γδ lymphocytes in mumps meningitis patients

Flowcytometric analysis on T-cell subpopulations in the blood and cerebrospinal fluid (CSF) of 10 children with mumps meningitis (MM) revealed that the proportion of lymphocytes which bore the γδ T-cell receptor for antigen was significantly higher in CSF than in autologous and heterologous blood samples. γδ T-cell values in CSF of MM patients were also significantly higher than those calculated in CSF specimens from nine children with non-inflammatory neurological disorders. Whether and how the expanded CSF γδ T-lymphocyte subset, either CD8 ⁺ or double-negative (CD4^-/CD8^-), contributes to the eradication of mumps virus infection from the central nervous system represents a central focus of our ongoing research.     

Acute transverse myelitis and Guillain-Barré overlap syndrome with serological evidence for mumps viraemia

Both acute transverse myelitis (ATM) and Guillain-Barré syndrome (GBS) occur as rare associations with mumps viraemia but to our knowledge, concurrent ATM and GBS related to mumps has only been reported once previously. We describe the case of a young woman presenting with confusion and collapse 2 weeks after a flu-like illness. An initial diagnosis of transverse myelitis was made on the basis of the clinical findings and radiological evidence of a swollen spinal cord with uniform high signal change on T2 weighted MRI. The patient was treated with intravenous methylprednisolone without significant recovery. The diagnosis was later revised to include GBS on the basis of worsening facial diplegia in the setting of a flaccid tetraparesis, and neurophysiological evidence of a sensorimotor axonal polyradiculoneuropathy. Acute mumps viraemia was confirmed on serological grounds. The patient made an improvement in ventilatory capacity with intravenous immunoglobulin treatment.     

The Immunisation Beliefs and Intentions Measure (IBIM): Predicting parents’ intentions to immunise preschool children

In England, uptake of the second dose of MMR (against measles, mumps, rubella), and dTaP/IPV or DTaP/IPV booster (against diphtheria, tetanus, pertussis, polio), is lower than that of the primary course. The Immunisation Beliefs and Intentions Measure (IBIM), based on the theory of planned behaviour (TPB) and qualitative interviews, was used to predict parents’ intentions to take preschoolers for these recommended vaccinations. Parents from 43 child groups in southern England were randomised to receiving questions about either MMR (N = 193) or dTaP/IPV (N = 159). Overall, 255 parents fully completed TPB-based items. Regression analyses revealed that parental attitudes about the protective benefits of immunising and perceived behavioural control were strong, reliable predictors of intention to immunise with MMR. For dTaP/IPV, perceived protective benefits and number of children reliably predicted intention to immunise. Differences between parents with ‘maximum immunisation intentions’ and those with ‘less than maximum intentions’ are described. The IBIM appears to be a useful measure for predicting parents’ intentions to immunise preschoolers. Implications for improving uptake are discussed.     

Experimental-scale measles and mumps vaccine production on microcarrier-grown cells

Small-scale measles and mumps virus propagation in microcarrier-grown cells was studied to assess putative advantages over conventional roller-type virus propagation. Significantly higher virus yields could not be attained with microcarrier cultures in cell stirrers, therefore making the advantages purely technological. The pattern of measles virus production was slightly different for the three types of microcarriers used. Experimental measles and mumps vaccine lots obtained met vaccine quality control requirements.     

Measles, mumps and rubella infections and atopic disorders in MMR-unvaccinated and MMR-vaccinated children

Vaccinations have been incriminated in the increase of atopic disorders. Especially the measles‐mumps‐rubella (MMR) vaccination is often refused by people having a notion that these infectious diseases are beneficial for a healthy development of a child’s immune system. This practice endangers herd immunity and is the cause of repeated outbreaks. As the clinical course of infections and also its possible impact on the development of atopy may be different in vaccinated and unvaccinated individuals, we explored in vaccinated and unvaccinated children associations of MMR infection with atopic disorders. Using data from a previously conducted study on the relationship between the diphtheria‐tetanus‐pertussis‐(inactivated) poliomyelitis vaccination in the first year of life and atopic disorders, the study population of 1872 8–12‐yr‐old was divided as children MMR‐unvaccinated and children MMR‐vaccinated in the first year of life. Within each group the association between MMR infections and atopic disorders (both as reported by the parents) was assessed. We found a statistically significant positive association between measles infection and ‘any atopic disorder’ [adjusted odds ratio, OR (95% confidence interval, CI): 1.77 (1.20–2.61)] in the MMR‐vaccinated group, mainly because of the relationship with eczema. For rubella there was a negative association with eczema and food allergy in the unvaccinated group: adjusted OR (95% CI): 0.57 (0.38–0.85) and 0.23 (0.07–0.76), respectively. All other associations were not statistically significant. We found a positive relationship between measles infection and any atopy in a group of MMR‐vaccinated children and a negative association between rubella infection and eczema and food allergy in unvaccinated children. However, we cannot conclude that these relationships are causal. The negative association with rubella may be an artefact. This study shows no evidence for any protective effects from MMR diseases for the development of atopy and therefore supports conclusions found elsewhere that childhood vaccinations do not cause atopy.     

