广州市海珠区有含麻疹成分疫苗免疫史麻疹病例特征

目的 了解广州市海珠区有含麻疹成分疫苗（MCV）免疫史的麻疹病例特征,为制定和完善麻疹防控策略和措施提供依据。方法 收集法定传染病报告系统及麻疹专项监测系统中广州市海珠区2009—2018年麻疹确诊病例相关资料,并对其中2014年起报告的病例增加静脉血定量检测麻疹IgM、IgG抗体和2015年4月起增加采集咽拭子检测麻疹病毒RNA资料进行统计分析。结果 2009—2018年广州市海珠区共报告有MCV免疫史麻疹病例57例,占总病例15.6%。不同年份有免疫史病例占当年总病例的比例不同（P<0.01）,与总病例的年龄分布不同（P<0.01）,但与总病例月份分布一致（r =0.81,P=0.021）。以IgM/IgG浓度比值为判断方法,2014年起报告病例中原发性、继发性免疫失败分别占有MCV免疫史病例的61.1%、38.9%。从2015年4月起报告的10例有免疫史病例的咽拭子中均未检出麻疹病毒RNA。有MCV免疫史与无免疫史病例的发热、皮疹、咳嗽、卡他、结膜炎及“麻疹典型症状”等症状发生率分别为70.2%和84.0%、71.9%和86.4%、54.4%和76.5%、36.8%和64.2%、40.4%和61.1%、57.9%和77.7%,差异均有统计学意义。结论 广州市海珠区有MCV免疫史的麻疹病例占比较高,症状较不典型,以原发性免疫失败为主,且传染性低。

Characteristics of measles cases with vaccination history of measles-containing vaccine in Haizhu District of Guangzhou

Objective To investigate the characteristics of measles cases with vaccination history of measles-containing vaccine(MCV) in haizhu district of Guangzhou City,and provide evidence for further measures and strategies of measles prevention and control.Methods Data of measles confirmed cases in a district of Guangzhou during 2009-2018 were collected and analyzed from reporting system of infectious diseases and measles monitoring system,and total measles cases reported from 2014 were collected serum samples to quantitatively detect measles IgM and IgG antibody, and cases from April 2015 were additionally collected throat swabs to detect measles virus nucleic.The data were statistically analyzed. Results Totally 57 measles cases with MCV history were reported in a district of Guangzhou City during 2009-2018,accounting for 15.6% of total reported measles cases.The proportion of cases with MCV history were different in different years（P<0.01）,and the age distribution in cases with MCV history and total cases was also significantly different（P<0.01）,but the month distribution in them wasn’t different（r=0.81,P=0.021）.Judged by IgM/IgG, 61.1% was due to primary vaccination failure,and 38.9% secondary failure among cases with MCV history reported from 2014. Measles virus nucleic weren’t detected in throat swabs of 10 cases with MCV history reported from April,2015. There were significantly different between cases with MCV history and total cases in the rates of fever(70.2%/84.0%), rash(71.9%/86.4%), cough(54.4%/76.5%), coryza (36.8%/64.2%),conjunctivitis(40.4%/61.1%), and the typical symptoms (57.9%/77.7%). Conclusion s Cases with MCV history are found with a certain percentage in measles case,and are less infectious,with atypical symptoms and primary vaccination failure.