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目的评估麻疹疫苗强化免疫实施对控制麻疹发病的效果,为加速控制麻疹工作提供科学依据。方法 2009年3月对梅州市8月龄至14岁儿童均实施麻疹疫苗强化接种,用酶联免疫吸附试验(ELISA)检测强化免疫前后目标人群麻疹IgG抗体;并利用全市麻疹病例监测资料,对强化免疫前5年(2004—2008年)和2009年强化免疫后1年麻疹发病情况进行比较分析。结果 2009年梅州市8月龄至14岁儿童麻疹疫苗强化免疫接种率为98.36%(868 396/882 878),强化免疫后人群麻疹抗体阳性率上升至98.52%(1 067/1 083),预防麻疹显性感染的抗体滴度≥1∶800的比例上升至88.09%(954/1 083),抗体几何均数从1 605.72 mIU/mL上升至5 870.33 mIU/mL,前后差异有统计学意义(P<0.01);2009年强化免疫后1年的全市平均发病率为0.06/10万,比强化免疫前5年(2004—2008年)的平均发病率(1.71/10万)明显下降;8月龄至14岁发病率为0.04/10万,比强化免疫前5年的(1.20/10万)明显下降;强化免疫后2009年5月至2010年4月仅发生3例麻疹,且无暴发疫情。结论在保持较高常规免疫覆盖率的基础上,实施麻疹疫苗初始强化免疫,对于迅速提高人群麻疹抗体水平,减少易感人群的比例,控制麻疹的暴发或流行效果显著。
Objective To evaluate the effect of measles vaccine on the control of measles and provide a scientific basis for accelerating the control of measles. Methods In March 2009, measles vaccine was vaccinated in children aged 8 months to 14 years in Meizhou, measles IgG antibody was detected by enzyme-linked immunosorbent assay (ELISA) in the target population before and after intensive immunization. Using the monitoring data of measles cases in the city, The incidence of measles in the first five years (2004-2008) and one year after the 2009 vaccination were compared and analyzed. Results In 2009, the measles immunization rate of 98.86% (868 396/882 878) measles immunized children aged 8 months to 14 years in Meizhou City was 98.52% (1067/1 083) The antibody titer of measles dominant infection increased to 88.09% (954/1 083) and the geometric mean of antibody increased from 1 605.72 mIU / mL to 5 870.33 mIU / mL, the difference was statistically significant ( P <0.01). The average incidence rate of the city at one year after 2009 was 0.06 / 100000, which was significantly lower than the average incidence (1.71 / 100000) in the five years prior to the intensive immunization (2004-2008) The incidence of asthma was 0.04 per 100 000 at the age of 14 years, which was significantly lower than that of the pre-booster (1.20 / 100 000) in the first 5 years of intensive immunization. Only 3 cases of measles and no outbreaks occurred after the boost in May 2009 to April 2010 . Conclusions The initial boost of measles vaccine on the basis of maintaining a relatively high conventional immunization coverage is significant for rapidly increasing the level of measles antibody, reducing the proportion of susceptible population and controlling the outbreak or epidemic of measles.