2005-2006年北京市东城区流行性腮腺炎发病的流行病学分析

目的 了解北京市东城区流行性腮腺炎(流腮)流行病学特征,为控制流行性腮腺炎提供科学依据.方法 利用流行性腮腺炎疫情资料,包括法定传染病报告系统和流腮监测系统流行病学个案调查及实验室监测资料,分析东城区流行性腮腺炎流行病学特征.结果 2005-2006年北京市东城区报告本地区流腮病例159例,年平均发病率11.28/10万.发病主要集中在5～15岁,占67.30%.学生发病占55.35%;3～5月发病占33.33%;有免疫史发病占50.31%.麻风腮疫苗免疫期限小于5年与免疫期限大于5年、无免疫史间差别显著.结论 提高麻风腮疫苗接种率的同时,适时地加强免疫是预防和控制流行性腮腺炎发生不可忽视的重要措施.     

以急性腮腺炎为首发表现的新型冠状病毒肺炎1例报告

2019年12月以来,新型冠状病毒肺炎(COVID-19)迅速蔓延。到目前为止,以急性腮腺炎为首发表现的COVID-19病例国内外尚无相关报道,极易被临床忽视和误诊。现将病例做如下报告,以期为其他医疗机构在COVID-19诊治方面提供参考。     

Long-term immunogenicity of measles,mumps and rubella-containing vaccines in healthy young children: A 10-year follow-up

Measles and mumps outbreaks still occur in countries that have successfully implemented universal routine immunization programs. Measles outbreaks are mostly associated to absent or incomplete vaccination, whereas for mumps outbreaks the combined effects of waning of immunity and circulating new strains are incriminated. It is therefore increasingly useful to characterize the long-lasting immunity induced by measles-, mumps, and rubella (MMR)-containing vaccines.In this 10-year study, 1887 healthy children aged 12–22 months, randomized to receive 1 or 2 doses of MMR-containing vaccines (Priorix or Priorix-Tetra; GSK), were included in an antibody persistence analysis. A total of 364 children in the 1-dose group received a second dose out of study according to their local vaccination schedule between Years 4 and 10 post-dose 1, and were included in a separate post-hoc analysis to evaluate the effect of the second dose when given later. Anti-measles, -mumps and -rubella antibody titers were measured by commercial ELISA kits (Enzygnost, Siemens) after each vaccine dose and at Years 1, 2, 4, 6, 8 and 10 post-vaccination.Antibodies against measles and rubella declined moderately after vaccination but remained well above the seropositivity threshold after 10 years. The anti-measles antibody titers elicited by Priorix-Tetra remained about 2-fold higher throughout the study as compared with Priorix. A second dose of MMR vaccine later in life had a minor and transient effect on anti-measles and anti-rubella waning titers. In contrast, anti-mumps antibody levels remained relatively stable over the 10-year follow-up and a second dose of MMR vaccine, given anytime over the 10-year period, had a boosting effect on anti-mumps antibody titers and seropositivity rates.In conclusion, 1 or 2 doses of MMR-containing vaccines given to children in their second year of life induced antibody responses against measles, mumps and rubella viruses that persisted at least up to 10 years post-vaccination.Clinical trial registration number: NCT00226499.     

应急接种等措施在一起流行性腮腺炎暴发疫情防控中的效果评价

目的 评价应急接种等措施在一起流行性腮腺炎暴发疫情防控中的效果。方法 根据病例定义收集该起暴发疫情中的所有病例发病、隔离日期,疫情中采取的应急接种、病例隔离、停课、洗手宣传教育等防控措施信息,计算应急接种的疫苗保护效率(vaccine efficiency,VE),采用离散时间模型对拟合实际暴发疫情数据计算传播能力,计算应急接种、病例隔离、停课和洗手的效果指数。结果 该起暴发疫情共调查共1 471人,发生4代病例,三代间距均为15 d;暴发期间共339人接种了麻腮风疫苗,应急接种率为73.38%,发病3人,罹患率0.88%。未应急接种的人数为123人,发病25人,罹患率20.33%。应急接种的疫苗保护效率为95.6%。隔离在第二至第四代的效果系数分别为0.43、0.46和0.47;停课和洗手联合措施在第二、三代病例发生时产生了作用,效果系数分别为0.279和0.078。模型模拟结果显示,接种率达到90%~100%,罹患率、疫情持续时间、疫情高峰出现周才能产生明显防控效果。结论 在流腮暴发疫情中,应急接种率达到90%~100%才能起到好的防控效果;停课和洗手等健康教育能起到一定作用,但主要防控措施应为高接种率和及时病例隔离。