2008年新疆精河县麻疹流行病学特征分析

目的分析2008年新疆精河县麻疹发病的流行病学特征。方法根据中国免疫规划信息管理系统的资料,对精河县2008年麻疹的流行病学特征进行描述流行病学分析。结果 2008年全县确诊麻疹病例103例,主要发生在2～4月;6岁及以下为麻疹高发年龄组,发病30例,占病例总数的29.13%;无免疫史者和免疫史不详者占69.90%;流动人口病例数占14.56%。结论小年龄组常规免疫工作和大年龄组儿童的麻疹疫苗复种工作急需加强,8月龄及以下婴儿正在成为麻疹控制中的一个焦点,应尽可能提高外来流动儿童的免疫覆盖率,并加强疫情监测,预防麻疹暴发。     

2008年新疆阿勒泰地区麻疹流行特征分析

目的分析2008年新疆阿勒泰地区麻疹流行病学特征,为政府加速控制麻疹提供科学依据。方法对麻疹疫情报告资料进行描述流行病学分析。结果 2008年阿勒泰地区麻疹发病大幅上升,报告发病率为198.79/10万,明显高于1998～2007年的发病水平。发病以≥15岁成人为主,占发病总数的62.23%,多为无明确麻疹减毒活疫苗免疫史和免疫史不详者。8月龄～1岁病例中无免疫史者占52.94%,发病集中在2～5月,农牧区发病人数占72.81%。结论麻疹母传抗体下降、麻疹疫苗接种不及时、传染病报告不及时和传染源管理不严等是造成本次麻疹流行的主要原因。     

9月龄～6岁健康儿童麻疹和风疹抗体水平监测

目的 了解新疆阿克苏地区9月龄～6岁健康儿童麻疹和风疹抗体水平,及时发现免疫薄弱人群,采取针对性免疫措施.方法 采用分层随机抽样法,采集839名9月龄～6岁健康儿童血清标本,采用酶联免疫吸附试验(ELISA)检测麻疹和风疹IgG抗体.结果 839名儿童麻疹抗体阳性率为94.3％,抗体几何平均滴度(GMT)为1 541.2 mIU/ml;风疹抗体阳性率为92.1％,抗体几何平均滴度(GMT)为958.4 mIU/ml.不同免疫剂次和不同年龄组儿童麻疹、风疹抗体阳性率和GMT水平不同,差异有统计学意义(P＜0.05).结论 阿克苏地区9月龄～6岁健康儿童麻疹、风疹IgG抗体水平总体较高,但仍存在薄弱环节,1岁以下儿童是麻疹和风疹的高危人群,应加强此部分人群的针对性免疫策略.     

2005～2012年甘肃陇南市麻疹疑似病例IgM抗体检测结果分析

目的检测麻疹疑似病例血清中麻疹IgM抗体,为麻疹的预防和控制提供科学依据。方法用酶联免疫吸附试验（ELISA）对2005～2012年甘肃陇南市839例麻疹疑似病例的血清标本进行IgM抗体检测,数据用Spss19．0软件进行统计学分析。结果共检出麻疹IgM抗体阳性534份,阳性率63．6％;每年都有病例报告,其中2008年阳性率最高,为82．6％;各区（县）均检出阳性病例,不同地区阳性检出率差异有统计学意义（χ2=86．917,P〈0．05）;发病人群集中在8月龄。25岁年龄段,占阳性病例总数的74．5％;麻疹每月均有发病,但高峰在3～7月。结论检测麻疹IgM抗体对病例的早发现、早诊断、早治疗、及时采取控制措施起到关键作用,各级医疗机构要重视疑似病例的血清采集工作,同时应大力加强麻疹基础免疫和重点人群的强化免疫工作;高度重视查漏补种工作,消除免疫空白点,提高免疫接种的覆盖率和及时率;加强健康教育工作,提高麻疹预防知识的知晓率。     

2004-2009年安岳县麻疹流行病学特征分析

目的分析2004-2009年安岳县麻疹发病与流行趋势,为控制和消除麻疹提供依据。方法对2004-2009年安岳县麻疹监测系统确诊的632例病例进行流行病学分析。结果 2004-2006年麻疹发病率呈下降趋势,2007年发病数显著上升,且呈现散发与局部暴发并存的态势。2008年3月全县开展8月龄1~5岁儿童普种麻疹疫苗,疫情得到明显控制,2009年发病数仅有3例。发病高峰集中在3-7月;病例中有免疫史的占30.54%,无免疫史和免疫史不详的占44.78%和24.68%。结论麻疹初免及加强免疫接种不及时、流动儿童增多是造成麻疹发病上升的主要原因。提高麻疹疫苗接种质量和及时接种率,加强流动人口管理是控制麻疹暴发和流行的重要手段。     

