Article(id=1325501900988228098, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325501865651216714, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025098, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1731513600000, receivedDateStr=2024-11-14, revisedDate=1737907200000, revisedDateStr=2025-01-27, acceptedDate=null, acceptedDateStr=null, onlineDate=1793953879829, onlineDateStr=2026-11-06, pubDate=1745510400000, pubDateStr=2025-04-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793953879829, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793953879829, creator=13701087609, updateTime=1793953879829, updator=13701087609, issue=Issue{id=1325501865651216714, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='4', pageStart='457', pageEnd='572 578', issueExtLink='null', onlineDate='null', pubDate='1745510400000', pubDateStr='2025-04-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793953871404, creator='13701087609', updateTime=1793953871404, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=592, endPage=596, ext={EN=ArticleExt(id=1325501901881614851, articleId=1325501900988228098, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Incidence of statutory and key-monitored infectious diseases among students in Beijing from 2016 to 2020, columnId=1325500884406379444, journalTitle=Chinese Journal of School Health, columnName=Disease Control, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the incidence of statutory and key-monitored infectious diseases among school students in Beijing from 2016 to 2020, so as to provide a reference for developing the prevention and control of infectious diseases in schools.

Methods

A descriptive statistical analysis was conducted on student cases aged 6-22 years in Beijing from 2016 to 2020 selected from the China Disease Surveillance Information Reporting Management System. Rate comparisons were performed using the χ2 test and trend χ2 test.

Results

From 2016 to 2020, the overall incidence of statutory and key-monitored infectious diseases among students in Beijing showed an upward trend (\begin{document}$\chi _{{\rm{trend}}}^2$\end{document}=582.42), the incidence rates of Category B and other infectious diseases exhibited a downward trend (\begin{document}$\chi _{{\rm{trend}}}^2$\end{document}=82.71, 18.34), while Category C infectious diseases demonstrated a significant upward trend (\begin{document}$\chi _{{\rm{trend}}}^2$\end{document}=911.75) (P < 0.01). Among Category B infectious diseases, scarlet fever, bacillary dysentery, tuberculosis, and HIV/AIDS were predominant, with annual average incidence rates of 61.33/100 000, 35.38/100 000, 13.88/100 000, and 3.78/100 000, respectively. Except for HIV/AIDS, the reported incidence rates of other infectious diseases showed a declining trend. Among Category C infectious diseases, influenza, other infectious diarrhea, hand-foot-mouth disease, and mumps were predominant, with annual average incidence rates of 956.13/100 000, 114.39/100 000, 111.37/100 000, and 28.24/100 000, respectively. Influenza showed a significant upward trend (\begin{document}$\chi _{{\rm{trend}}}^2$\end{document}=1 508.30), while the other infectious diarrhea, hand-foot-mouth disease, and mumps exhibited a downward trend (\begin{document}$\chi _{{\rm{trend}}}^2$\end{document}=13.84, 25.78, 6.13) (P < 0.05). Among other infectious diseases, varicella was predominant (\begin{document}$\chi _{{\rm{trend}}}^2$\end{document}=17.47, P < 0.05). Scarlet fever, influenza, hand-foot-mouth disease, and mumps had higher incidence rates among primary and middle school students; other infectious diarrhea and varicella were more prevalent among high school students; tuberculosis and bacillary dysentery were more common among high school and college students; and HIV/AIDS had higher incidence rates among college and high school students.

Conclusion

From 2016 to 2020, the incidence of Category B infectious diseases among students in Beijing showed a declining trend, while influenza, a Category C infectious disease, exhibited a significant upward trend.

