克拉玛依市2008年麻疹监测与控制情况分析

分析克拉玛依市麻疹流行状况及预防控制措施,为消除麻疹提供依据。采用描述流行病学分析方法,对2008年克拉玛依市麻疹资料进行分析。结果显示,克拉玛依市2008年麻疹发病率为38.83/10万(138/355381),呈高度散发,较2007年有所上升。发病高峰在3～5月,发病数占全年的83.33%。年龄分布大年龄组高于小年龄组,>20岁年龄组病例占50.00%,<1岁病例占18.84%;流动人口发病占51.11%。应切实提高麻疹常规免疫接种率和做好入托、入学儿童查验预防接种证工作,加强麻疹监测,提高实验室确诊病例的比例。     

Immunological effectiveness of a booster inoculation against measles in children remaining seronegative after vaccination

Booster immunization against measles with a highly immunogenic vaccine leads to the development of prolonged postvaccinal immunity lasting at least 6-7 years (the term of observation) in the groups of children found to be seronegative after the titration of their blood sera with 1 hemagglutinating unit (HAU) of the antigen. The booster immunization of children in whose blood sera the minimal concentrations of antibodies can be determined in the presence of 1 HAU of the antigen (seronegative in the presence of 4 HAU) is less effective. The serological checks of immunized children entering preschool institutions and the primary grades at schools and the subsequent booster immunization of children found to be seronegative will lead to a further decrease in measles morbidity.     

郑州市麻疹疫苗强化免疫前后麻疹流行病学特征分析

目的了解郑州市麻疹疫苗强化免疫对疾病流行特征的影响,为消除麻疹采取针对性措施提供科学依据。方法对郑州市麻疹强化免疫活动前后的2010年和2011年麻疹发病情况进行描述性流行病学分析。结果郑州市强化免疫后麻疹病例大幅减少,2011年较2010年病例数减少90%;全年病例散发,无明显季节性高峰出现;病例构成仍以1岁以下儿童和无免疫史者为主;城区发病高于农村。结论此次麻疹强化免疫活动效果明显,致使麻疹发病率显著下降。     

梅州市两次麻疹疫苗强化免疫效果分析

目的综合评估分析梅州市两次麻疹疫苗强化免疫效果,为消除麻疹提供科学依据。方法综合分析麻疹疫苗强化免疫现场调查资料、评估法定传染病报告系统中麻疹发病率的变化;随机对辖区内1～12岁健康儿童216名,采用酶联免疫吸附试验(ELISA)进行强化免疫前及完成二次强化免疫后麻疹lgG抗体水平监测。结果监测人群完成二次强化免疫后麻疹IgG抗体阳性率达100.00%(216/216),2009年强化组、2010年强化组麻疹IgG抗体保护率和几何平均滴度(GMT)分别为82.08%、87.62%和1958.83、2050.26,均显著高于强化免疫前;2009年强化免疫后麻疹年发病率由强化免疫前五年平均发病率1.71/10万下降至0.22/10万,下降率87.13%,2010年强化后麻疹年发病率再次下降(0.039/10万),下降率82.27%。结论梅州市两次麻疹疫苗强化免疫效果显著,均大幅度降低了麻疹发病率、提高了人群麻疹抗体水平。     

Epidemiological situation of measles in Japan and measures for its control

In 2007, measles outbreak occurred mainly among teen/twenties in Japan, and many high-school, universities and colleges were closed to reduce spread of measles. Some high school students became measles when they were in foreign countries where measles has been eliminated, visited as school excursion. Since introducing measles vaccine as routine immunization, number of measles has been reduced remarkably in Japan. However, we had measles outbreak in 2001, and total annual patients number were estimated 200-300 thausands mainly among young infants. The main reason was low immunization coverage of measles at 1 year old, and operation to give measles vaccine as "the gift for 1 year old birthday" has been introduced widely. Then immunization coverage at this age was increased up from 50-60% (2001) to 80-90% (2006) and total measles number was estimated less than 10,000 at 2005 and 2006, however, measles outbreak occurred this time among teen/twenties in 2007. The total number of adult measles (more than 15 y.o.) were higher than the number of them at 2001 outbreak. To discontinue outbreak and to eliminate measles, enhancement of measles control activities has been introduced in Japan. Two doses policy with measles and rubella (MR) vaccine at 1 y.o. and before elementary school has been introduced since 2006 and further, supplementary immunization with MR at 1st grade in junior high school and 3rd grade in high school for 5 years from 2008 will start to eliminate measles by 2012. Reporting system will be also changed from sentinels system to notify to all measles cases system. In this paper, present epidemiological situation on measles in Japan, measles elimination strategy in WPRO, and plan for measles elimination in Japan are described.     

