洪涝灾区健康人群免疫水平及控制钩体病对策

目的调查洪涝灾区健康人群免疫水平，探讨洪涝灾区控制钩体病流行对策。方法选择湖北省仙桃、宜都市，公安县等钩体病流行较为严重的地区作为调查点，进行血清学等调查。结果近年洪灾频繁发生，钩体病传染源扩散较快，健康人血清隐性感染率较高，公安县以黄疸出血群和流感伤寒群免疫水平较高，仙桃和宜都市以黄疸出血群和波摩那群免疫水平较高，健康人血清钩体IgG显著高于IgG抗体。健康人血清黄胆出血群、波摩那群、流感伤寒群抗体阳性率分别为27．61％，13．73％，11．68％，分别低于10年前平均水平20％～54％。结论首次定量调查健康人血清钩端螺旋体IgG和IgM抗体水平，奠定了我省健康人钩端螺旋体免疫水平测定、钩端螺旋体疫苗效果测定和钩端螺旋体病人诊断基础。控制钩体病的流行应采取接种钩体菌苗等综合性防治措施。     

浙江省钩端螺旋体菌苗接种率调查和管理探讨

钩端螺旋体病是一种以鼠、猪、牛和蛙为主要传染源的急性自然疫源性疾病。接种钩端螺旋体菌苗(简称钩体菌苗)是预防钩体病的有效措施,据我省调查,未接种菌苗者发病率是接种者的5.5倍。近年来我们加强了对全省钩体菌苗接种率的检查,现将1991~1996年我省钩体菌苗接种率调查情况总结如下。材料和方法一、钩体菌苗:由卫生部上海生物制品研究所生产,5毫升/支,按规定方法运输、保存和供应。有三种型号:浙甲型(含黄疽出血群和流感伤寒群各50%)、浙乙型(黄疽出血群和波摩那群各50%)和浙丁型(含黄疽出血群和七日热群各50%)。二、苗苗接种对象和时间:近三年年均发病>3例的疫区乡镇、年龄15~50岁的农业人口;每年4月下旬开始,要求在流行高峰前1月即5月底前完成接种。     

1993—2000年四川省钩端螺旋体菌群分布

目的：分析、研究四川省钩端螺旋体（下称钩体）菌群分布,掌握菌群动态,为钩体病的科研和防制提供科学依据。为钩体菌苗生产提供流行菌株。方法：按全国本病监测方案,从病人和带菌动物中分离钩体,按中国药品生物制品检定所的钩体菌种检定程序进行检定,结果324株钩体分属8个血清群。即黄疸出血、七日热、秋季、澳州、流感伤寒、波摩那、犬、爪哇群。另从水牛尿中首次检出七日热群钩体2株。结论：黄疸出血群钩体仍为四川省人间钩体病流行和啮齿食虫目动物携带的主要菌群,占81．48％。趴齿食虫目仍为主要宿主动物,尤以黑线姬鼠为四川稻本病主要传染源,水牛是七日热群钩体病的重要传染源和宿主动物之一。     

钩端螺旋体不同型别外膜菌苗人体免疫效果观察

我国 6 0年代研制成功的钩端螺旋体全菌体菌苗 (简称菌体苗 ) ,一直沿用至今 ,对控制钩端螺旋体病 (简称钩体病 )流行起到重要作用。然而菌体苗接种次数多 ,反应较大 ,免疫效果不太理想。为了提高钩体菌苗接种后的免疫效果 ,80年代 ,卫生部上海生物制品研究所张锦麟等通过改进制备工艺 ,研制成了钩端螺旋体外膜菌苗 (简称外膜苗 ) ,通过实验室小量人体试验 ,具有较好的免疫效果。在进一步完善各项质控指标和改进生产工艺的同时 ,通过多年努力 ,先后研制成了二型、三型与五型钩体外膜苗。通过 2次小剂量人体接种反应观察 ,证明外膜苗全身和局…     

