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1.
INTRODUCTION AND METHODS. Prior to the institution of universal childhood vaccination against measles in Israel in 1967, large outbreaks occurred in epidemic cycles at intervals of 2-4 years. The mean annual incidence in the pre-vaccination period, 1950-66, was 470/100,000 per year. With the institution of routine measles vaccination, incidence rates fell, and since 1970 measles incidence has averaged less than one-tenth the pre-vaccination incidence rate, although epidemics occurred in 1975, 1982, 1984-85, and 1991. In this report, based upon cases of measles reported to and investigated by the Ministry of Health, we present an analysis of the 1991 measles epidemic, the measures taken to contain it, and an overview of the prospects for measles control in Israel in the future. RESULTS AND CONCLUSIONS. The 1991 measles epidemic, 1036 reported cases (incidence: 20.0/100,000), began in the south of the country among underimmunized Beduin children and spread to the Jewish population in the south and then to the rest of the country. The highest incidence was in children aged 12-23 months, followed by children less than 12 months of age and children aged 2-4 years. In the main, cases occurred in persons never immunized in the past, but in 37% of cases vaccine failure seems to have occurred. Control measures included mass vaccination of children in the south and lowering the age for routine measles vaccination nationwide to 12 months. Despite very substantial gains towards measles control in Israel, elimination of the disease is not a realistic goal, mainly because the transmission potential of the disease is too high and vaccine coverage and efficacy are not high enough. Trends in measles incidence over the last four decades allow a cautious optimism that measles containment can be achieved.  相似文献   

2.
To monitor the extent and spread of the epidemic of measles that began in New Zealand in 1991, a special surveillance system was established. Reports from 13 area health boards were received on a weekly basis; the Bay of Plenty Area Health Board provided data aggregated over several weeks on a less frequent schedule. Nine thousand two hundred thirty-nine measles cases were reported during the 6-month period July-December 1991, with the highest incidence being reported from the Tairawhiti (1,027 cases/100,000 population) and Taranaki (558/100,000) Area Health Boards; South Island areas reported rates that were all below the national average of 280/100,000. Of the 8,684 cases for which information on age was obtained, over one-third (2,957, or 34%) occurred among children less than 5 years of age, most of whom had not been vaccinated. The failure to vaccinate a sufficiently high percentage of children against measles is the major factor that contributed to this epidemic.  相似文献   

3.
In Maputo city, immunization is available at government health facilities, all contacts being used to vaccinate children. Door-to-door mobilization is conducted to identify eligible children and refer them for immunization. Card-documented measles vaccine coverage, estimated by community surveys, rose from 48% in 1982 to 86% in 1986 and 92% in 1992. The median age at measles vaccination was 10.2 months in 1986 and 9.2 months in 1992. The reported measles incidence rates per 100,000 population fell by 92% from 569 in 1977-78 (pre-vaccination) to 44 in 1990-92, and the reported inpatient measles mortality fell from 19.8 to 0.7 per 100,000. Among children whose age at measles onset was known, the proportion of reported measles cases in children under 9 months of age fell from 2162 (20.3% of 10,636 cases) in 1982-85 to 1695 (17.8% of 9501 cases) in 1986-92. The proportion of cases in children aged > or = 5 years increased from 15.2% to 32.8% in the corresponding periods. The global goals for measles control can be achieved by a single dose of Schwarz vaccine at 9 months of age.  相似文献   

4.
目的了解临武县2003—2006年麻疹流行病学特征,为更好地预防、控制麻疹提供科学依据。方法对2003—2006年临武县麻疹发病情况进行描述流行病学分析,检测流动人口、常住人口健康儿童的麻疹抗体水平进行分析。结果4年里临武县报告麻疹病例221例,年均发病率为17.67/10万;流动人口、常住人口发病89例、132例,年均发病率80.99/10万、10.59/10万。流动人口、常住人口3~7岁健康儿童的麻疹抗体水平检测147人、150人,麻疹抗体水平≥1:800的阳性保护率为45.57%、72.67%,差异有统计学意义(x^2=22.56,P〈0.005)。结论流动人口儿童麻疹报告病例的增多是临武县麻疹病例报告急增的主要原因。流动儿童的麻疹抗体阳性保护率过低,存在发病隐患和免疫空白点,是控制麻疹发病急需解决的问题。  相似文献   

5.
遵义地区1992年麻疹流行因素的探讨   总被引:4,自引:0,他引:4  
遵义地区自实施麻疹疫苗免疫以来,麻疹发病率大幅度下降,1990年发病率降至最低为0.69/10万。但1991年有所回升, 1992年发病率高达70.27/10万,疫情波及所辖13个县(市)、 71.65%的区(91/127)、19.95%的乡(153/767)、9.53%的村或居委会(488/5121).<6岁发病数占总病例数的41.38%,7~14岁病例数占43.17%。反映出按照儿童免疫程序8月龄初种和7岁复种麻疹疫苗的工作质量未达到技术要求,造成易感者的积累,导致麻疹的流行。  相似文献   

