中国公共卫生, columnName=公共卫生案例, runingTitle=null, highlight=null, articleAbstract=
目的

调查分析河南省一起小学麻疹暴发疫情,为麻疹疫情防控工作提供参考依据。

方法

对中国疾病预防控制信息系统报告的与本次疫情相关的疑似病例进行现场流行病学调查和疫情处置,采集疑似病例及密切接触者的血液、咽拭子样本。实验室检测包括麻疹病毒血清学检测、核酸检测和基因型鉴定,采用Excel 2019软件进行数据分析。

结果

2024年5月,河南省报告一起小学麻疹暴发疫情,确诊病例3例,2例测序后为B3基因型;病例出现发热、出疹等典型症状。病例所在年级明确有≥2剂次含麻疹成分疫苗(MCV)免疫史的学生占75.41%(276/366);8.47%(31/366)的学生无MCV免疫史。采取应急接种、查漏补种等处置措施后,疫情得到有效控制。

结论

该起暴发疫情由麻疹病毒株B3基因型引起,学校人口密集以及免疫屏障薄弱是本次疫情暴发的主要因素,建议完善学校入学接种证查验及补种制度,提高MCV覆盖率,筑牢免疫屏障。

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刘迎迎(2001—),硕士在读,研究方向:流行病学

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张延炀,E-mail:
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注:●为本次测序得到的基因序列。

, figureFileSmall=9gaMUX+6/Au/+0QN85PElg==, figureFileBig=OFnHTmV1yHmGTvqtE9uj4Q==, tableContent=null), ArticleFig(id=1320438077223449299, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438069157802606, language=EN, label=Tab.1, caption=

Confirmed cases of a measles outbreak in an elementary school in Henan province, 2024

, figureFileSmall=null, figureFileBig=null, tableContent=
病例性别年龄/岁发病日期/(年/月/日)就诊日期/(年/月/日)免疫史/剂末次疫苗接种日期/(年/月/日)诊断依据基因型转归
1女生122024/5/62024/5/822013/11/14IgM、核酸阳性痊愈
2男生122024/5/92024/5/922013/8/28IgM、核酸阳性B3痊愈
3女生122024/5/102024/5/1112014/6/28IgM、核酸阳性B3痊愈
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2024年河南省一起小学麻疹暴发疫情确诊病例情况

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病例性别年龄/岁发病日期/(年/月/日)就诊日期/(年/月/日)免疫史/剂末次疫苗接种日期/(年/月/日)诊断依据基因型转归
1女生122024/5/62024/5/822013/11/14IgM、核酸阳性痊愈
2男生122024/5/92024/5/922013/8/28IgM、核酸阳性B3痊愈
3女生122024/5/102024/5/1112014/6/28IgM、核酸阳性B3痊愈
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Results of the rapid assessment of vaccination coverage in the community where the cases are located

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年龄/岁MCV1MCV2
应种数/剂次实种数/剂次接种率/%应种数/剂次实种数/剂次接种率/%
0~5480.00000.00
1~121191.675360.00
2~212095.24212095.24
3~2929100.002929100.00
4~1111100.001111100.00
5~1515100.00151386.67
6~1212100.001212100.00
合计10510297.14938894.62
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病例所在社区接种率快速评估结果

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年龄/岁MCV1MCV2
应种数/剂次实种数/剂次接种率/%应种数/剂次实种数/剂次接种率/%
0~5480.00000.00
1~121191.675360.00
2~212095.24212095.24
3~2929100.002929100.00
4~1111100.001111100.00
5~1515100.00151386.67
6~1212100.001212100.00
合计10510297.14938894.62
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Results of vaccination certificate verification in the school with the outbreak

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年级总人数持证人数持证率/%0剂次1剂次≥2剂次
人数构成比/%人数构成比/%人数构成比/%
142839291.59112.81246.1235791.07
247546898.53142.99439.1941187.82
358752389.10315.93499.3744384.70
452742580.65286.597116.7132676.71
556542775.58225.158519.9132074.94
649036674.69318.475916.1227675.41
合计3 0722 60184.671375.2733112.732 13382.01
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疫情发生学校接种证查验结果