龙游县钩端螺旋体病地理流行病学分析

龙游县自1970年首次报告钩端螺旋体病至1997年共发生1369例,死亡9例,年均发病率为13.41/10万,病死率为0.66%,其中1973年为历史发病最高年份,发病率为105.09/10万,在27年期间共发生五次钩体病局部暴发流行。发病季节以8~10份为高峰,发病以农民青壮年为主,男性多于女性,本病流行形式主要为稻田型和洪水型。临床上以黄疸出血型和流感伤寒型为主。鼠类、猪是主要传染源,从鼠类、活蛙、猪肾、犬肾和牛尿等615份标本中分离到钩端螺旋体菌株6株,菌型分布主要是黄疸出血群和七日热群。鼠总密度为13.01%,黑线姬鼠为优势种。观察菌苗接种与发病的关系,无接种史者发病的危险度为接种者的4.91倍。     

1991—2006年常山县钩端螺旋体病疫情与监测分析

目的了解常山县钩端螺旋体（钩体）病的流行特征，为制定防治对策提供科学依据。方法用描述性流行病学方法对1991—2006年常山县钩体病的流行特征进行分析，采用患者和宿主动物病原学、血清学检测方法探索主要的流行菌群。结果1991-2006年常山县钩体病平均发病率为19．29／10万，以中青年农民为主，男性高于女性；79月为发病高峰，流行形式主要呈稻田型。检出钩体菌株36株，以黄疸出血群为主，563．89％（23／36）。血清学检测阳性率50．74％（171／337），以黄疸出血群和七日热群为主，分别占50．29％（86／171）和30．41％（52／171）。黑线姬鼠为优势种，占41．48％（475／1145），带菌率为2．95％（14／475），蛙、猪、牛等未检出菌。结论常山县钩体病的主要流行菌群为黄疸出血群和七日热群，主要宿主动物为黑线姬鼠。采用相应的菌苗接种为主导措施，可以有效控制钩体病的流行。     

两型钩端螺旋体外膜疫苗人体免疫水平观察

为了解黄疸出血群赖型和七日热群七日热型钩端螺旋体 (钩体 )外膜疫苗免疫后的人体免疫水平 ,我们对两型钩体外膜疫苗进行了免疫后 1年抗体水平和加强免疫效果观察 ,现简报如下。1　钩体疫苗和观察对象　钩体外膜疫苗 ,含黄疸出血群赖型和七日热群七日热型 ,每型含量为 2 0 0 μｇ/ｍｌ,批号 :930 0 1、930 0 2。钩体菌体疫苗 ,其菌型与配比同钩体外膜疫苗 ,菌浓度为各含 1 5亿 /ｍｌ,批号 :930 0 3,作为对照组。观察对象为本县非钩体病流行区、未接种过钩体疫苗的中学生 ,年龄 15～ 16岁 ,健康 ,无禁忌证。来自本县职业中学、第三中学和城…     

钩端螺旋体外膜菌苗的研究 Ⅳ 多价外膜菌苗小量人群实验接种的观察

钩端螺旋体外膜菌苗人体接种后反应轻微。免疫后1~3月抗体有明显增长。外膜菌苗一针注射即能达到或超过普通菌苗全程接种水平。一个月犬型及流感伤寒型抗体增长最高（t>3），黄疸出血型次之（t=1.9），秋季型较低（t=0.l）。三个月四型抗体均以外膜菌苗组高（t>2.5）。六个月两类菌苗抗体虽均明显下降，但仍以外膜菌苗组高（t>2.5）。     

钩端螺旋体外膜菌苗接种后的人体反应观察

本文应用不同抗原含量的钩端螺旋体外膜菌苗在１５～１６岁中学生中进行了反应观察，大多数正常，无不良反应，个别在接种后的２４小时出现体温升高和局部红晕反应，主要在２００ｕｇ组，４８小时很快恢复正常。同菌体苗组比较，差异无显著性意义。实验结果表明外膜菌苗安全可靠，副反应小。     

江油地区首次发现黄疸出血群赖型钩端螺旋体

本文报告了四川省江油市１９９５年９月，钩端螺旋体病（以下简称钩体病）暴发流行期间，首次从３３例病人血液标本检出钩体７株，阳性率为２１．２１％，分属二个血清群三个血清型、黄疸出血群黄疸出血型５株，赖型１株，七日热群棉兰型１株。培养鼠肾２２５份，检出钩体３１株（待定１株，失传１株），阳性率为１３．７８％，以黄疸出血群赖型为主要血清型，病原体带菌宿主以黑线姬鼠为主，为我市稻田型钩体病的主要传染源，携带钩体与本次钩体病暴发流行人间主要流行菌群和型一致。     