, authors=Wenjie XU1, Chengxu BAI1, Dongni CHEN1, Zhiwei XIA1, Shuangsheng WU*, 1, Xin GUO*, 2, Peng YANG1, authorsList=Wenjie XU, Chengxu BAI, Dongni CHEN, Zhiwei XIA, Shuangsheng WU, Xin GUO, Peng YANG, authorCompany=null, correspAuthors=Shuangsheng WU, Xin GUO, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Chinese Journal of School 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=1325501903852937732, articleId=1325501900988228098, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=北京市学生2016—2020年法定和重点监测传染病发病情况, columnId=1325500884628677558, journalTitle=中国学校卫生, columnName=疾病控制, runingTitle=null, highlight=null, articleAbstract=
目的

了解2016—2020年北京市学生法定和重点监测传染病的发病情况,为制定学校传染病防控策略提供参考依据。

方法

在“中国疾病监测信息报告管理系统”中选择2016—2020年北京市6~22岁的学生病例进行描述性统计分析;率的比较采用χ2检验和趋势χ2检验。

结果

2016—2020年,北京市学生法定传染病和重点监测传染病发病率总体呈上升趋势(\begin{document}$\chi _{趋势}^2 $\end{document}=582.42),乙类、其他类传染病发病率呈下降趋势(\begin{document}$\chi _{趋势}^2 $\end{document}值分别为82.71,18.34);丙类传染病发病率呈上升趋势(\begin{document}$\chi _{趋势}^2 $\end{document}=991.75)(P值均 < 0.01)。乙类传染病中以猩红热、细菌性痢疾、肺结核、艾滋病病毒感染和艾滋病(HIV/AIDS)为主,年均发病率分别为61.33/10万、35.38/10万、13.88/10万、3.78/10万;除HIV/AIDS外,其余传染病报告发病率均有下降趋势。丙类传染病以流行性感冒、其他感染性腹泻、手足口病和流行性腮腺炎为主,年均发病率分别为956.13/10万、114.39/10万、111.37/10万、28.24/10万;其中流行性感冒呈上升趋势(\begin{document}$\chi _{趋势}^2 $\end{document}=1 508.30),其他感染性腹泻、手足口病、流行性腮腺炎发病率均呈下降趋势(\begin{document}$\chi _{趋势}^2 $\end{document}值分别为13.84,25.78,6.13)(P值均 < 0.05)。其他传染病以水痘为主,年均发病率呈下降趋势(\begin{document}$\chi _{趋势}^2 $\end{document}=17.47,P < 0.05)。猩红热、流行性感冒、手足口病、流行性腮腺炎在小学生和中学生中发病率较高,其他感染性腹泻、水痘在高中生中发病率较高,肺结核、细菌性痢疾在高中生、大学生中发病率较高,HIV/AIDS在大学生、高中生中发病率较高。

结论

2016—2020年北京市学生人群中乙类传染病发病呈现下降趋势,丙类传染病中流行性感冒有大幅上升趋势。

, authors=徐文婕1, 白承续1, 陈东妮1, 夏志伟1, 吴双胜*, 1, 郭欣*, 2, 杨鹏1, authorsList=徐文婕, 白承续, 陈东妮, 夏志伟, 吴双胜, 郭欣, 杨鹏, authorCompany=null, correspAuthors=吴双胜, 郭欣, authorNote=

徐文婕(1986- ),女,甘肃省人,硕士,主管医师,主要研究方向为学校卫生。

, correspAuthorsNote=
吴双胜,E-mail:
郭欣,E-mail:
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徐文婕(1986- ),女,甘肃省人,硕士,主管医师,主要研究方向为学校卫生。

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徐文婕(1986- ),女,甘肃省人,硕士,主管医师,主要研究方向为学校卫生。

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Comparison of reported incidence rates of notifiable and key monitored infectious diseases among students in Beijing from 2016 to 2020

, figureFileSmall=null, figureFileBig=null, tableContent=
年份乙类丙类其他合计
20162 891(143.88)8 202(408.21)4 102(204.15)15 195(756.24)
20173 183(160.82)12 413(627.18)4 708(237.88)20 304(1 025.88)
20182 925(144.82)19 903(985.40)4 905(242.85)27 733(1 373.07)
20192 716(131.48)64 289(3 112.24)4 949(239.58)71 954(3 483.31)
2020761(35.41)19 018(884.92)2 282(106.18)22 061(1 026.51)
均值2 495(122.04)24 765(1 211.24)4 189(204.89)31 449(1 538.16)
$\chi _{趋势}^2 $值82.71991.7518.34582.42
P值<0.01<0.01<0.01<0.01
), ArticleFig(id=1325501909318115895, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501900988228098, language=CN, label=表1, caption=

