肾综合征出血热自然感染和人工免疫后的抗体形成

目的 调查肾综合征出血热(hemorrhagic fever with renal syndrome,HFRS)病毒自然感染,分析免疫接种后抗体变化规律,为调整出血热预防控制策略提供依据.方法 采取分层整群抽样方法,在出血热高发病区、低发病区和非疫区共抽取600人,进行发病调查和血清IgG抗体酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)检测.结果 既往出血热发病人群IgG水平＞高发区接种人群＞低发区接种人群＞高发区非发病非接种人群＞低发区非发病非接种人群;既往出血热病例的IgG水平每10年衰降25％,30年后仍是接种人群的2倍以上;高发病区汉坦病毒隐性感染率33％,低发病区隐性感染率为23％;完成基础免疫接种即可获得较高抗体水平,末次接种5 ～ 10年后抗体水平下降40％,10～20年下降60％.结论 出血热显性感染可获得持久免疫力,在出血热历史疫区隐性感染率较高,出血热疫苗末次接种7～8年需再加强一针.

Antibody variation in individuals with hantavirus infection and vaccination

Objective To analyze the antibody variation in individuals after hantavirus infection and vaccination, and provide evidence for the control and ＇prevention of hemorrhagic fever with renal syndrome （HFRS）. Methods Cluster and random sampling were used in the HFRS high incidence areas, low incidence areas and non-infected areas, and 600 per- sons were sampled. Health information of each person was investigated, blood was collected and detected by ELISA for anti- hantavirus nucleoprotein IgG specific antibodies. Results Specific IgG titers showed as ： infected group 〉 vaccinated group in high incidence of HFRS areas 〉 vaccinated group in low incidence of HFRS areas 〉 unvaccinated higher group of healthy people in high incidence of HFRS areas 〉 unvaccinated group of healthy people in low incidence of HFRS areas. Thirty years later, specific IgG titers in HFRS patients was still two times than that in the vaccinated group, patients＇ with history of HFRS showed that specific IgG levels decreased about 25% in each decade. In high prevalence area, hantavirus recessive in- fection rate in human was 33%, but in low prevalence area, that was 23%. After basic immunization, human body could ob- tain a higher specific IgG level, this specific IgG titer decreased about 40% after 5 to 10 years of vaccination, and decreased about 60% after l0 to 20 years of immunization. Conclusions In HFRS epidemic areas, hantavirus recessive infection rate is high in human. After the onset of HFRS, patients may get lasting immunity against the pathogenic viruses, For long-term protection by the vaccine, human need one booster dose vaccine per 7-8 years after the last vaccination.