浙江省肾综合征出血热纯化灭活疫苗现场免疫效果和免疫策略研究

本文报告肾综合征出血热纯化灭活疫苗在浙江省高发疫区大面积人群接种后的安全性、血清学和流行病学近期防病效果。本次共接种１０４６０人，全程接种者占９７．３０％；对照１６１５９人。全程接种后两周荧光抗体阳转率为９８．５５％（６８／６９），中和抗体阳转率为４４．８３％，几何平均滴度分别为６９．３６和４．４４。经一个流行期观察，接种组无发病；对照组发病１２例，发病率为７４．２６／１０万，人群近期保护率达１００％。人群接种后局部和全身反应较明显，注射局部疼痛感达１００％，但均未发生异常反应（包括隐性感染者）。预测疫苗接种后当年发病数减少了３３例，取得一定的经济和社会效益。     

流感疫苗安全性和免疫效果观察

[目的 ]　评价流行性感冒疫苗 (防感灵TM)接种后的安全性和抗体阳转情况。 [方法 ]　采用随机和双盲法选择接种组和对照组 ,分别接种流感疫苗和伤寒Vi疫苗。接种后 3天内进行安全性观察。同时 ,免后 4个月时采集静脉血检测流感血凝抑制抗体的产生情况。 [结果 ]　接种组一般副反应率为 1.70 % ,全身副反应率为0 .6 4% ,与对照组差异无显著性。A1、A3、B型的血凝抑制抗体阳转率分别为 97.7%、99.2 %和 82 .9% ,接种组GMT均明显高于对照组。 [结论 ]　流感疫苗 (防感灵TM)安全性良好 ,并且有较好的免疫原性     

芜湖市2010～2012年疑似预防接种异常反应监测分析

目的分析芜湖市疑似预防接种异常反应（AEFI）的发生特征,评价AEFI监测系统运转情况、预防接种质量和疫苗安全性,探讨AEFI防范措施。方法通过疑似预防接种异常反应信息管理系统收集全市2010-2012年AEFI个案数据,采用描述性方法对AEFI监测的相关指标进行流行病学分析。结果 2010~2012年全市共报告AEFI 308例,其中一般反应257例（83.44%）,异常反应49例（15.91%）,偶合症2例（0.65%）。各县均有AEFI报告县与预防接种门诊AEFI报告覆盖率分别为100.00%、93.55%;48h内报告率为97.40%,48h内调查率为100.00%。81.82%的AEFI发生于疫苗接种后1d内。89.94%的AEFI发生于0~2岁及6岁儿童。临床诊断以发热、红肿、硬结及过敏性反应为主。AEFI报告发生率为12.10/10万,其中一般反应为10.10/10万,异常反应为1.93/10万。85.06%的AEFI发生于国家免疫规划（NIP）疫苗,69.81%的AEFI发生于第一剂次疫苗接种;不良反应发生较多的疫苗分别为无细胞百白破疫苗（39.29%）、白破疫苗（15.26%）、A＋C群流脑结合疫苗（7.79%）、23价肺炎疫苗（5.19%）、麻风疫苗（4.87%）。NIP疫苗与第二类疫苗的一般反应与异常反应发生率差异无统计学意义（χ2一般反应=2.29,P〉0.05;χ2异常反应=0.46,P〉0.05）。结论目前芜湖市AEFI监测系统运行状况良好,AEFI监测较为敏感。     

上海市部分地区儿童水痘疫苗免疫后流行病学效果观察

[目的]观察水痘疫苗接种情况和接种水痘疫苗1~7年后的水痘发病情况。[方法]在本市部分地区选择接种组和未接种组儿童,采用统一调查问卷调查水痘疫苗接种情况和水痘发病情况。[结果]调查地区儿童水痘疫苗累积接种率为4.12%,12岁以下人群为26.90%。1999~2005年接种组总发病率为1.00%,未接种组为4.35%,水痘疫苗接种保护率为77.0%;各年接种组发病率分别为1.62%、2.06%、0.29%、0.43%和0.66%,疫苗接种保护率在67.9%~90.3%之间;接种进口和国产水痘疫苗后水痘发病率分别为0.8%和1.0%,疫苗接种保护率分别为81.6%和75.3%。[结论]本市儿童水痘疫苗接种率呈上升趋势。水痘疫苗对接种者具有较好的保护率,进口和国产水痘疫苗的保护率相似。     