北京市2016—2020年学生法定及重点监测传染病报告发病率比较

, figureFileSmall=null, figureFileBig=null, tableContent=
年份乙类丙类其他合计
20162 891(143.88)8 202(408.21)4 102(204.15)15 195(756.24)
20173 183(160.82)12 413(627.18)4 708(237.88)20 304(1 025.88)
20182 925(144.82)19 903(985.40)4 905(242.85)27 733(1 373.07)
20192 716(131.48)64 289(3 112.24)4 949(239.58)71 954(3 483.31)
2020761(35.41)19 018(884.92)2 282(106.18)22 061(1 026.51)
均值2 495(122.04)24 765(1 211.24)4 189(204.89)31 449(1 538.16)
$\chi _{趋势}^2 $值82.71991.7518.34582.42
P值<0.01<0.01<0.01<0.01
), ArticleFig(id=1325501909389419064, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501900988228098, language=EN, label=Tab.2, caption=

Comparison of reported incidence rates of major infectious diseases among students in Beijing from 2016 to 2020/10-5

, figureFileSmall=null, figureFileBig=null, tableContent=
年份乙类丙类水痘
猩红热细菌性痢疾肺结核HIV/AIDS其他感染性腹泻流行性感冒手足口病流行性腮腺炎
201658.8851.0621.854.18126.81136.12110.6933.89184.99
201785.7947.3414.805.15132.08347.77113.2333.50220.45
201886.4933.0714.613.32120.36643.09190.4230.99222.00
201972.5734.2313.074.11132.112 816.02131.4330.01221.43
20206.6512.985.682.2363.84789.5316.7014.6693.99
$\chi _{趋势}^2 $值22.0422.268.140.6913.841 508.3025.786.1317.47
P值<0.01<0.01<0.010.41<0.01<0.01<0.010.01<0.01
), ArticleFig(id=1325501909477499449, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501900988228098, language=CN, label=表2, caption=

北京市2016—2020年学生主要传染病报告发病率比较/10-5

, figureFileSmall=null, figureFileBig=null, tableContent=
年份乙类丙类水痘
猩红热细菌性痢疾肺结核HIV/AIDS其他感染性腹泻流行性感冒手足口病流行性腮腺炎
201658.8851.0621.854.18126.81136.12110.6933.89184.99
201785.7947.3414.805.15132.08347.77113.2333.50220.45
201886.4933.0714.613.32120.36643.09190.4230.99222.00
201972.5734.2313.074.11132.112 816.02131.4330.01221.43
20206.6512.985.682.2363.84789.5316.7014.6693.99
$\chi _{趋势}^2 $值22.0422.268.140.6913.841 508.3025.786.1317.47
P值<0.01<0.01<0.010.41<0.01<0.01<0.010.01<0.01
), ArticleFig(id=1325501909536219706, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501900988228098, language=EN, label=Tab.3, caption=

Comparison of reported incidence rates of major infectious diseases among students with different educational stagesn in Beijing from 2016 to 2020

, figureFileSmall=null, figureFileBig=null, tableContent=
学段乙类丙类水痘
猩红热细菌性痢疾肺结核HIV/AIDS其他感染性腹泻流行性感冒手足口病流行性腮腺炎
小学6 213(135.24)1 041(22.66)47(1.02)1(0.02)4 390(95.56)71 195(1 549.69)10 151(220.96)2 447(53.26)8 638(188.02)
初中43(2.96)457(31.46)195(13.42)3(0.21)1 636(112.61)11 793(811.72)794(54.65)203(13.97)2 806(193.14)
高中10(0.80)860(68.82)496(39.69)52(4.16)2 660(212.88)8 303(664.48)304(24.33)110(8.80)3 797(303.87)
大学4(0.14)1 259(43.02)681(23.27)330(11.28)3 008(102.79)6 454(220.54)136(4.65)145(4.95)3 917(133.85)
χ2值385.8829.1942.4421.5369.091 137.45383.8372.6474.76
P值<0.01<0.01<0.01<0.01<0.01<0.01<0.01<0.01<0.01
), ArticleFig(id=1325501909590745659, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501900988228098, language=CN, label=表3, caption=