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年级总人数持证人数持证率/%0剂次1剂次≥2剂次
人数构成比/%人数构成比/%人数构成比/%
142839291.59112.81246.1235791.07
247546898.53142.99439.1941187.82
358752389.10315.93499.3744384.70
452742580.65286.597116.7132676.71
556542775.58225.158519.9132074.94
649036674.69318.475916.1227675.41
合计3 0722 60184.671375.2733112.732 13382.01
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2024年河南省一起小学麻疹暴发疫情调查
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刘迎迎 1, 2 , 肖占沛 2 , 张延炀 1, 2, *, * , 丰达星 2 , 李军 2 , 张肖肖 2 , 郭永豪 2 , 路明霞 2 , 杜冰会 2 , 史鲁斌 2 , 张明瑜 2 , 马雅婷 2 , 唐玉婷 1, 2
中国公共卫生 | 公共卫生案例 2026,42(3): 365-369
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中国公共卫生 |公共卫生案例 2026 , 42 (3) : 365 -369
2024年河南省一起小学麻疹暴发疫情调查
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2河南省疾病预防控制中心免疫预防与规划所,郑州 450016, bio={"content":"

刘迎迎(2001—),硕士在读,研究方向:流行病学

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刘迎迎(2001—),硕士在读,研究方向:流行病学

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刘迎迎1, 2, 肖占沛2, 张延炀1, 2, *, * , 丰达星2, 李军2, 张肖肖2, 郭永豪2, 路明霞2, 杜冰会2, 史鲁斌2, 张明瑜2, 马雅婷2, 唐玉婷1, 2
作者信息
  • 1郑州大学公共卫生学院,郑州 450001
  • 2河南省疾病预防控制中心免疫预防与规划所,郑州 450016
通讯作者:
张延炀,E-mail:
作者简介:

刘迎迎(2001—),硕士在读,研究方向:流行病学

A measles outbreak in an elementary school in Henan province, 2024: a case report
Yingying LIU1, 2, Zhanpei XIAO2, Yanyang ZHANG1, 2 , Daxing FENG2, Jun LI2, Xiaoxiao ZHANG2, Yonghao GUO2, Mingxia LU2, Binghui DU2, Lubin SHI2, Mingyu ZHANG2, Yating MA2, Yuting TANG1, 2
Affiliations
  • 1College of Public Health, Zhengzhou University, Zhengzhou 450001, China
  • 2Institute for Immunization Prevention and Programme, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
  • Corresponding Author:
    ZHANG Yanyang, E-mail:
出版时间: 2026-03-10 doi: 10.11847/zgggws1147102
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目的

调查分析河南省一起小学麻疹暴发疫情,为麻疹疫情防控工作提供参考依据。

方法

对中国疾病预防控制信息系统报告的与本次疫情相关的疑似病例进行现场流行病学调查和疫情处置,采集疑似病例及密切接触者的血液、咽拭子样本。实验室检测包括麻疹病毒血清学检测、核酸检测和基因型鉴定,采用Excel 2019软件进行数据分析。

结果

2024年5月,河南省报告一起小学麻疹暴发疫情,确诊病例3例,2例测序后为B3基因型;病例出现发热、出疹等典型症状。病例所在年级明确有≥2剂次含麻疹成分疫苗(MCV)免疫史的学生占75.41%(276/366);8.47%(31/366)的学生无MCV免疫史。采取应急接种、查漏补种等处置措施后,疫情得到有效控制。

结论

该起暴发疫情由麻疹病毒株B3基因型引起,学校人口密集以及免疫屏障薄弱是本次疫情暴发的主要因素,建议完善学校入学接种证查验及补种制度,提高MCV覆盖率,筑牢免疫屏障。

麻疹  /  B3基因型  /  小学  /  麻疹病毒  /  基因型鉴定  /  血清学检测  /  麻疹成分疫苗  /  河南省
Objective

To investigate and analyze a measles outbreak in an elementary school in Henan province, thereby providing a basis for the prevention and control of measles outbreaks.

Methods

On-site epidemiological investigation and outbreak disposition were carried out for the suspected cases related to this outbreak reported by the China Disease Control and Prevention Information System. Blood and pharyngeal swab specimens were collected from suspected cases and close contacts. Laboratory tests included serological testing, nucleic acid testing, and genotyping for measles virus, and data were analyzed in Excel 2019 software.

Results

An outbreak of measles in an elementary school was reported in May 2024 in Henan province, with three confirmed cases, two of which were sequenced to be of the B3 genotype. The cases showed typical symptoms such as fever and rash. Among the students in the grades where the cases were located, 75.41% (276/366) had a history of immunization with ≥2 doses of measles component-containing vaccine (MCV) and 8.47% (31/366) had no history of immunization with MCV. The outbreak was effectively controlled after taking emergency vaccination, catch-up vaccination after checking for missed cases, and other measures.