2008年1～5月乌鲁木齐市麻疹疫情暴发的检测结果分析

目的了解2008年1～5月乌鲁木齐市麻疹疫情爆发流行的原因，探讨控制策略。方法采用酶联免疫吸附试验（ELISA）检测血清麻疹IgM抗体，对麻疹阳性病例共分5个年龄组进行统计学分析。结果这次疫情共送检麻疹疑似病例3513例，实验室确诊麻疹病例1481例，阳性率为42.16%，其中男性813例，女性668例，男女性别比为1.22∶1，两组之间的差异具有统计学意义（χ^2=13.25，P〈0.005）；从年龄组分布来看，发病主要集中在0～8月龄组，阳性率为56.97%。其次是9月～8岁和29岁～的成人组也占有相当大的比例，分别为50.97%和50.69%；9～18岁组阳性率最低为22.75%。0～8月龄组和9～18岁组麻疹发病率的差异具有统计学意义（χ^2=170.78，P〈0.005）。结论麻疹病例逐渐向未到免疫年龄人群和成人转移，给当前麻疹防治工作提出了新的挑战。另外，掌握麻疹的采血时间，才能更好的提高麻疹的检出率。     

2008年新疆维吾尔自治区实施麻疹疫苗后续强化免疫活动评价

目的探讨加速控制和消除麻疹的策略和措施。方法 2008年对新疆维吾尔自治区全区范围8月龄～6岁儿童实施了麻疹疫苗（MV）后续免疫活动;利用新疆维吾尔自治区统计局资料、疫苗分发数、疫情资料等,对报告接种情况进行了评价。结果全疆麻疹强化免疫应种儿童1641861人,实际免疫儿童1616117人,接种率为98.99%,以县为单位报告接种率95%以上。结论开展MV初始强化免疫和后续强化免疫对控制麻疹效果非常显著。     

2012年新疆博州0～15岁儿童麻疹抗体血清学监测分析

目的了解新疆博尓塔拉蒙古自治州(简称博州)0~15岁儿童的麻疹抗体水平,为消除麻疹提供科学依据。方法每个县(市)随机调查0~2岁、3~5岁、6~8岁、9~11岁、12~14岁5个年龄组的儿童,每组10人;每个县(市、区)共抽查50人,采集儿童静脉血5 ml,离心后立即送博州疾病预防控制中心实验室进行检测。结果 2012年博州儿童麻疹发病数为0;共检测麻疹标本166份,检出IgM抗体阳性161份,阳性率96.9%,3~11岁儿童阳性率最高;地区、城乡、性别、年龄的分布,各类人群麻疹抗体阳性率都大于90%,8个月~2岁组儿童是基础免疫对象,麻疹抗体阳性率92.3%,3~15岁儿童至少有3次以上麻疹类疫苗接种史,麻疹抗体阳性率为95%以上。结论博州麻类疫苗基础免疫与强化免疫接种质量较高,但应加强<8月龄儿童、流动儿童的预防接种,避免免疫薄弱人群的出现。     

2008年桂林市麻疹流行分析

目的了解桂林市麻疹发病情况,为控制麻疹制定科学依据。方法采用描述流行病学方法统计分析。结果 2008年全市报告麻疹病例192例,报告发病率3.87/10万,<8月龄51例,占总病例数的26.6%,>15岁病例51例,占26.6%,散居儿童发病125例,占65.1%;病例以市区为主,占病例数的52.6%,主要集中在流动人口较多的城乡结合部;病例中未免疫的128例,免疫史不祥的52例,分别占总病例数的66.7%、27.1%。结论桂林市麻疹发病以小年龄婴儿和成人为主,要控制麻疹,在做好常规免疫工作的同时,必须加强流动人口的管理,提高流动儿童的接种率。     