6.
The licensure of whole-cell pertussis vaccine combined with diphtheria and tetanus toxoids as DTP in the 1940s--and its widespread use in infants and children--led to a dramatic decline in the incidence of reported pertussis. In the prevaccine era, the average annual incidence and mortality for reported pertussis were 150 cases and six deaths per 100,000 population, respectively. From 1989 to 1991, pertussis cases were reported by state and local health departments to CDC through two distinct national surveillance systems: the National Notifiable Diseases Surveillance System (NNDSS) and the Supplementary Pertussis Surveillance System (SPSS). During the period 1989-1991, 11,446 pertussis cases were reported to the NNDSS (4,157 in 1989; 4,570 in 1990; and 2,719 in 1991), for an unadjusted annual incidence of 1.7, 1.8, and 1.1 cases per 100,000 population in 1989, 1990, and 1991, respectively. For the period 1989-1991, case reports were received through the SPSS on 9,480 (83%) of the 11,446 patients reported to the NNDSS. Age-specific incidence and hospitalization rates were highest among children < 1 year of age and declined with increasing age. Long-term trends suggest an increase in the reported incidence of pertussis in the United States since 1976. The peak in reported pertussis cases in 1990 represents the highest annual incidence of pertussis since 1970. However, the incidence of pertussis declined 41% from 1990 through 1991. Whether the long-term increase in reported pertussis is a true increase in incidence is unclear; the observed increase may be a function of improved surveillance.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

7.
The number of notified measles cases in Poland in 2001 was 133, incidence per 100,000 inhabitants was 0.3. The low incidence has been observed for the last 3 years. Only 73 out of 133 cases were serologically confirmed, 6 other cases were epidemiologically linked to the laboratory confirmed cases. Unvaccinated cases have accounted for almost half of cases. Differences in incidence were noticed across the country and ranged from 0 cases in Opolskie and Zachodniopomorskie voivodeships to 0.7/100,000 in Ma?opolskie and 1.0/100,000 in Swietokrzyskie voivodeship. The highest incidence was observed in the children one year of age (3.7/100,000) and seven years old (2.3/100,000), however, in general, the age distribution of cases has been shifted toward older ages with 44 cases (33% of all cases) in adults. A proportion of children 13-24 months of age vaccinated with first dose of measles vaccine was 77.1%, and proportion of seven years old children vaccinated with second dose of measles vaccine was 81.7%.  相似文献   

8.
《Vaccine》2014,32(51):6927-6933
ObjectiveWe describe the epidemiological trends of measles in Singapore in relation to its progress towards measles elimination and identify gaps in fulfilling the World Health Organization Western Pacific Regional Office regional measles elimination criteria.MethodsEpidemiological data on measles maintained by the Communicable Diseases Division, Ministry of Health from 1981 to 2012 were collated and analysed. Data on measles vaccination coverage were obtained from the National Immunization Registry and School Health Services, Health Promotion Board. To assess the seroprevalence of the population, the findings of periodic seroepidemiological surveys on measles were traced and reviewed.FindingsWith the successful implementation of the National Childhood Immunization Programme using the monovalent measles vaccine, measles incidence declined from 88.5 cases per 100,000 in 1984 to 6.9 per 100,000 in 1991. Resurgences were observed in 1992, 1993 and 1997. A ‘catch-up’ vaccination programme using the trivalent measles, mumps and rubella (MMR) vaccine was conducted in 1997, followed by introduction of the two-dose vaccination schedule in January 1998. Measles incidence subsequently declined sharply to 2.9 per 100,000 in 1998. Vaccination coverage was maintained at 95% for the first dose and 92–94% for the second dose. Seroprevalence surveys showed seropositivity for measles IgG antibodies in over 95% of adults in 2004, and in 83.1% of children aged 1–17 years in 2008–2010. Sporadic cases with occasional clusters of two or more cases continued to occur among the unvaccinated population, especially children aged below 4 years. The predominant measles virus genotype has shifted from D9 to the B3 and G3 genotypes, which are endemic in neighbouring countries.ConclusionSingapore has made good progress towards the elimination of endemic measles. To further eliminate sporadic cases of measles, the national immunisation schedule has recently been amended to vaccinate children with 2 doses of MMR vaccine before 2 years of age.  相似文献   

