我国部分地区人群风疹免疫水平的监测

用血凝抑制（HI）试验对我国部分地区人群风疹免疫水平进行了检测,共检测1～15岁人群5911人,≥16岁女青年2610人．结果表明：1～15岁人群HI抗体平均阳性率为47．1％,其中≤3岁儿童为17.8％;随着年龄的增长人群风疹HI抗体的阳性率呈上升趋势;≥16岁女青年HI抗体的平均阳性率为83．6％．我国目前存在广泛的风疹易感人群,特别是女青年的易感率仍达16．4％．提示实施对婴幼儿及女青年的风疹疫苗免疫,对控制风疹流行、减少先天性风疹综合征的发生,显得十分迫切和必要．     

婴儿麻疹 风疹减毒活疫苗联合免疫效果观察

为探讨麻疹、风疹减毒活疫苗联合免疫的可行性,于1997年4～12月随机选择了本市342名8月龄婴儿进行了观察．所有入选婴儿被随机分成3组：第1组105人,皮下接种BRD－Ⅱ株风疹疫苗;第2组105人,分别在左、右上臂同时皮下接种BRD—Ⅱ株风疹疫苗和沪191株冻干麻疹疫苗;第3组132人,皮下接种沪191株冻干麻疹疫苗．在免疫前,第1组与第2组的风疹血凝抑制（HI）抗体阳性率均为2．86％,几何平均滴度（GMT）均为1：1．06;第2组与第3组的麻疹HI抗体阳性率分别为2．86％和5.30％,GMT分别为1：1.02和1：1.60.免疫后1个月,第1组与第2组的风疹HI抗体阳性率分别为98.10％和99．05％,GMT分别为1：144.15和1：148.99,两者的差异无显著的统计学意义;第2组与第3组的麻疹HI抗体阳性率分别为99.05％和97.73％,GMT分别为1：35．10和1：32．85,两者的差异亦无显著的统计学意义．所有免疫的儿童均未发现局部和全身反应．结果表明：麻疹、风疹减毒活疫苗联合免疫可产生与常规免疫相同的免疫应答,风疹疫苗初免月龄定于8月龄与麻疹疫苗联合免疫是可行的．     

麻疹 流行性腮腺炎 风疹活疫苗(M-M-RⅡ)免疫效果观察及免疫程序探讨

选择在8～9月龄时已完成麻疹减毒活疫苗（MV）初免的11～16月龄儿童为观察对象,对麻疹、流行性腮腺炎（腮腺炎）、风疹活疫苗（M－M－RⅡ）的免疫效果进行了观察,并探讨其免疫程序．M－M－RⅡ免疫后麻疹血凝抑制（HI）抗体阳性率100％,抗体≥4倍增长率为55．42％,几何平均滴度（GMT）1：46．60,较免疫前增长2．27倍;腮腺炎HI抗体阳转率95.23％,GMT1：9．60;风疹HI抗体阳转率100％,GMT1：392．47．作者认为,在上海市M－M－RⅡ初始免疫程序确定为已完成MV初免的12～18月龄儿童是合理的,且能产生理想的免疫效果．     

冻干风疹减毒活疫苗免疫持久性的研究

目的：了解冻干风疹减毒活疫苗的免疫持久性。方法：在湖南省浏阳市8月-6岁风疹血清HI抗体阴性儿童中，进行了连续5年的冻干风疹减毒活疫苗后血清学效果研究。结果：免疫1个月后风疹HI抗体的阳转率为97.2％，抗体几何平均滴度倒数（GMT）为157.6。免后1、2、3、4、5年风疹HI抗体阳性率仍维持较高水平，分别为99.7％，100.0％，98.3％，97.3％和95.5％；而HI抗本的GMT则出现显性下降，分别为141.2，113.3，67.4，37.3和31.2。在连续观察的5年当中，共有32名观察对象的HI抗体（≤1：32）出现4倍增长，获得隐性感染，共有17名观察对象的HI抗体阴转，5年累积阴转率为9.24％。结论：国产冻干风疹减毒活疫苗免疫持久性效果满意。     