上海市闸北区1999～2008年麻疹流行病学特征分析

目的了解上海市闸北区麻疹流行病学特征,为加速控制和消除麻疹提供依据。方法对上海市闸北区1999-2008年麻疹疫情资料进行描述流行病学分析。结果1999～2008年闸北区麻疹发病185例,无死亡病例,平均年发病率2.31/10万;外来人口发病率是本区人口发病率的16.11倍;3～8月发病人数占总发病人数的78.92%;男女病例数之比为1.08∶1;10岁儿童占总发病数的51.89%;≥20岁成人占总发病数的37.84%;本区人口发病以成人为主,≥20岁病例占56.14%,外来人口发病以儿童为主,10岁占58.59%。无免疫史,免疫史不详者分别占总发病数的56.76%和28.65%。结论加强对外来人口的管理、提高麻疹疫苗及时接种率和2剂次免疫率是控制和消除麻疹的工作重点,同时应加强麻疹的监测,开展成人麻疹疫苗免疫接种工作。     

现阶段消除麻疹关键防控技术策略分析与探讨

基于对泰安市1999～2010年麻疹监测与防控工作,分析了当前麻疹发生与流行的主要特征,提出了麻疹首例病例、疫情季节性流行低谷、医院感染、小于8月龄及成人病例为主的两极年龄分布等特征对于疫情预测与防控工作的重要意义,重点探讨消除麻疹关键防控技术措施,强调规范疫情应急处置及强化行政干预的重要性,并力求纠正当前消除麻疹工作中存在的一些问题。     

Optimum age for measles immunization in Malaysia

A study was carried out at the University Hospital, Kuala Lumpur, Malaysia to determine the age-specific prevalence of measles infection by serology and the age specific-seroconversion rates following measles vaccination. The results show that the percentage of children with passively acquired measles antibodies decreased with increasing age till 3 to 5 months of age. From 12 months of age, the percentage of positivity increased sharply due probably to natural infection. The geometric mean antibody titre was low at birth, but from 6 months it started to increase. These results indicate that measles infection is common in Malaysia and a small number of children began to acquire natural measles infection from 6 to 8 months of age; however the peak age for the acquisition of measles infection was from 12 months to 5 years of age. Seroconversion rates following vaccination from 9 months of age, ranged from 94% to 99%. However, the rates and the geometric mean titre were higher among those vaccinated at 11 months of age or older compared with those vaccinated at 9 or 10 months of age. Basing on the above results, it was concluded that the optimum age for measles immunization in Malaysia should be 11 months.     

A seroepidemiological study of measles infection in normal and handicapped persons in Lagos, Nigeria

Serological studies in a group of children showed that there was a high degree of immunity to measles at birth (100%), but this decreased rapidly so that by the age of 5 months there was 36% immunity and by 7-8 months the level had dropped to 5%. However, there was a gradual rise from the age of 9 months onwards, so that by the age 6-9 years there was 75% immunity and from 10 years onwards there was 100% immunity. The findings suggest that measles vaccination can be given from the age of 6 months onwards, but this needs to be confirmed by further studies. There is need to compare children under the age of 5 years who are blind or deaf with a control group in order to determine the aetiological role of measles infection in these handicaps in Lagos.     

Impact of mass measles campaigns among children less than 5 years old in Uganda

In 1999-2001, a national measles control strategy was implemented in Uganda, including routine immunization and mass vaccination campaigns for children aged 6 months to 5 years. This study assesses the impact of the campaigns on measles morbidity and mortality. Measles cases reported from 1992 through 2001 were obtained from the Health Management Information System, and measles admissions and deaths were assessed in six sentinel hospitals. Measles incidence declined by 39%, measles admissions by 60%, and measles deaths by 63% in the year following the campaigns, with impact lasting 15 to 22 months. Overall, 64% of measles cases were among children <5 years of age, and 93% were among children 相似文献   

Measles incidence before and after mass vaccination campaigns in Burkina Faso

Burkina Faso conducted mass measles vaccination campaigns among children aged 9 months to 4 years during December 1998 and December 1999. The 1998 campaign was limited to six cities and towns, while the 1999 campaign was nationwide. The last year of explosive measles activity in Burkina Faso was 1996. Measles surveillance data suggest that the 1998 urban campaigns did not significantly impact measles incidence. After the 1999 national campaign, the total case count decreased during 2000 and 2001. However, 68% of measles cases occurred among children aged 5 years or older who were not included in the mass vaccination strategy. During 2000 and 2001, areas with high measles incidence were characterized by low population density and presence of mobile and poor populations. Measles control strategies in Sahelian Africa must balance incomplete impact on virus circulation with cost of more aggressive strategies that include older age groups.     