9.
上海市1990-2006年风疹流行病学特征分析   总被引:3,自引:1,他引:3  
目的了解1990—2006年上海市风疹流行病学特征。方法用描述流行病学方法分析1990—2006年上海市传染病报告疫情数据库,数据采用Excel整理与分析。结果1990—2006年上海市风疹报告发病率为0.15110万~451.57/10万;1993年上海市发生风疹大流行,是风疹发病最高的年份,共报告风疹病例58104例,1998年是风疹发病的最低年份,共报告19例;1990—1994年(疫苗使用前)年平均报告发病率为93.00/10万,在疫苗使用前,风疹发病有明显的季节性特征,每年发病高峰集中在3—6月;风疹病例主要集中在儿童和青少年人群,即以5~9岁和10~14岁年龄组为主。1995年开始在上海市大规模使用风疹联合疫苗(MMR)后,全市MMR接种率达85%以上。风疹发病率呈逐渐下降趋势,每年报告风疹发病数除1995年外均〈100例,风疹的发病得到有效控制。但疫苗使用后,风疹发病的年龄构成有所改变,0~4岁发病年龄构成增加,占总发病数的21.00%,且发病年龄有逐年后移趋势,20岁以上年龄组发病占总发病数的31.62%,1995—2006年25~29岁年龄组和30~34岁年龄组风疹发病率均高于疫苗使用前(除1993年)相同年龄组的发病率。结论上海市风疹发病年龄后移。  相似文献   

10.
As it is typical for the year after epidemic, in 1999, the number of new cases of measles decreased and incidence was 0.3 per 100,000. No cases of measles were reported in five out of 16 newly formed voivodeships. The highest incidence was in voivodeships dolno?laskie and ma?opolskie (0.5 per 100,000). Regarding age groups it was highest among 5 years old--2.3 per 100,000 and among 13-24 months old--2.0 per 100,000. Cases of older children reflect delay in vaccination. For another consecutive year the fraction of cases confirmed serologically (assay for IgM) was insufficient (15.2%) and it requires further improvement.  相似文献   

11.

Background

Pertussis remains a cause of considerable morbidity in children worldwide. Due to the resurgence of the disease, two vaccine doses for schoolchildren were added to the routine Israeli schedule. In 2005 a 5th dose was introduced for second-graders (aged 7-8), and in 2008 an additional catch-up dose in the eighth grade (13-14 year-olds).

Methods

Population-based epidemiologic study of pertussis in the Jerusalem district.

Results

1736 pertussis cases were reported from 1990 to 2009. The pertussis incidence rates increased sharply from 2.6/100,000 in 1990, to 10/100,000 in 2000, peaking at 28.8/100,000 in 2006, then declining to 22/100,000 in 2008 and to 15.7 in 2009 (2006 vs. 2009, p = 0.0001). Most cases (74.4%, 1134/1524 during 1998-2009) were under 20 years. Infants under one year had the highest average incidence rate (72.3/100,000; 12.5% of cases); specifically those under 6 months (84.3% of cases under one year). The case distribution among 1-4, 5-9, 10-14, and 15-19 year-olds was: 11%, 18%, 24.1%, and 8.9%. The vaccination status (age-appropriate) was: unvaccinated - 19.2%, partially vaccinated - 7.6%, and fully vaccinated - 73.2%. The overall hospitalization rate was 5.4%; infants - 33.5%. Household transmission occurred in 16.1% of cases.The two age groups showing significant decline were children aged 5-9 (61.5% reduction) and 10-14 years (73.9% reduction); there is as yet no significant decline in other age groups.

Conclusions

The recent marked decline in pertussis incidence among the 5-14 year-olds is encouraging. Young infants still constitute a significant disease burden, and the incidence in this age group should be followed closely.  相似文献   

12.
目的了解柳州市麻疹发病状况。方法对2003—2005年麻疹监测数据进行流行病学分析。结果柳州市2003—2005年共报告疑似麻疹病例851例,诊断麻疹760例,麻疹发病率分别为3.50/10万、7.08/10万、10.82/10万,麻疹发病逐年上升,三年共发生14起暴发,暴发病例数占总病例数的15.39%。发病年龄以≤15岁儿童为主,发病时间集中在1—5月。有麻疹疫苗(MV)免疫史者占14.47%,无免疫史者占33.82%,免疫史不详者占51.71%。2003—2005年1~3岁儿童MV免疫成功率分别为88.25%、88.07%、73.51%。结论由于漏种、免疫失败和免疫空白点存在等原因,导致麻疹发病逐年上升和局部点暴发。  相似文献   