北京市2016—2020年不同学段学生主要传染病报告发病率比较

, figureFileSmall=null, figureFileBig=null, tableContent=
学段乙类丙类水痘
猩红热细菌性痢疾肺结核HIV/AIDS其他感染性腹泻流行性感冒手足口病流行性腮腺炎
小学6 213(135.24)1 041(22.66)47(1.02)1(0.02)4 390(95.56)71 195(1 549.69)10 151(220.96)2 447(53.26)8 638(188.02)
初中43(2.96)457(31.46)195(13.42)3(0.21)1 636(112.61)11 793(811.72)794(54.65)203(13.97)2 806(193.14)
高中10(0.80)860(68.82)496(39.69)52(4.16)2 660(212.88)8 303(664.48)304(24.33)110(8.80)3 797(303.87)
大学4(0.14)1 259(43.02)681(23.27)330(11.28)3 008(102.79)6 454(220.54)136(4.65)145(4.95)3 917(133.85)
χ2值385.8829.1942.4421.5369.091 137.45383.8372.6474.76
P值<0.01<0.01<0.01<0.01<0.01<0.01<0.01<0.01<0.01
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北京市学生2016—2020年法定和重点监测传染病发病情况
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徐文婕 1 , 白承续 1 , 陈东妮 1 , 夏志伟 1 , 吴双胜 *, 1 , 郭欣 *, 2 , 杨鹏 1
中国学校卫生 | 疾病控制 2025,46(4): 592-596
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中国学校卫生 |疾病控制 2025 , 46 (4) : 592 -596
北京市学生2016—2020年法定和重点监测传染病发病情况
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徐文婕1, 白承续1, 陈东妮1, 夏志伟1, 吴双胜*, 1 , 郭欣*, 2 , 杨鹏1
作者信息
  • 1北京市疾病预防控制中心学校卫生所, 北京 100013
  • 2中国疾病预防控制中心
通讯作者:
吴双胜,E-mail:
郭欣,E-mail:
作者简介:

徐文婕(1986- ),女,甘肃省人,硕士,主管医师,主要研究方向为学校卫生。

Incidence of statutory and key-monitored infectious diseases among students in Beijing from 2016 to 2020
Wenjie XU1, Chengxu BAI1, Dongni CHEN1, Zhiwei XIA1, Shuangsheng WU*, 1 , Xin GUO*, 2 , Peng YANG1
Affiliations
  • 1Institute of School Health, Beijing Municipal Center for Disease Control and Prevention, Beijing (100013), China
出版时间: 2025-04-25 doi: 10.16835/j.cnki.1000-9817.2025098
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目的