珠海市1～30岁健康人群风疹抗体水平监测和风疹疫苗免疫的血清学效果

为给我省将风疹疫苗接种纳入计划免疫管理提供科学依据，１９９６年以珠海市为试点，在该市三个区选择９４４名１～３０岁健康人群，用微量血球凝集抑制（ＨＩ）试验检测风疹ＨＩ抗体，总阳性率为６８．２％，几何平均滴度倒数（ＧＭＲＴ）为３６．１，其中＜１６岁儿童的风疹抗体阳性率和ＧＭＲＴ均明显低于≥１６岁人群。从９４４人中随机抽取１６９人接种风疹疫苗，观察免疫后的血清效果，免疫成功率为４７．３％，其中免前抗体阴性者，免后阳转率为９６．５％，免前抗体≤１：６４者，免疫成功率为９５．６％，免后比免前ＧＭ－ＲＴ增长９．３倍。同时对珠海市１～７岁儿童普遍接种风疹功苗，接种率为６１．２％，其中１岁儿童接种率７１．１％。疫苗接后未发现严重副反应，显示风疹疫苗有良好的免疫原性，安全可靠，建议逐步将风疹疫苗接种纳入计划免疫管理。     

安徽省农村地区风疹感染基线调查及风疹疫苗免疫效果观察

对安徽省农村地区115名≤2岁～≥23岁的健康人检测了风疹血凝抑制（HI）抗体,结果表明：风疹HI抗体平均阳性率为67．89％;≤5岁儿童为43.85％;育龄期妇女易感率为8．59％。对361名≤2岁～≥23对岁的健康人接种了BRDⅡ株风疹减毒活疫苗,免疫应答研究结果表明：各年龄组对风疹疫苗均有较好的免疫应答反应;免疫前HI抗体阳性者接种风疹疫苗后仍可获得良好的免疫应答．说明我国选育的BRDⅡ株风疹减毒活疫苗具有良好的免疫原性。作者建议：①在全省建立风疹的监测系统;②将风疹疫苗的接种纳入计划免疫管理,实行1岁儿童完成初种及对婚前育龄期妇女给予1剂风疹疫苗的接种方案;③在条件许可的情况下,对全省农村地区14岁以下儿童进行普种．     

国产BRDⅡ株风疹疫苗起始免疫月龄的血清学研究

为科学制订国产BRDⅡ株风疹疫苗初次免疫程序，作者对268名6～18月龄组儿童初免风疹疫苗前后风疹血凝抑制（HI）抗体水平进行了血清学研究。结果表明：在6、7、8、9、12和18月龄组儿童中，风疹疫苗免前HI抗体的阴性率分别为100．00％、95．56％、93．02％、96．36％、97．96％和93．94％，几何平均滴度（GMT）分别为0．00、1．17、1．21、1．12、1．07和1．13．各级之间的差异无显著性意义（P＞0．05）；初免风疹疫苗1个月后，其免疫成功率分别为97.67％、95．56％、97．67％、98.18％、97．96％和96．67％，GMT分别为110．71、197．02、155．32、177．63、192．92和142．17，各组之间的差异亦无显著性意义（P＞0．05），且免前低滴度HI抗体对免疫应答结果无明显影响。另外，蓬莱、海阳两市儿童母亲风疹HI抗体的阳性率分别为85．59％和94.67％，其差异具有显著性意义（x2＝5．40，P＜0．05）。鉴于上述结果及我国现行的儿童计划免疫程序，作者建议国产风疹疫苗的起始免疫月龄定为儿童出生后8月龄接种为宜。     

不同厂家生产的冻干麻疹-风疹-腮腺炎三联减毒活疫苗免疫效果及安全性观察

目的 为了解不同厂家生产的冻干麻疹-风疹-腮腺炎三联减毒活疫苗免疫效果和安全性。方法 对545名18—24月龄儿童分组接种三种MMR疫苗，观察疫苗接种的安全性，并分别于免前免后采血，用微量血凝抑制法定量检测接种者的HI抗体GMT水平。结果三组观察对象接种MMR后麻疹HI抗体阳转率均在90％以上，风疹HI抗体阳转率均为100％，腮腺炎HI抗体阳转率均在80％左右，三组均无明显差异，疫苗接种后三组对象全身和局部反应轻微。结论国产与进口的三种MMR疫苗均有良好的有效性和安全性，可用于预防麻疹、风疹、腮腺炎。     