Conclusions

The outbreak is caused by a measles virus strain of B3 genotype, and the dense school population and weak immunization barriers are main factors for this outbreak. In the future, efforts should be made to improve the system of school enrollment vaccination certificate verification and catch-up vaccination, increase the coverage of MCV, and build a strong immunization barrier.

measles  /  B3 genotype  /  elementary school  /  measles virus  /  genotyping  /  serological testing  /  measles containing vaccine  /  Henan province
刘迎迎, 肖占沛, 张延炀, 丰达星, 李军, 张肖肖, 郭永豪, 路明霞, 杜冰会, 史鲁斌, 张明瑜, 马雅婷, 唐玉婷. 2024年河南省一起小学麻疹暴发疫情调查. 中国公共卫生, 2026 , 42 (3) : 365 -369 . DOI: 10.11847/zgggws1147102
Yingying LIU, Zhanpei XIAO, Yanyang ZHANG, Daxing FENG, Jun LI, Xiaoxiao ZHANG, Yonghao GUO, Mingxia LU, Binghui DU, Lubin SHI, Mingyu ZHANG, Yating MA, Yuting TANG. A measles outbreak in an elementary school in Henan province, 2024: a case report[J]. Chinese Journal of Public Health, 2026 , 42 (3) : 365 -369 . DOI: 10.11847/zgggws1147102
麻疹是由麻疹病毒(measles virus, MeV)引起的具有高度传染性的急性发热出疹性疾病,潜伏期为6~21 d,主要通过呼吸道飞沫传播,在人口密集且疫苗接种率不高的地区易发生流行[1]。实现疫苗高接种率使人群免疫力维持在较高水平是实现消除麻疹的基础,快速有效地调查处置暴发疫情亦是消除麻疹的重要措施。自2011年河南省与全国同步开展强化免疫后,河南省麻疹发病率呈显著下降趋势,暴发疫情的规模和数量也明显减少[2]。近年来,全球麻疹疫情呈现上升趋势,已消除麻疹的欧美地区亦出现麻疹疫情卷土重来趋势[3–5]。因此,麻疹疫情回升带来的输入性风险不容忽视。2024年5月,河南省某小学共报告麻疹病例3例,为全省自2016年以来首起校园麻疹暴发疫情。本研究通过对此次疫情的流行病学特征及处置情况进行分析,为麻疹疫情防控工作提供参考依据。
通过“中国疾病预防控制信息系统”的“麻疹监测信息报告管理系统”,对河南省2024年5月12—13日报告的3例麻疹疑似病例进行现场流行病学调查。
(1)疑似病例:出现发热、出疹,伴咳嗽、卡他性鼻炎、结膜炎等症状之一者。(2)确诊病例:疑似病例中血样本检测麻疹IgM抗体阳性者或核酸阳性者。(3)麻疹暴发疫情:指以村(居委会、学校或其他集体机构)为单位,10 d内发生≥2例麻疹;以乡(镇、社区、街道)为单位,10 d内发生≥5例麻疹;以县为单位,7 d内发病水平较前5年同期平均水平升高1倍以上。(4)疫情结束:最后1例麻疹病例发病后21 d内无新发病例可判断为暴发疫情结束。
(1)个案调查及采样:按照《全国麻疹监测方案》(2014年)[6]中的麻疹监测病例流行病学个案调查表,由专业人员对相关病例进行现场调查。调查内容包括基本信息、临床信息、暴露史、麻疹既往病史、疫苗接种史、居住地和其发病前7~21 d以及在传染期的活动轨迹等;并采集病例急性期血液样本和咽拭子样本。为了解疫情的波及规模,对同班学生等密切接触者人员进行血液和咽拭子采样,检测血清IgM和核酸。(2)病例搜索:通过查阅该县全部医疗机构(内科、儿科、皮肤科、传染病科等)自2024年3月4日以来的门诊日志、出入院登记等诊疗记录,搜索既往发热或出疹病例;对该县全部中小学严格落实晨、午检查,根据缺勤记录对缺勤的学生进行电话调查和登记,符合麻疹疑似病例的进行个案调查、采样检测,坚持日报告为零报告3周以上;此外,对病例所在社区及附近住户,通过走访搜索病例。(3)接种率评估:采用入户查看接种证及查阅河南省免疫规划信息管理系统的方式,收集病例所在小区<7岁儿童以及疫情发生学校所有学生含麻疹成分疫苗(measles containing vaccine, MCV)的接种情况。