了解2016—2020年北京市学生法定和重点监测传染病的发病情况,为制定学校传染病防控策略提供参考依据。

方法

在“中国疾病监测信息报告管理系统”中选择2016—2020年北京市6~22岁的学生病例进行描述性统计分析;率的比较采用χ2检验和趋势χ2检验。

结果

2016—2020年,北京市学生法定传染病和重点监测传染病发病率总体呈上升趋势(\begin{document}$\chi _{趋势}^2 $\end{document}=582.42),乙类、其他类传染病发病率呈下降趋势(\begin{document}$\chi _{趋势}^2 $\end{document}值分别为82.71,18.34);丙类传染病发病率呈上升趋势(\begin{document}$\chi _{趋势}^2 $\end{document}=991.75)(P值均 < 0.01)。乙类传染病中以猩红热、细菌性痢疾、肺结核、艾滋病病毒感染和艾滋病(HIV/AIDS)为主,年均发病率分别为61.33/10万、35.38/10万、13.88/10万、3.78/10万;除HIV/AIDS外,其余传染病报告发病率均有下降趋势。丙类传染病以流行性感冒、其他感染性腹泻、手足口病和流行性腮腺炎为主,年均发病率分别为956.13/10万、114.39/10万、111.37/10万、28.24/10万;其中流行性感冒呈上升趋势(\begin{document}$\chi _{趋势}^2 $\end{document}=1 508.30),其他感染性腹泻、手足口病、流行性腮腺炎发病率均呈下降趋势(\begin{document}$\chi _{趋势}^2 $\end{document}值分别为13.84,25.78,6.13)(P值均 < 0.05)。其他传染病以水痘为主,年均发病率呈下降趋势(\begin{document}$\chi _{趋势}^2 $\end{document}=17.47,P < 0.05)。猩红热、流行性感冒、手足口病、流行性腮腺炎在小学生和中学生中发病率较高,其他感染性腹泻、水痘在高中生中发病率较高,肺结核、细菌性痢疾在高中生、大学生中发病率较高,HIV/AIDS在大学生、高中生中发病率较高。

结论

2016—2020年北京市学生人群中乙类传染病发病呈现下降趋势,丙类传染病中流行性感冒有大幅上升趋势。

传染病  /  人群监测  /  发病率  /  学生
Objective

To analyze the incidence of statutory and key-monitored infectious diseases among school students in Beijing from 2016 to 2020, so as to provide a reference for developing the prevention and control of infectious diseases in schools.

Methods

A descriptive statistical analysis was conducted on student cases aged 6-22 years in Beijing from 2016 to 2020 selected from the China Disease Surveillance Information Reporting Management System. Rate comparisons were performed using the χ2 test and trend χ2 test.

Results

From 2016 to 2020, the overall incidence of statutory and key-monitored infectious diseases among students in Beijing showed an upward trend (\begin{document}$\chi _{{\rm{trend}}}^2$\end{document}=582.42), the incidence rates of Category B and other infectious diseases exhibited a downward trend (\begin{document}$\chi _{{\rm{trend}}}^2$\end{document}=82.71, 18.34), while Category C infectious diseases demonstrated a significant upward trend (\begin{document}$\chi _{{\rm{trend}}}^2$\end{document}=911.75) (P < 0.01). Among Category B infectious diseases, scarlet fever, bacillary dysentery, tuberculosis, and HIV/AIDS were predominant, with annual average incidence rates of 61.33/100 000, 35.38/100 000, 13.88/100 000, and 3.78/100 000, respectively. Except for HIV/AIDS, the reported incidence rates of other infectious diseases showed a declining trend. Among Category C infectious diseases, influenza, other infectious diarrhea, hand-foot-mouth disease, and mumps were predominant, with annual average incidence rates of 956.13/100 000, 114.39/100 000, 111.37/100 000, and 28.24/100 000, respectively. Influenza showed a significant upward trend (\begin{document}$\chi _{{\rm{trend}}}^2$\end{document}=1 508.30), while the other infectious diarrhea, hand-foot-mouth disease, and mumps exhibited a downward trend (\begin{document}$\chi _{{\rm{trend}}}^2$\end{document}=13.84, 25.78, 6.13) (P < 0.05). Among other infectious diseases, varicella was predominant (\begin{document}$\chi _{{\rm{trend}}}^2$\end{document}=17.47, P < 0.05). Scarlet fever, influenza, hand-foot-mouth disease, and mumps had higher incidence rates among primary and middle school students; other infectious diarrhea and varicella were more prevalent among high school students; tuberculosis and bacillary dysentery were more common among high school and college students; and HIV/AIDS had higher incidence rates among college and high school students.