A retrospective survey of the safety of trivalent influenza vaccine among adults working in healthcare settings in south metropolitan Perth, Western Australia, in 2010

In Australia, annual vaccination with trivalent influenza vaccine (TIV) is recommended for healthcare providers. Each year, an influenza vaccination program is run in south metropolitan area hospitals in Perth, Western Australia. In 2010, a survey to examine side effects following vaccination and subsequent significant respiratory illnesses during the influenza season was undertaken. A total of 2245 individuals vaccinated in the area-wide hospital vaccination program responded, representing 50% of consenting recipients. Data linkage was performed to ascertain additional information such as brand details. Side effects within 48 h of receipt of the influenza vaccine were reported by 387 (17.2%). Only 30 respondents (1.3%) had to seek health advice following a side effect temporally related to influenza vaccination and 10 (0.4%) required treatment. Recipients who received Fluvax^® (364, 18.0%; CSL Biotherapies) were more likely to report side effects than those who received another brand (23, 10.2%; OR 1.94, 95% CI 1.24–3.03, P = 0.004). The difference in the side effect profiles was largely confined to systemic effects. Most respondents (1621, 72.2%) did not require time off work for a respiratory illness during the subsequent influenza season. Overall, the influenza vaccine was demonstrated to be safe among this large sample of predominantly healthcare workers. A higher rate of adverse events, albeit primarily mild, was reported among recipients of Fluvax^® in 2010.     

国产麻疹流行性腮腺炎风疹联合疫苗初免效果及免疫程序探讨

目的为观察麻疹、流行性腮腺炎(腮腺炎)、风疹联合疫苗(MMR疫苗)的安全性和免疫原性,并探讨其免疫程序.方法选择91名8月龄儿童,接种MMR疫苗,观察接种后局部反应和全身反应,并检测接种后6周血清麻疹、腮腺炎、风疹抗体阳转率和几何平均滴度(GMT).结果91名8月龄儿童接种MMR疫苗后,有8名儿童发生一过性发热,2名儿童发生皮疹,2名儿童发生局部弱反应.麻疹、风疹、腮腺炎血凝抑制(HI)抗体阳转率分别为98.61%、100.00%、74.07%,GMT分别为145.25、1248.71、14.29.结论MMR疫苗对8月龄儿童接种具有较好的安全性和免疫原性,将其初免月龄定为8月龄儿童是可行的.     

The Effects of Vole Bacillus Vaccination of African Mine Workers in the Northern Rhodesian Copper Mines

African mine workers exposed to siliceous dust in the metalliferous mines of Northern Rhodesia were tuberculin tested; of 17,697 tested, 13,667 were tuberculin positive and 4,030 negative. The negative reactors were divided at random into two approximately equal groups and 1,984 were vaccinated with vole bacillus vaccine and 2,046 were left unvaccinated. These two groups were subsequently followed up and their original radiological categories at the time of tuberculin testing and vaccination were compared with their radiological categories after varying periods of further dust exposure. The object of the investigation was to ascertain whether or not vaccination with vole bacillus vaccine introduced an acclerating factor in the rate of radiological change in pneumoconiosis. The results of the investigation showed that radiological changes in the two groups were minimal and that there was virtually no difference between them. No accelerated changes were recorded in the negative vaccinated group. This is regarded as evidence that anti-tuberculosis vaccine does not introduce an accelerating factor in pneumoconiosis.

No case of pulmonary tuberculosis occurred in the negative vaccinated group. Three cases were recorded in the negative non-vaccinated group, suggesting that vaccination with vole bacillus vaccine affords some measure of protection against tuberculosis, and in view of the absence of any evidence that it had an accelerating effect in pneumoconiosis it appears desirable that miners should receive this protection.