血清学检测使用德国维润赛润公司提供的试剂盒,参照说明书,采用酶联免疫吸附试验(enzyme-linked immunosorbent assay, ELISA)检测疑似病例及密切接触者的麻疹 IgM 抗体。使用江苏硕世生物科技有限公司提供的麻疹病毒核酸检测试剂盒(荧光定量PCR法)对疑似病例的咽拭子样本进行核酸检测。对麻疹核酸阳性咽拭子样本进行麻疹病毒分离培养,同时进行麻疹病毒N(Nucleoprotein, N)基因编码序列羧基(COOH)末端对应的450个核苷酸序列(N450)进行测序,对所得序列与基因型参考序列进行比对,从而确定基因型。
采用Excel 2019软件对数据进行整理,统计疫苗接种率、免疫史构成比等指标,采用描述性方法分析此次疫情流行特征。
此次麻疹暴发疫情发生在河南省东南部某县的一所实验中学附属小学。该校为非寄宿制学校,学生共计3 072人,教职工192人。该起麻疹暴发疫情共报告3例麻疹病例,均为12岁,为该小学6年级同班同学且座位邻近(该班级学生共86人,罹患率为3.49%)。病例1,首发病例,女生,曾在2024年5月2—3日前往邻近省份儿童医院陪其弟看病,并在附近商场购物;5月6日发热38.7 ℃,自行口服退烧药后正常返校上课;5月9日,出现皮疹,下午放学后量体温至39.3 ℃,前往一诊所就诊,诊断为“病毒疹”;5月10—11日,前往该县医院就诊,以“感染性发热”收治于该县人民医院感染科。病例2,男生,发病前21 d无旅游史,于5月9日出现发热,前往该县一诊所输液;5月13日前往县人民医院发热门诊就诊,以“感染性发热”收治于县人民医院感染科。病例3,女生,发病前21 d无旅游史,于5月10日出现发热39.5 ℃,颈部出现散在红疹。5月11—12日,持续高热,红疹增加,前往某卫生院就诊;医生问诊后未开药,嘱咐其回家继续观察。
本次确诊的3例病例症状典型,均出现发热、出疹,伴咳嗽、流涕等症状,面部、前胸、后背有散在红色斑丘疹,口腔、咽部周围有红晕的白色斑点。
3例麻疹病毒核酸检测均为阳性,其中病例2和病例3咽拭子样本经RT-PCR扩增后测序,聚类分析显示与B3基因型参考序列在同一分支。基因序列同源性分析显示,分离自病例2和病例3的麻疹核苷酸序列完全一致,同源性100%,与B3型参考株序列(MVi/Ibadan.NGE/0.97/1)同源性最高,达到97.0%。证明这是一起B3亚型麻疹野病毒引起的暴发疫情。
对3例确诊病例立即进行隔离和对症治疗,均痊愈。对病例所在班级师生及其他密切接触者人员共计119人进行核酸和抗体检测,其中9人核酸或IgM阳性,但无麻疹相关症状,密切接触者按照方案要求居家隔离观察。观察期限为最后一次接触21 d后,无新发病例。该起暴发疫情结束。
2024年5月13日—6月3日,对该县医疗机构、学校、病例所在小区开展病例主动搜索,以“发热、麻疹、疹”等为关键词搜索HIS系统,查阅医疗机构门诊日志、出入院登记等记录;对全县中小学校和托幼儿童进行晨午检和因病缺勤学生追踪调查,共搜索发热等症状病例13 489例,未发现麻疹疑似及确诊病例。
对确诊病例所居住的小区进行接种率快速评估调查,共调查108人,其中105人达到起始免疫年龄,MCV1接种率为97.14%,MCV2接种率为94.62%,不同年龄组MCV接种率情况见表2。对疫情发生学校开展接种证查验,共查验3 072人,有471人(15.33%)免疫史不详。查阅到接种证的学生中82.01%有≥2剂次MCV免疫史,5.27%无MCV免疫史,各年级有≥2剂次MCV免疫史的学生占比在74.94%~91.07%;病例所在年级≥2剂次MCV免疫史的学生占75.41%,8.47%的学生无MCV免疫史,见表3。疫情发生3天内对该校(3 264人)及所属中学(1 287人)共4 551名在校教职工和学生进行麻腮风疫苗应急接种,共计接种4 173人,应急接种率达91.69%。在全县范围内,对<15岁儿童开展麻疹疫苗查漏补种工作,查漏10 774人,实补种10 257人,补种率为95.20%。
近年来,河南省MCV接种率一直维持在较高水平[7]。因此,发生大规模麻疹暴发疫情的风险较小,但局部暴发疫情的风险仍然存在。赵东阳等[8]研究显示,7~15岁、学生和入托儿童的麻疹抗体浓度及阳性率相对其他人群较低。学校因人员密集且人群免疫屏障相对薄弱,历来是肠道及呼吸道等传染病暴发的高风险场所[9–10]。2016—2020年我国共报告344起麻疹暴发疫情,其中发生在学校有54起[11],可见学校依然是麻疹防控的重点场所。然而,国内针对学校麻疹暴发疫情调查处置的研究相对较少。