Conclusion

From 2016 to 2020, the incidence of Category B infectious diseases among students in Beijing showed a declining trend, while influenza, a Category C infectious disease, exhibited a significant upward trend.

Communicable diseases  /  Population surveillance  /  Incidence  /  Students
徐文婕, 白承续, 陈东妮, 夏志伟, 吴双胜, 郭欣, 杨鹏. 北京市学生2016—2020年法定和重点监测传染病发病情况. 中国学校卫生, 2025 , 46 (4) : 592 -596 . DOI: 10.16835/j.cnki.1000-9817.2025098
Wenjie XU, Chengxu BAI, Dongni CHEN, Zhiwei XIA, Shuangsheng WU, Xin GUO, Peng YANG. Incidence of statutory and key-monitored infectious diseases among students in Beijing from 2016 to 2020[J]. Chinese Journal of School Health, 2025 , 46 (4) : 592 -596 . DOI: 10.16835/j.cnki.1000-9817.2025098
学校是传染病的潜在高发区域和聚集性疫情、突发公共卫生事件的主要场所,学生是流行性感冒、诺如病毒感染性胃肠炎、手足口病等传染病的易感人群[1-2]。尽早发现学校的传染病疫情和突发公共卫生事件,预防学校传染病暴发疫情的发生和发展,是维持正常教学秩序、保障广大师生和人民群众健康的关键,也是对全社会传染病和突发公共卫生事件防控的重要环节。本研究旨在充分利用传染病网络直报系统监测数据,分析和评估2016—2020年北京市学生人群传染病流行病学特征和发病趋势,为制定高效的学校传染病防控策略提供参考。
从“中国疾病预防控制信息系统”中选择发病时间在2016年1月1日—2020年12月31日的北京市6~22岁学生报告病例,疾病种类为国家法定甲、乙、丙类传染病和纳入北京市疾病监测系统的其他法定管理和重点监测疾病,病例类型包括临床诊断病例和确诊病例。人口数据资料引自《北京市教育事业发展统计概况》[3]中的小学、初中、高中及大学学生总数,其中大学生包括普通本专科学生,高中生包括普通高中、普通中专、职业高中、技工学校学生。数据内容包括性别、年龄、发病日期、诊断疾病等。
从上述信息系统中导出Excel数据,用SPSS 20.0软件进行描述性统计,计数资料采用频数和率描述,率的比较采用χ2检验或趋势χ2检验。以P<0.05为有统计学意义。
见表1。
2016—2020年,学生法定传染病和重点监测传染病发病数从2016年的15 195例(756.24/10万)上升至2019年的71 954例(3 483.31/10万),随后下降至2020年的22 061例(1 026.51/10万),年平均报告发病数31 449例(1 538.16/10万),总体发病率呈上升趋势($\chi _{趋势}^2 $=582.42,P<0.01)。法定传染病年均报告数为27 260例(1 333.27/10万),各年均无甲类传染病报告病例,乙、丙类传染病年均报告发病数分别为2 495例(122.04/10万)、24 765例(1 211.24/10万);其他传染病年均报告发病4 189例(204.89/10万)。2016—2020年,乙类、其他类传染病报告发病率呈下降趋势($\chi _{趋势}^2 $值分别为82.71,18.34),丙类传染病报告发病率总体呈上升趋势($\chi _{趋势}^2 $=991.75)(P值均<0.01)。