     

流行性感冒疫苗的预防效果观察

为了解流行性感冒（流感）疫苗的预防效果和安全性,于1996～1998年为健康军人及其家属共2 378人接种流感疫苗（免疫组）,并按儿童、成人、老年3个年龄段选取2 280人设立对照组。经6个月追踪观察结果显示,流感疫苗对流感样症状的预防有效率在儿童、成人、老年组中为 82.7％、69.6％和78.6％,平均77.4％,对预防上呼吸道感染症状的有效率分别是44.6％、50.7％和46.7％,平均47.8％。在第2年的观察中,接种流感疫苗的副反应率为1.2％。证实流感疫苗具有良好预防效果和安全性。     

Vaccine effectiveness against COVID-19 related hospital admission in the Netherlands: A test-negative case-control study

IntroductionReal-world vaccine effectiveness (VE) estimates are essential to identify potential groups at higher risk of break-through infections and to guide policy. We assessed the VE of COVID-19 vaccination against COVID-19 hospitalization, while adjusting and stratifying for patient characteristics.MethodsWe performed a test-negative case-control study in six Dutch hospitals. The study population consisted of adults eligible for COVID-19 vaccination hospitalized between May 1 and June 28, 2021 with respiratory symptoms. Cases were defined as patients who tested positive for SARS-CoV-2 by PCR during the first 48 h of admission or within 14 days prior to hospital admission. Controls were patients tested negative at admission and did not have a positive test during the 2 weeks prior to hospitalization. VE was calculated using multivariable logistic regression, adjusting for calendar week, sex, age, comorbidity and nursing home residency. Subgroup analysis was performed for age, sex and different comorbidities. Secondary endpoints were ICU-admission and mortality.Results379 cases and 255 controls were included of whom 157 (18%) were vaccinated prior to admission. Five cases (1%) and 40 controls (16%) were fully vaccinated (VE: 93%; 95% CI: 81 – 98), and 40 cases (11%) and 70 controls (27%) were partially vaccinated (VE: 70%; 95% CI: 50–82). A strongly protective effect of vaccination was found in all comorbidity subgroups. No ICU-admission or mortality were reported among fully vaccinated cases. Of unvaccinated cases, mortality was 10% and 19% was admitted at the ICU.ConclusionCOVID-19 vaccination provides a strong protective effect against COVID-19 related hospital admission, in patients with and without comorbidity.     

Association between ChAdOx1 nCoV-19 vaccination and bleeding episodes: Large population-based cohort study

ObjectiveTo compare prevalence of skin, nose and gingival bleedings after receipt of adeno-vectored or mRNA-vaccines against COVID-19. The hypothesis is that milder symptoms indicating altered thrombocyte function may affect a larger proportion of vaccinated individuals than the recently reported severe cases with thrombosis and thrombocytopenia.MethodsUsing an ongoing large, population-based cohort study, more than 80 000 cohort participants were asked through electronic questionnaires about COVID-19 vaccination and potential side effects during weeks 11–13, 2021. The response rate was 58% (81267/138924). Among the vaccinated, 83% were female, 85% health care workers and 80% were aged 40–55 years.The prevalence of self-reported episodes of skin, nose and gingival bleedings were compared after mRNA and adenovirus-vectored vaccination. Estimates were adjusted for age, sex, occupation, previous COVID-19 infection and chronic disease.ResultsFour of the 3416 subjects (0.2%) who were vaccinated with a single dose of mRNA vaccine reported skin bleeding as a side effect, as opposed to 163 of 5132 subjects (3.2%) vaccinated with a single dose of the adenovirus-vectored vaccine, OR (odds ratio) = 16.0 (95% confidence interval (CI) 7.5–34.1). Corresponding ORs for nose and gingival bleeding were 8.0 (4.0–15.8) and 9.3 (4.3–20.0), respectively.ConclusionsThese findings could potentially indicate that the adenovirus-vectored vaccine may lead to mild bleeding episodes in a larger proportion of vaccinated individuals, and not only in rare cases with documented thrombosis and thrombocytopenia. Studies are needed to understand the possible mechanisms behind these observations, and to establish or refute whether they share similarities with the severe thromboembolic bleeding complications.