148例麻疹临床分析

目的 分析2005—2011年本院收治的148例麻疹流行病学和临床特点,为进一步预防和控制麻疹提供依据。方法 回顾性调查148例麻疹病例的流行病学和临床特点。结果 本地区春季发病率高,3—6月达114例(77.0%);8月龄以下婴幼儿发病数增加,成人麻疹发病率逐年上升,21~40岁80例(54.0%)。结论 建议加强对高危人群中的成年人强化免疫,加强对外来流动人口麻疹疫苗接种的监测。     

Spectrum of complications of measles in Afghanistan: a study of 784 cases

Seven hundred and eight-four patients with measles admitted to the Institute of Child Health, Kabul (Afghanistan) between April 1980 and March 1982 were studied. Almost three-quarters (73.6%) of children (4 months to 12 years) with measles were below the age of 3 years. The maximum number of cases occurred in the 1 to 2 years age group (43.1%). Eighty-nine patients (11.3%) contracted the disease before 1 year of age whereas only 13 infants had developed measles before the age of 7 months. Measles occurred throughout the year and there was no significant seasonal variation. Bronchopneumonia was the commonest complication (85.4%) followed by enteritis (30.2%) and laryngotracheobronchitis (22%). The overall mortality was 10.8%. Respiratory complications including bronchopneumonia and laryngotracheobronchitis were the commonest causes of death followed by encephalitis and gastroenteritis. However, the case fatality rate was highest among patients who suffered from encephalitis and laryngotracheobronchitis. In our study, there was no significant difference in the incidence of mortality between well-nourished and moderately undernourished children. It is recommended that in developing countries measles vaccination should be given around 8-9 months of age and must be completed before the age of 1 year.     

Effect of vitamin A supplementation on measles-specific antibody levels in Guinea-Bissau

We have previously reported that vitamin A supplementation with measles vaccine at age 9 months increases measles-specific antibody concentrations in children at age 18 months compared with placebo. We examined these children when they reached age 6-8 years. Fewer vitamin A-supplemented children had non-protective antibody concentrations (p=0.0095); among children with protective antibody levels, vitamin A-supplemented children tended to have higher geometric mean antibody titres (p=0.09). Thus, simultaneous administration of vitamin A and measles vaccine at age 9 months had a long-term effect on measles-specific antibody levels and may contribute to improved measles control in less-developed countries.     

Measles vaccination before nine months

Summary objective  To measure the protective effect of measles vaccine administered before 9 months of age and compare overall mortality of children vaccinated at 6–8 months and at 9–11 months.nsp;Non-concurrent cohort study involving all 13 134 children born between 16 January 1986 and 31st December 1991 in Kaniyambadi block near Vellore who had not left the area by six months of age. Main outcome measures were risk of disease and death among the under-five-year-olds according to age at measles immunization.ensp;Unimmunized children had a higher risk of developing measles compared to the immunized( P < 0.05). There was no significant difference in risk of measles among those vaccinated prior to and after nine months of age. Unvaccinated children were at significantly higher risk of death than vaccinated children ( P < 0.001). There was no difference in risk of death between infants vaccinated between 6 and 8 months and those vaccinated between 9 and 11 months. There was no difference in the risk of death between boys and girls vaccinated between 6 and 8 months with standard-titre Edmonston-Zagreb vaccine.p; Administration of standard-titre Edmonston-Zagreb measles vaccine at 6–8 months is an effective and safe preventive measure for measles, especially where the age-specific attack rate for childrenis high.     

Measles incidence, vaccine efficacy, and mortality in two urban African areas with high vaccination coverage

Measles incidence, vaccine efficacy, and mortality were examined prospectively in two districts in Bissau where vaccine coverage for children aged 12-23 months was 81% (Bandim 1) and 61% (Bandim 2). There was little difference in cumulative measles incidence before 9 months of age (6.1% and 7.6%, respectively). Between 9 months and 2 years of age, however, 6.1% contracted measles in Bandim 1 and 13.7% in Bandim 2. Even adjusting for vaccination status, incidence was significantly higher in Bandim 2 (relative risk 1.6, P = .04). Even though 95% of the children had measles antibodies after vaccination, vaccine efficacy was not more than 68% (95% confidence interval [CI] 39%-84%) and was unrelated to age at vaccination. Unvaccinated children had a mortality hazard ratio of 3.0 compared with vaccinated children (P = .002), indicating a protective efficacy against death of 66% (CI 32%-83%) of measles vaccination. These data suggest that it will be necessary to vaccinate before age 9 months to control measles in hyperendemic urban African areas.