Four years of measles elimination in the Czech Socialist Republic

In 1982, Czechoslovakia succeeded in eliminating measles infection throughout the country. The paper describes the strategy of the measles immunization program following its introduction in 1969, showing it to reflect the objective epidemiological situation as revealed by the regular immunological surveys carried out in a broad population sample. As it turned out, decisive for achieving and maintaining a permanent measles elimination in the country was the introduction of second vaccination into the regular immunization schedule. Since 1982, its timing of is from 6 to 10 months after primary immunization. Over the 4-year period between 1982 and 1985, confirmed measles occurred only sporadically in the CSR, 115 cases altogether, and of these as many as 67 were classified as imported or their immediate contacts (38 measles patients were tourists from abroad). Of these 115 measles cases, 52 had had vaccination prior to acquiring the disease, 46 were individuals who had never before been vaccinated and in the remaining 17 patients no vaccination data were available. The vaccine failures, at least in 18 cases, could have been explained by the primary immunization prior to reaching 15 months of age. According to the estimates, at least 670 thousand cases of measles, 470 deaths, 100 thousand complications and some 33 thousand hospitalizations had been averted between 1972 and 1985 on the territory of CSR as a result of the introduction of the measles immunization program in Czechoslovakia.     

沭阳县2007年麻疹疫情流行病学分析及应对措施

了解沭阳县2007年1月至8月份麻疹流行病学特征,为制订消除麻疹策略提供依据。采用描述流行病学方法对法定传染病报告系统和麻疹监测系统资料进行分析。结果显示,沭阳县2007年1月至8月份共发生麻疹150例,其中≤8月龄、8月~15岁、15~19岁、≥20岁成人,分别占26.00%、44.66%、12.67%和16.67%;无免疫史、有1次免疫史、有2次免疫史和免疫史不详的病例分别占46.67%、10.67%、8.00%和34.66%。因此,适时在重点人群中强化麻疹免疫,是短期内迅速提高人群免疫水平,降低发病率乃至阻断麻疹病毒传播的有效手段。     

Measles morbidity among children inoculated against this infection

In the serological survey of 2009 children immunized against measles 285 children (14.2%) were found to be seronegative to this infection in the hemagglutination inhibition test with 4 hemagglutinating units of the antigen. Among 1724 immunized children showing positive response to vaccination and placed under dynamic observation for 11 years, 2 cases of measles were registered. At the same time, in the dynamic observation of 111 seronegative children 66 measles cases (59.5%) were registered during the above period, while among 169 children, also seronegative, but receiving booster immunization against measles, morbidity rate was only 1.2%. In some vaccinees the decrease of postvaccinal immunity to seronegative values was observed, but such decrease had no essential influence on the morbidity level among the vaccines. The increase of measles morbidity among schoolchildren immunized against this infection was due not to the decrease of their postvaccinal immunity, but to their concentration in schools and to their more intensive contacts with the sources of infection in comparison with children of preschool age.     

我们离麻疹消除还有多远?