2016—2020年学生中共报告19种乙类传染病,年均发病率排前4位的分别为猩红热(61.33/10万)、细菌性痢疾(35.38/10万)、肺结核(13.88/10万)和艾滋病病毒感染及艾滋病(HIV/AIDS)(3.78/10万),前4种疾病累计报告发病数占乙类传染病累计总数的93.72%(11 692/12 476),其中猩红热、细菌性痢疾、肺结核、HIV/AIDS分别占乙类传染病的50.26%(6 270/12 476)、28.99%(3 617/12 476)、11.37%(1 419/12 476)和3.09%(386/12 476)。从发病趋势来看,2016—2020年,猩红热、细菌性痢疾、肺结核报告发病率均有下降趋势(P值均<0.01),HIV/AIDS报告发病率趋势性变化无统计学意义(P>0.05)。见表2。
2016—2020年,学生中共报告7种丙类传染病,年均发病率排前4位的分别为流行性感冒(956.13/10万)、其他感染性腹泻(114.39/10万)、手足口病(111.37/10万)和流行性腮腺炎(28.24/10万),前4种疾病累计报告发病数占乙类传染病累计总数的99.92%(123 729/123 825),其中流行性感冒、其他感染性腹泻、手足口病、流行性腮腺炎分别占报告丙类传染病的78.94%(97 745/123 825),9.44%(11 694/123 825),9.19%(11 385/123 825)和2.35%(2 905/123 825)。从发病趋势来看,流行性感冒报告发病率从2016年的136.12/10万上升到2019年的2 816.02/10万,达到高峰,随后2020年回落,总体呈上升趋势;其他感染性腹泻、手足口病、流行性腮腺炎报告发病率均呈现下降趋势(P值均<0.05)。见表2。
水痘是学生群体中除法定传染病之外最主要的传染病。2016—2020年共报告病例19 158例,年均发病率为187.40/10万,占除法定传染病以外其他传染病的91.46%(19 158/20 946)。2016—2020年,水痘的报告发病率呈下降趋势(P<0.01),从2016年的184.99/10万下降至2020年的93.99/10万。见表2。
2016—2020年,小学生报告发病率以猩红热、流行性感冒、手足口病、水痘为主,初中生以流行性感冒、其他感染性腹泻、水痘为主,高中生、大学生以细菌性痢疾、流行性感冒、水痘、其他感染性腹泻为主。从各病种在各学段的发病率来看,猩红热、流行性感冒、手足口病、流行性腮腺炎在小学生和中学生中发病率较高,表现为小学生>初中生>高中生>大学生;其他感染性腹泻、水痘在高中生中发病率较高,表现为高中生>初中生>大学生、小学生;肺结核、细菌性痢疾在高中生、大学生中发病率较高,表现为高中生>大学生>初中生、小学生;HIV/AIDS在大学生和高中生中发病率较高。见表3。
2016年作为“十三五”开局之年,原北京市卫生和计划生育委员会与北京市教育委员会联合发布《北京市中小学校卫生防病工作规划(2016年—2020年)》[4],其中提出预防和控制学校重点传染病暴发的目标和多项主要措施,包括加强学校传染病防控及突发公共卫生事件管理工作,完善学校传染病及突发公共卫生事件的监督、监测、预警、报告和应急处理工作;严格按照《中小学校晨午检规范》(DB11/T 1326—2016)[5]开展工作,实现传染病防控关口前移;落实学校传染病防控和突发公共卫生事件安全责任制度和责任追究制度,加强健康教育,预防控制学校传染病疫情暴发及突发公共卫生事件。本研究通过分析2016—2020年间北京市学生传染病报告发病情况,发现北京市学生人群乙类传染病和其他类传染病发病率有明显下降趋势,丙类传染病除流行性感冒外,其他病种都出现明显下降趋势;与教育部门高度重视学校传染病防控,积极督促指导学校建立和完善传染病预防控制制度,加强传染病各项防控措施的落实密切相关。
学生人群中流行性感冒的发病率从2016到2019年逐年上升,在2019年达到发病高峰,与北京市全人群的发病趋势一致[6],属于季节性流行。病例增多的原因也与流感快检技术的出现、就诊习惯改变有关,随着生活水平的改善,疾病防控意识提高,人们发病后就医更加积极主动。张奕等[7]研究发现流行性感冒症状的严重程度促进就医习惯的改变,《流行性感冒诊疗方案(2018年版修订版)》[8]中对流行性感冒治疗药物开具的严格要求也是导致流感病例数激增的因素,流行性感冒的临床病例占比由2009年的6.89%上升到2019年的89.12%也证实了以上假设。学校是流感疫情暴发的主要场所,医疗结构诊断的流行性感冒中一半以上是学生[9],并且12岁以下儿童是流行性感冒多次感染的危险因素[10]。