国产麻疹、流行性腮腺炎、风疹疫苗免疫效果观察

目的了解国产麻腮风疫苗安全性和免疫效果。方法对379名18～24月龄儿童分两组分别接种国产及进口麻腮风，观察疫苗接种的安全性，于免前免后采血，用微量血凝抑制法定量检测接种者的HI抗体。结果两组观察对象接种MMR后麻疹HI抗体阳转率均在90％以上，风疹HI抗体阳转率为100％，腮腺炎HI抗体阳转率均在80％左右，两组无明显差异，疫苗接种后两组对象全身和局部反应轻微。结论国产与进口的MMR疫苗有效性和安全性相似，可用于预防麻疹、风疹、腮腺炎。     

中山市7～15岁学生风疹疫苗血清学效果监测

根据省卫生厅、教育厅文件精神 ,中山市 2 0 0 0年对中小学生开展了风疹疫苗接种工作。为了解风疹抗体水平与风疹疫苗的免疫效果 ,评价和考核免疫成功率 ,随机抽取 7～ 15岁学生进行风疹疫苗免疫前、后血清抗体监测 ,现将结果简报如下。对中山市城区中小学生按每个年级抽取 30人 ,在风疹疫苗免疫前及免疫后 1个月分别采集末梢血0 3ml,分离血清于 - 18℃保存待检。按中国药品生物制品检定所《风疹血球凝集抑制试验操作细则》 ,用微量法检测风疹HI抗体。免疫前抗体阴性免疫后抗体阳性者、免疫前抗体阳性免疫后抗体呈≥ 4倍增长者均判为免疫…     

Vaccination with a live RA 27/3 strain rubella vaccine (Rudivax), a follow-up study

Thirteen-year-old Helsinki schoolgirls were screened for rubella antibodies using fingertip blood specimens and the single radial haemolysis (SRH) test. The seronegative individuals (326/1234; 26.4%) were immunized with the RA 27/3 strain of rubella vaccine (Rudivax®). All 326 produced SRH and haemagglutinin inhibition (HAI) antibodies and 129 IgM antibodies (39.4%) detected by enzyme immunoassay in the two-month follow-up serum samples. The incidence and nature of side effects was low. In the twenty-four month follow-up serum samples all individuals had substantial levels of rubella antibodies and no clinical reinfections had occurred during the observation period.     

Rubella virus antibodies in women of childbearing age.

Rubella is a common contagious disease with mild constitutional symptoms, but when it occurs during pregnancy there is significant risk of severe damage to the fetus. A study was undertaken to determine the level of rubella virus antibodies in females in the childbearing age (from 15-40). A total of one hundred and thirty sera were examined for rubella-specific IgG antibodies by hemagglutination inhibition (HAI) test. Ninety out of these sera were examined also by ELISA, for comparative purposes. It was found that, by HAI test, the percentage of antibody positive sera in the females was 72.2% (HAI titer greater than 1:16), while by the more sensitive ELISA test, the percentage of antibody positive sera was 92.2% (50 IU/ml antirubella IgG). The most susceptible females were in the age group of 20-25 years. The need to ensure the protection of seronegative susceptible women of childbearing age by immunization before marriage or pregnancy is emphasized. ELISA is more sensitive, rapid, specific, reproducible and easily adaptable test to large scale screening than the conventional HAI test.     

酶联免疫法检测风疹病毒急性感染结果分析

目的探讨酶联免疫法在诊断风疹病毒急性感染中的应用。方法对2100例无偿献血者血浆样本分别检测风疹病毒IgM抗体、IgG抗体,对IgM抗体阳性和IgM抗体阴性且IgG抗体阳性的样本检测其IgG抗体亲合力。结果 2100例样本中,风疹病毒IgM抗体阳性率为0.76%,IgG抗体阳性率为78.67%,447例样本个体风疹病毒IgM抗体和IgG抗体均为阴性。在对IgM抗体阴性且IgG抗体阳性的样本进行IgG抗体亲合力检测时,有19例样本为低亲合力,可判定为原发性感染。在对IgM抗体阳性的样本进行IgG亲合力检测时,样本SZ0259和SZ1490IgM抗体为可疑值,IgG抗体阳性,IgG抗体高亲合力,可能由于IgM抗体常年保持低水平,并非正处于风疹病毒急性感染期。最终确定风疹病毒急性感染的样本为33例,感染率1.57%。结论可同时检测风疹病毒IgM抗体和风疹病毒IgG抗体亲合力来诊断风疹病毒感染,IgM抗体阳性或IgG抗体低亲合力的样本均可判定为风疹病毒急性感染。     

Rubella infection during pregnancy in the 1985–86 epidemic: Follow-up after seven years