中国麻疹发病率自2008年起出现大幅度下降,但2012年底以来麻疹发病疫情呈上升趋势,部分城市出现了以成人为主的疫情暴发。导致麻疹疫情再次上升的一个可能原因是中国的麻疹疫苗实际接种率低于报告接种率,常规免疫有不到位的情况。同时,中国存在部分麻疹免疫空缺人群,既未接种过麻疹常规疫苗,也没有参加过2004—2010年的补充免疫活动。这类人群积累到一定程度后,可引起聚集性的疫情暴发。中国在消除麻疹方面虽已取得显著进展,但近年来疫情再次抬头值得警惕。进一步增加常规麻疹两剂疫苗接种率,对重点地区和人群适当增加补充免疫活动,更好地落实麻疹应急预案等,将有助于控制并消除麻疹疫情。     

鸡西市1957-2003年麻疹流行特征分析

目的:了解鸡西市麻疹流行病学特征,探讨控制麻疹的策略。方法:采用描述流行病学,对鸡西市1957～2003年麻疹发病及死亡情况进行分析。结果:1957～1966年麻疹发病呈高发状态,年平均发病率为1280.03/10万,每年1～6月份发病占病例总数的83.09%,使用麻疹疫苗前具有明显的周期性,每隔3～4年出现1个发病高峰,使用麻疹疫苗后整个流行呈明显下降态势;发病主要集中在1～7岁年龄组,占84.09%,男女性别比为1.27:1。结论:实施计划免疫对控制麻疹疫情效果显著,为控制麻疹疫情应继续加强麻疹疫苗的常规免疫,适时开展强化免疫,加强麻疹监测与报告。     

新会区2004—2013年麻疹流行特征分析

目的了解新会区麻疹流行特征,为今后麻疹防控工作及全面实现消除麻疹提供依据。方法对2004—2008年(强化免疫前五年)和2009—2013年(强化免疫后五年)的数据采用EXCEL统计软件和SPSS17.0进行统计分析。结果 2004—2013年麻疹发病率在(0~27.59)/10万之间,平均发病率为7.45/10万;2004—2008年(强化免疫前五年)与2009—2013年(强化免疫后五年)的人群年龄分布、病例分类和流动性情况的差异存在统计学意义(χ2=62.870;917.254;19.170),而免疫史情况差异无统计学意义(χ2=0.949)。结论应加强麻疹防控工作,制定有效防控措施,实现全面消除麻疹。     

Immunostructure of school-age children inoculated against measles

The mass serological survey of school children immunized against measles was carried out by means of the hemagglutination inhibition test. As a result, 20.4% of these school children were found to be seronegative, and in 9.5% of them even the minimum concentration of measles antihemagglutinins (when titrated with 1 hemagglutinating unit of the antigen) was not detected. The accumulation of a considerable seronegative (measles-susceptible) stratum among children of school age occurred due to the low immunogenic potency of some batches of live measles vaccine, used for immunization in 1973, as well as due to the formerly practiced immunization of children under 1 year of age. A direct and close dependence of focal measles morbidity among immunized children having had contacts with the source of infection on the number of children among them, found to be seronegative after titration with 1 hemagglutination unit of measles antigen, was established.     

The duration and intensity of measles immunity after a repeat inoculation against this infection

Controlled study lasting 6 years showed that booster immunization against measles was highly effective in children remaining seronegative, i. e. susceptible to this infection, after primary immunization: E = 97.5 +/- 0.12% (K = 35.7). Annual serological examination of children given booster immunization revealed that 87.6% of initially seronegative children retained specific antihemagglutinins for 5.5 years (the term of observation). The effectiveness of booster immunization against measles did not depend on the age when primary immunization had been made.     

Effectiveness of measles immunoprophylaxis and the criteria for assessing its possible elimination

The study of measles morbidity in Donetsk Province in 1960-1984 and the study of antimeasles immunity in different groups of the population have shown that the problem of the liquidation of measles cannot be solved by immunizing the population in a single administration of the vaccine. To enhance the effectiveness of the immunoprophylaxis of measles and its influence on the epidemic process, a number of problems must be solved with the aim to improve the quality of the vaccine, especially its thermal stability, to establish the possibility of shifting the beginning of immunization from 15-17 months to 12 months of age, to increase the coverage of children with immunization against measles by decreasing the number of groundless exemptions from immunization and by immunizing children in risk groups according to individual schedules and dosage, to carry out selectively the booster immunization of persons who have lost their postvaccinal immunity, as revealed by laboratory test, or in whom such loss may be supposed, to introduce the objective method (indirect hemagglutination test) for controlling the state of immunity among different groups of the population into laboratory practice at sanitary and epidemiological stations. As to the possibility of the liquidation of measles, the statement of this problem is correct, but for its solution a complex of additional prophylactic and epidemic-control measures should be taken.     