北京市2016—2020年学生人群中猩红热报告发病率呈下降趋势,与北京市[11]、上海市[12]报告发病趋势一致,报告发病率高于全国同期发病率,与我国猩红热发病率北方高于南方、多聚集在经济较为发达城市的特点一致[13-14]。细菌性痢疾和其他感染性腹泻报告发病率均出现下降趋势,与同期研究结果一致[15-18],与餐饮管理、环境治理等综合防控措施有关,也与家长、学生传染病基本素养的提高有关;但细菌性痢疾、其他感染性腹泻发病数仍然是法定传染病中较高的疾病。由诺如病毒引起的感染性腹泻,其传播力强、容易在学校引起暴发性疫情,因此需要做好学校饮食、饮水及环境的监督管理,在冬夏两个流行高峰期间加强症状监测及对腹泻、呕吐病例的管理,有针对性地对学生及家长开展防控知识宣传,防止出现暴发性疫情。肺结核报告发病率出现下降趋势,与同期全国肺结核疫情的总体趋势一致,发病率低于全国的报告发病率[19]。其中小学生肺结核发病率很低,但不能反映儿童的结核病流行现状,与儿童结核病的病例发现水平和诊疗水平有关[20];高中阶段是肺结核发病率最高的阶段,结核病疫情多发生在初高中和大学低年级学生;疫情发生的主要原因为出现肺结核可疑症状时未及时就诊、诊断为肺结核后未及时告知学校、学校肺结核首发病例后未及时对密切接触者进行排查等[21]。故要重视初高中、大学的入学体检,落实结核病筛查工作,以早期发现和治疗肺结核患者,加强学校结核病防治知识的普及,对发现的患者早期隔离治疗,做好密切接触者的追踪筛查工作。2016—2020年,北京市学生人群中HIV/AIDS增长趋势得到一定遏制,这与北京市认真贯彻党中央、国务院的决策部署,全面推进《中国遏制和防治艾滋“十三五”行动计划》《遏制艾滋病传播实施方案(2019—2022年)》[22-23]的各项政策落实有关。
针对在学校发病率较高的传染病,应在开展晨午检工作时重点关注这些传染病的前驱症状,如对发热、咳嗽、呕吐、腹痛、腹泻、皮疹等的症状监测,在传染病发生的早期发现可疑病例并及时排查,发现可疑传染病病例时要尽早隔离、治疗和跟进就诊情况,被诊断为传染病的学生一定要在病愈且隔离期满后才能复课。学校应落实各项学校卫生措施,如保持环境卫生清洁、定期消毒与通风,保证食品安全与卫生等,各学段可根据学生的年龄特点和重点防控的传染病,开展如手卫生、咳嗽礼仪、良好卫生和生活习惯、不带病上课等主题健康教育和健康促进活动,高中生、大学生可开展预防结核、HIV/AIDS专题防控教育活动,提高学生的传染病素养水平。
本研究也存在一定的局限性:法定传染病及重点监测传染病发病属于被动监测,发病数的报告来源于各级医疗机构,受就诊人数、上报质量等因素的影响;2020年开始的新型冠状病毒感染疫情造成医疗机构就诊人数骤降,造成报告病例的减少,可能会对结果有一定的影响。
  • 2021年中央引导地方科技发展资金项目(Z211100000221019)
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2025年第46卷第4期
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doi: 10.16835/j.cnki.1000-9817.2025098
  • 接收时间:2024-11-14
  • 首发时间:2026-11-06
  • 出版时间:2025-04-25
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  • 收稿日期:2024-11-14
  • 修回日期:2025-01-27
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2021年中央引导地方科技发展资金项目(Z211100000221019)
作者信息
    1北京市疾病预防控制中心学校卫生所, 北京 100013
    2中国疾病预防控制中心

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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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