The study covered 310 pregnant women from southern Poland who were exposed to rubella during the 1985–86 epidemic, none of whom had been vaccinated against rubella. Rubella specific antibodies were detected by hemagglutination –inhibition (HI) tests, and IgM antibodies by enzyme immunoassay (ELISA) (Organon Teknika). Clinical symptoms according to anamnesis were recorded. The consequences of serologically confirmed maternal rubella on the course of pregnancy and on fetal outcome were evaluated. IgM antibodies could be examined in only 10 newborns at delivery or in the first days of life. After seven years, follow-up studies of children born to infected mothers were done. The mental development of 14 of these children was evaluated with Terman-Merrill test. Among 310 women examined during pregnancy, rubella infection was confirmed serologically in 46 cases (14.8%). All but 3 of those had clinical symptoms. The course of pregnancy was observed in 36 of the infected mothers. Only 5 women (22.7%) who had the infection in the first trimester of pregnancy delivered a healthy child. The rate of complications in pregnancy among women infected in the second trimester was lower, and 8 (66.7%) bore healthy children. All the children born to mothers infected in the third trimester were healthy. Eight of the 10 newborns examined at delivery were IgM positive. Of 29 children congenital rubella syndrome (CRS) was confirmed in 5 cases, CRS compatible or CRS possible in 7 and 3 had congenital infection only confirmed serologically (IgM-positive) without defects or symptoms. Seventheen (58.6%) children were found healthy including the 3 who had congenital infection only. The mental development of 14 children at age 7 was assessed; 10 cases (72%) fell within rank II 130-85, and 4 (28%) were of borderline intelligence. The study indicates that congenital rubella is still a serious problem in Poland. Immunization was introduced only in 1988–89, for 13-year-old girls. Women of child- bearing age should be screened for rubella antibodies and those susceptible to rubella infection should be vaccinated.     

北京市西城区2008年-2011年风疹IgM抗体实验室检测情况与分析

目的:通过对北京市西城区2008年-2011年风疹血清IgM抗体检测结果的分析,了解北京市西城区风疹疫情动态及流行病学特点,为如期实现消除麻疹、降低风疹发病率提供科学依据。方法:采用酶联免疫吸附试验(ELISA)对北京市西城区2008年-2011年采集的疑似麻疹、风疹血清标本进行麻疹IgM抗体、风疹IgM抗体检测。结果:2008年-2011年四年间共检测送检血清标本177份。其中,风疹IgM抗体阳性61份,总阳性率为34.46%。结论:北京市西城区2008年-2011年风疹基本呈散发状态,其阳性率基本维持在一定的水平。四年间的阳性率差异没有统计学意义(χ2=4.737,P>0.192)。风疹发病主要集中在3月-6月间,并有明显的年龄分布特征。应加强风疹的免疫预防工作,以控制风疹蔓延。     

Rubella in Orkney: seroepidemiology and vaccination

Rubella haemagglutination inhibiting (HAI) antibody titres were determined in 54 seronegative women and 31 naturally immune women after vaccination and revaccination with Wistar RA27/3 strain rubella vaccine administered by the intranasal or subcutaneous routes or revaccination with the Cendehill strain administered subcutaneously. In addition, HAI antibody titres were determined in 46 seronegative schoolgirls after vaccination with the Cendehill strain and revaccination with the RA27/3 strain.     

Interruption of rubella virus transmission in Australia may require vaccination of adult males: evidence from a Victorian sero-survey.

Prior to the introduction of rubella vaccine to Australia in 1970 rubella was primarily a disease of primary school aged children. Vaccination programs have subsequently altered rubella age and sex susceptibility. Between July 2001 and June 2002, 85 per cent of the 32 laboratory-confirmed cases of rubella ascertained from enhanced surveillance in Victoria were males aged 20-42 years. This study aimed to determine rubella susceptibility by age group and sex in Victoria and to examine the implications of susceptibility for the interruption of circulating rubella virus. Rubella immunoglobulin G concentrations were determined for 934 residual diagnostic sera stored at the Victorian Infectious Diseases Reference Laboratory using a standard commercial enzyme immunoassay. Susceptibility was analysed by age groups defined by previous and current Australian rubella immunisation schedules. Among all subjects aged 1-55 years, males were more susceptible to rubella infection than females (10.2% vs 2.6%, p < 0.0001). Although this sex difference occurred in all age groups, it was unlikely to be explained by sampling variation in sera from subjects aged 23-44 years, for whom rubella vaccine had been recommended only for girls aged 10-14 years and rubella susceptible women post-partum. Australia's past rubella immunisation policies have resulted in a susceptible cohort of adult males. If rubella virus transmission is to be interrupted in Australia, consideration needs to be given to a rubella vaccination program targeting men aged 17-44 years. A campaign, targeting both men and women in a similar age group has recently been successful in Costa Rica.     