河南省漯河市2005—2010年麻疹流行病学分析

目的掌握河南省漯河市麻疹流行特征与规律,探讨漯河市麻疹防治对策与措施。方法收集漯河市2005—2010年麻疹疫情及监测资料,用Excel统计软件进行分析。结果漯河市2005—2010年共报告麻疹病例683例,平均发病率为4.55/10万,2005—2007年发病率逐年上升,2008—2010年逐年下降,3—5月份为发病高峰,发病年龄以≤3岁散居儿童为主。结论提高麻疹疫苗常规免疫接种覆盖率及8月龄儿童麻疹疫苗及时接种率是控制和消除麻疹的关键。     

沪191麻疹疫苗免疫持久性和影响因素的评价

１９９１～１９９８年,我们对荆州区川店镇５０３名６～１５月龄儿童进行了现行沪１９１麻疹疫苗血清流行病学效果观察,结果表明,初次免疫后１个月麻疹ＩｇＧ抗体阳转率为９１６５％,ＧＭＴ为１∶２６６７４,达保护滴度者比例为４６５％。随着时间的推移,第４年上述指标迅速下降到４６８６％、１∶１２７４和１８５％,第６年时低至２９４３％、１∶４８９和１３６％。０２ｍｌ、０３ｍｌ和０５ｍｌ麻疹疫苗组的近期和远期效果是类似的,初免后１个月时ＩｇＧ滴度越高,其免疫持久性越好;初免月龄是影响麻苗免疫效果的主要原因,６月龄初免组的免疫效果明显低于≥８月龄组。结果提示麻苗８月龄初免是可行的。     

Successful boosting of a DNA measles immunization with an oral plant-derived measles virus vaccine

Despite eradication attempts, measles remains a global health concern. Here we report results that demonstrate that a single-dose DNA immunization followed by multiple boosters, delivered orally as a plant-derived vaccine, can induce significantly greater quantities of measles virus-neutralizing antibodies than immunization with either DNA or plant-derived vaccines alone. This represents the first demonstration of an enhanced immune response to a prime-boost vaccination strategy combining a DNA vaccine with edible plant technology.     

宁夏2004—2007年麻疹监测分析

为了客观评价宁夏麻疹监测系统现状,探讨控制和消除麻疹的策略。对宁夏2004—2007年麻疹流行病学和实验室监测工作进行分析。结果显示,宁夏麻疹监测系统的灵敏性较高,疑似麻疹病例标本采集率和血清学诊断率等主要监测指标已达较高水平。同时,对监测到的36株麻疹野病毒基因型进行了探讨,全部为H1基因型H1a亚型,未发现其它基因亚型。因此,宁夏亟需加速控制麻疹,应继续做好麻疹监测和麻疹疫苗免疫接种。     

Catch-up immunization programs will eliminate measles threat for most schoolchildren.

The threat of measles will be eliminated for 72% of Canadian schoolchildren this spring as seven provinces/territories establish routine two-dose schedules for measles-mumps-rubella vaccination, including five jurisdictions that are undertaking universal catch-up immunization programs. The initiatives move the country closer to its commitment to eradicate measles by the year 2000.     

Immunization

Vaccines have eliminated or substantially reduced the incidence in Canada of smallpox, poliomyelitis, measles, mumps, rubella, diphtheria, tetanus and pertussis. The Canadian Medical Association (CMA) advocates a single immunization schedule, complete for all age groups and diseases where immunization is indicated and available. CMA has endorsed in principle (1984), the second edition of the Guide to Immunization for Canadians compiled by the National Advisory Committee on Immunization and requested that it be disseminated to all practising physicians in Canada. CMA also firmly endorses the concept of a readily accessible nationwide method of recording immunization status. In keeping with the World Health Organization''s commitment to global control of measles, CMA (1981) supports and encourages mandatory vaccination against measles for children. The association advocates a much more aggressive and sustained public education program to promote public awareness and acceptance of immunization.