2016年天津市一起高免疫覆蓋率下的中學(xué)麻疹暴發(fā)
發(fā)布時(shí)間:2018-01-28 17:03
本文關(guān)鍵詞: 麻疹 暴發(fā) 含麻疹成分疫苗 免疫失敗 出處:《中國(guó)疫苗和免疫》2017年01期 論文類(lèi)型:期刊論文
【摘要】:目的分析天津市津南區(qū)某中學(xué)2016年1起麻疹暴發(fā)的原因。方法對(duì)學(xué)校暴發(fā)病例開(kāi)展流行病學(xué)調(diào)查,收集病例血標(biāo)本和咽拭子進(jìn)行實(shí)驗(yàn)室檢測(cè);調(diào)查全校學(xué)生含麻疹成分疫苗(Measles containing vaccine,MCV)免疫史;檢測(cè)并比較津南區(qū)和無(wú)麻疹疫情的寧河區(qū)健康學(xué)生的麻疹抗體水平。結(jié)果該中學(xué)共1 530人,麻疹發(fā)病31例,其中高一年級(jí)19例、初二年級(jí)11例。26例本地病例均有≥2劑次MCV免疫史,5例外省轉(zhuǎn)入學(xué)生病例免疫史不詳。26例病例采集了急性期血清,其中16例麻疹I(lǐng)gG抗體濃度≥2 000mIU/ml,幾何平均濃度(GMC)為2 819.05mIU/ml。分離到3株麻疹病毒,均為H1基因型。該校82.61%的本地學(xué)生有≥2劑次MCV免疫史。在有免疫史學(xué)生中接種后平均時(shí)間(中位數(shù))為13.72年(5-17年)。津南區(qū)和寧河區(qū)健康學(xué)生麻疹抗體陽(yáng)性率為90.96%和90.74%(x~2=0.01,P=0.94);GMC分別為488.03mIU/ml和535.49mIU/ml(t=-1.19,P=0.23)。結(jié)論繼發(fā)性免疫失敗(Secondary vaccination failure,SVF)是本起學(xué)校麻疹暴發(fā)的原因;SVF在麻疹病毒傳播中的作用需要更多的研究。
[Abstract]:Objective to analyze the causes of a measles outbreak in a middle school in Jinnan District of Tianjin on 2016. Methods Epidemiological investigation was carried out on school outbreak cases and blood samples and throat swabs were collected for laboratory examination. To investigate the immunization history of measles vaccine measures containing vaccine in the whole school. The measles antibody levels of healthy students in south Jinnan district and Ninghe district without measles epidemic were detected and compared. Results there were 1 530 cases of measles in this middle school, 31 cases of measles, including 19 cases of grade one in senior high school. There were more than 2 doses of MCV immunization in 11 cases and 26 local cases in grade 2 of junior high school. 5 cases were transferred to the province and the history of immunization was unknown. 26 cases were collected the serum of acute phase. Among them, 16 measles IgG antibody concentration 鈮,
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