我国麻疹病毒学监测结果显示,H1型是我国麻疹病毒流行的绝对优势本土基因型。自2009年起,我国陆续监测到国外输入的非H1基因型病毒,主要包括D8、D9、B3等[12–13]。目前B3基因型已经成为非洲大部分地区的本土优势流行基因型,并输入欧洲和美洲等多个国家[4,14–16]。2013年中国首次在上海分离到B3基因型麻疹毒株[17],之后在江苏省[18]、河北省[19]、福建省[20]等地区陆续有B3基因型麻疹病例的报道。本起疫情溯源追踪结果表明,病例1可能为传染源,但具体的感染来源尚不明确。此次监测到的麻疹病例与H1a、D8等基因型麻疹病例临床表现类似,出现发热、出疹、咳嗽等典型症状[18,21]。麻疹早期症状多为发热、咳嗽等非特异性表现,与其他病毒性感冒难以区分,易出现误诊情况[22],往往不易引起重视,未及时隔离和治疗,引起疫情扩散。因此,应加强麻疹健康教育和知识培训,对医疗机构医务人员进行麻疹诊断培训,进一步提高麻疹的早期识别和诊断能力。
世界卫生组织认为疫苗接种率≥95%时,可建立有效的免疫屏障[23]。但接种率现场评估结果显示,病例所在学校82.01%的学生有≥2剂次MCV免疫史,其中病例所在年级仅为75.41%,由于15.33%学生免疫史不详,MCV接种率可能被低估,但是该校5.27%的学生无免疫史,且有1例确诊病例仅接种1剂次MCV,表明该校免疫屏障相对薄弱,可能促进了本次疫情的传播;与陈泓泓等[24]、吕宛玉等[25]对麻疹暴发疫情的研究结果一致。建议教育部门联合卫生部门制定入学接种证查验及补种制度,提高2剂次MCV的接种率是预防和控制学校麻疹暴发流行的有效措施。尽管接种疫苗可以有效降低麻疹病毒感染的发生率,但研究表明,麻疹保护性抗体水平随年龄增长逐渐衰减[26];这可能是确诊病例接种MCV后仍然发病的主要原因,与先前研究一致。Ma R等[27]研究发现,距离末次接种MCV的时间与麻疹发病风险显著相关,距离末次接种MCV≥10年的发病风险是<10年的4.6~5.5倍。本次疫情中确诊的3例病例距离末剂MCV接种间隔为10~11年,麻疹抗体水平可能较低,或许是本次疫情暴发的原因之一。建议在疫苗接种后加强对血清抗体的监测,进一步研究疫苗诱导抗体的持久性,针对抗体水平较低的人群进行补充免疫接种。
在麻疹疫苗接种率高覆盖的情况下,对暴发疫情进行及时有效的处置,是我国消除麻疹工作的重点[11]。在此次疫情调查的同时,对病例所在学校、小区开展接种率快速评估,了解周围人群的免疫状况,据此进行应急接种、查漏补种,从而在短期内保护易感者、减少二代病例、阻断病毒持续传播。此外,积极开展全面排查、主动搜索疑似病例,对密切接触者进行排查与隔离是成功阻断此次学校疫情传播的重要措施。
本研究还存在一些局限性。本起暴发疫情,首例病例的感染来源尚不明确;未开展麻疹IgG抗体亲和力检测,因而无法判定是否存在原发性和继发性免疫失败。
综上所述,该起小学麻疹暴发疫情由麻疹病毒株B3基因型引起,学校人口密集以及免疫屏障薄弱是本次疫情暴发的主要因素。今后应完善学校入学接种证查验及补种制度,提高MCV覆盖率,筑牢免疫屏障。同时,应加强血清抗体水平监测,进一步研究疫苗诱导抗体的持久性,针对抗体水平较低的人群开展疫苗补充免疫。此外,加强健康教育和诊断培训对于早期识别病例具有重要意义,以便及时采取措施防止疫情扩散。

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doi: 10.11847/zgggws1147102
  • 接收时间:2025-02-14
  • 首发时间:2026-10-23
  • 出版时间:2026-03-10
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  • 收稿日期:2025-02-14
  • 修回日期:2025-03-14
  • 录用日期:2025-10-17
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    1郑州大学公共卫生学院,郑州 450001
    2河南省疾病预防控制中心免疫预防与规划所,郑州 450016

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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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