20172023年上海市静安区流感样病例监测及流感疫苗接种情况初探

A preliminary exploration of influenza-like illness surveillance and influenza vaccination in Jingan District of Shanghai2017‒2023

  • 摘要:
    目的 了解上海市静安区流感样病例(ILI)监测及流感疫苗接种情况,为完善流感防控策略提供依据。
    方法 通过中国流感监测信息系统和上海市预防接种信息系统收集2017年9月—2023年8月上海市静安区哨点监测的ILI、流感病原学和流感疫苗接种信息,采用描述性流行病学方法分析ILI的时间、人群分布特征,分析ILI病原学监测结果及流感疫苗接种情况。
    结果 2017年9月—2023年8月上海市静安区哨点医院ILI就诊百分比(ILI%)呈逐年上升趋势(F=18.841,P=0.012)。流行高峰主要出现在冬春季,2019年9月—2020年8月、2020年9月—2021年8月和2021年9月—2022年8月出现冬春季和夏季双高峰,2022年9月—2023年8月冬春季出现双高峰,且在下降过程中出现反弹。ILI样本平均阳性检出率为21.64%(2 421/11 189),除2020年9月—2021年8月外,其余每个冬春季均存在阳性检出高峰,2017年9月—2018年8月冬春季流感的流行优势毒株为B/Yamagata和A/H1N1;2018年9月—2019年8月和2022年9月—2023年8月冬春季流感流行优势毒株均为A/H1N1;2019年9月—2020年8月和2021年9月—2022年8月冬春季流行优势毒株为B/Victoria;各年毒株交替流行,近年来以A/H1N1和A/H3N2为主。2017年9月—2023年8月静安区流感疫苗平均接种率为2.94%,接种覆盖人群以低龄儿童为主;女性接种率高于男性(χ2=546.963,P<0.001),本市户籍人员接种率高于外来人员(χ2=123.141, P<0.001)。
    结论 上海市静安区ILI%呈上升趋势,近年来以甲型为流行优势株,目前流感疫苗接种率水平较低,不足以对流感疫情产生影响。建议继续加强ILI和流感毒株变化监测,同时关注流感疫苗接种率的提升。

     

    Abstract:
    Objective To understand the surveillance of influenza-like illness (ILI) and influenza vaccination status in Jing’an District, Shanghai, and to provide a basis for optimizing influenza prevention and control strategies.
    Methods The sentinel surveillance data for ILI and virological surveillance data of influenza viruses in Jing’an District were collected from the Chinese influenza surveillance information system, and data for influenza vaccination were collected from Shanghai immunization information system from September 2017 to August 2023. Epidemiological characteristics of ILI, influenza etiology, and the temporal and population distributions of influenza vaccination were analyzed using descriptive epidemiological methods.
    Results ILI as a percentage of total visit surveillance units (ILI%) reported by sentinel hospital was increased in Jing’an District of Shanghai from September 2017 to August 2023 (F=18.841, P=0.012). The peak of the influenza cases mainly appeared in winter-spring, but there were two peaks in winter-spring and summer from September 2019 to August 2020, from September 2020 to August 2021, and from September 2021 to August 2022. In particular, there were two peaks in winter-spring from September 2022 to August 2023, with a rebound during the descending process. The average positive rate of ILI was 21.64% (2 421/11 189) during the 6 years. There was a peak in winter-spring during every year with the exception of the period from September 2020 to August 2021. The dominant strains were B/Yamagata and A/H1N1 in winter-spring from September 2017 to August 2018. The dominant strain was A/H1N1 in winter-spring from September 2018 to August 2019 and from September 2022 to August 2023. The dominant strain was B/Victoria in winter-spring from September 2019 to August 2020 and from September 2021 to August 2022. Different subtype strains occurred alternately, and the dominant strains were A/H1N1 and A/H3N2 in recent years. The influenza vaccination coverage was 2.94% from September 2017 to August 2023, and the vaccination coverage was highest in young children. The vaccination coverage for females was higher than that for males (χ2=546.963, P<0.001), and the vaccination coverage for registered residents was higher compared to that for migrants (χ2=123.141, P<0.001).
    Conclusion ILI% exhibits an upward trend in Jing’an District of Shanghai, and the dominant strain is A subtype. The influenza vaccination coverage is still low, which is insufficient to have an impact on the spread of influenza. It is recommended that the surveillance of ILI and variations of influenza virus strains should be improved continuously, and effective steps should be taken to promote influenza vaccination.

     

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