122对母婴风疹病毒抗体水平检测及意义

目的了解孕产妇及其新生儿血液中风疹病毒抗体水平,评估孕产妇及其新生儿对风疹病毒的易感性,为预防和控制先天性风疹综合征提供科学依据。方法随机采集2011年吉林大学第二医院妇产科住院部分孕产妇及其配对新生儿血液,应用酶联免疫吸附法(ELISA)检测血清中风疹病毒特异性抗体。运用统计学软件SPSS对可能影响孕产妇及其新生儿风疹抗体水平的因素进行分析。结果 122名孕产妇风疹抗体免疫球蛋白G(IgG)阳性率为77.8%,新生儿风疹抗体IgG阳性率为82.6%。一对母婴风疹IgG抗体均>2 500 IU/ml,其母亲的风疹抗体免疫球蛋白M(IgM)阳性。母体内风疹病毒IgG抗体阳性率随年龄增加而下降。母传抗体增高的平均倍数为1.5倍,降低的倍数为2.0倍。结论及时监测孕产妇及其新生儿风疹IgG及IgM抗体,提高育龄妇女风疹免疫力,是减少先天性风疹综合征发病的有效手段。     

A rubella outbreak investigation and BRD-II strain rubella vaccine effectiveness study,Harbin city,Heilongjiang province,China, 2010–2011

Background

In the 1990s, China introduced rubella vaccine into the private market using BRD-II virus strain, which is different than the globally used RA27/3 strain. In 2007, BRD-II rubella containing vaccine was introduced into the national immunization program and recommended for routine use. However, to our knowledge, there are no field vaccine effectiveness (VE) studies of BRD-II rubella vaccine. In April 2011, a rubella outbreak was detected in two daycare centers in Harbin city, China. We conducted an investigation to determine VE of BRD-II rubella vaccine.

Methods

Rubella cases were either laboratory-confirmed or epidemiologically linked to laboratory-confirmed cases. We collected demographic characteristics, migrant status, and history of rubella and measles vaccination from all children in the two daycare centers.

Results

The first case of rubella was on 22 November, 2010. Among the 143 children in the two daycare centers, 22 acquired rubella, for an overall attack rate (AR) of 15.4% (22/143). The AR in higher-grade classes (21.7%) was higher than in lower grade classes (3.9%). The AR among migrant children (47.8%) was higher than among local children (9.2%). Rubella vaccine coverage was 17% (24/143), while measles vaccine coverage was 100%. The AR among rubella-vaccinated children was 0% (0/24), and the AR among rubella-unvaccinated children was 18.5% (22/119), for a VE of 100% (P value = 0.025, 95% CI: 35–100%). Rubella vaccine coverage among children born before 2007 was 10.2% (10/98), and was lower than that for children born in 2007 or after (31.1% (14/45), RR = 0.33, 95%CI: 0.16–0.68). Emergency vaccination was conducted on 11 and 12 April 2011, and the outbreak stopped in one week later.

Conclusions

Domestic BRD-II strain rubella vaccine showed high vaccine effectiveness against rubella. Rubella vaccine coverage through routine immunization was insufficient. Consideration should be given for measuring rubella vaccine coverage to determine the need for catch-up vaccination in China.     

2006年山东省风疹暴发地区孕妇风疹病毒早期感染状况调查

[目的]了解风疹暴发地区孕妇风疹病毒早期感染状况,为监测与预防先天性风疹综合症（CRS）提供依据。[方法]2006年4月,在山东省5处近期风疹暴发地区采集部分未发生风疹的孕妇血清,检测风疹IgM抗体,并对阳性孕妇所生儿童进行追踪观察。[结果]调查孕妇1030名,风疹IgM抗体阳性5例,阳性率为0．49％;5例孕妇孕周分别为16周、19周、20周、21周和40周,其中2例（孕周16周、20周）流产,3例均顺利生产,跟踪观察1年,儿童未发现出生缺陷。[结论]山东省风疹暴发地区孕妇风疹病毒早期感染率不高。