13.
目的 分析比较2005-2014年广州市萝岗区麻疹高发、低发、反弹三个流行阶段疫情特征,为制定麻疹防控工作策略提供科学依据。 方法 查阅2005-2014年传染病报告信息管理系统、麻疹监测信息报告管理系统、档案资料的麻疹个案信息,分析麻疹发病水平并比较三个阶段流行特征。 结果 2005-2014年广州市萝岗区麻疹累计发病269人,年平均发病率为8.26/10万。2005-2008、2009-2012、2013-2014年分别为高发期、低发期、反弹期,年平均发病率分别为15.39/10万、1.26/10万、8.02/10万;3-6月是高发期和反弹期的发病高峰,此外12月-次年1月是反弹期另一个发病高峰,低发期发病季节性不明显,但4月均有病例;发病年龄由高发期以8月~14岁免疫目标人群为主逐渐转变为反弹期以<8月、>14岁为主的非免疫目标人群,年龄分布差异有统计学意义(χ2=14.583,P=0.006);散居儿童在三个流行阶段职业分布排序中均为第1位,学生、托幼儿童在高发期为2、3位,而工人在低发和反弹期均为2位;三个流行阶段流动人口均超过50.00%,反弹期户籍人口比例升高(χ2=11.295,P=0.004);三个流行阶段患者性别比、免疫史、发病前7~21 d医疗机构暴露史差异无统计学意义(P>0.05)。 结论 2005-2014年萝岗区麻疹发病经历了高发、低发、反弹三个流行阶段,发病高峰、年龄、职业、流动人口构成在三个阶段分布有差异,应根据不同阶段麻疹的流行病学特征,采取针对性的麻疹防控措施。  相似文献   

14.
On the basis of seroprevalence and incidence data we describe the distribution of individuals susceptible and immune to measles in Italy in 1996-97. In regions where vaccination coverage was at least 70%, approximately 10% of 3-year-old children were susceptible to measles, whereas 40% were in this category in regions with lower vaccination coverage. Seroprevalence among children older than 4 years was similar for the two groups of regions; in the age group 20-39 years it was approximately 95%. During 1990-96 in the regions with lower vaccination coverage the incidence was highest among children aged 4-6 years, and the median age of cases was 7 years; in the regions with higher vaccination coverage, however, the incidence remained at around 5% for the age group 4-16 years, and the overall median age was 10 years. These data confirm the partial reduction in measles incidence in Italy, although transmission has still not been interrupted. The size and geographical distribution of the current pool of susceptible individuals can be expected to present an obstacle to measles elimination if appropriate vaccination strategies, such as catch-up campaigns, are not adopted.  相似文献   

15.
目的了解蚌埠市1991—2007年脊髓灰质炎(脊灰)等9种主要疫苗针对性疾病流行特征,为进一步预防和控制(防控)针对性疾病提供依据。方法对脊灰等9种主要疫苗针对性疾病发病情况进行描述流行病学分析。结果1991—1995年共报告脊灰16例,1995年以后无脊灰病例发生;1991—2007年无白喉病例报告,2007年百日咳、新生儿破伤风、乙型脑炎(乙脑)发病率分别为:0.15/10万、0.04‰、0.12/10万;乙型肝炎(乙肝)年均发病率为75.56/10万,2002年后5岁以下儿童发病明显减少,占0.34%;结核病年均发病率41.75/10万;2000年以后麻疹发病率波动在1.07/10万~23.10/10万,2000年前发病高峰年龄组为5~9岁,2000年后高峰年龄组为0~4岁;1991—1998年流脑病例主要为15岁以下人群,占72.53%,1998年后,大年龄组(10~19岁)发病增加112.70%,30岁以上成人发病增加62.49%;乙肝、麻疹、流脑城市和农村发病率分别为:105.2/10万和67.01/10万(1991—2007年)、8.80/10万和5.73/10万(2001—2007年)、0.79/10万和0.16/10万(1999—2007年)。结论目前乙肝、麻疹、流脑等疫苗针对性疾病出现发病年龄变化、农村发病较高等新的流行特征,应在加强常规接种工作的基础上,采取针对性措施,开展疫苗免疫接种等防控工作。  相似文献   

16.
目的了解台州市2004-2008年的麻疹流行特征,为制定更科学的防控措施提供依据。方法 采用描述性流行病学方法描述麻疹流行状况。结果2004-2008年,该市麻疹报告病例数分别为426例、1 734例、189例、677例、2 121例,年报告发病率分别为8.27/10万、33.65/10万、3.67/10万、13.14/10万、41.16/10万,无死亡病例报告;流动人口麻疹病例数分别为208例、484例、75例、278例、607例。2005年开展“消除麻疹专项强化免疫活动”,2006年麻疹发病率最低,为3.67/10万。发病高峰月份为每年的3~5月份。在麻疹高发的2008年,病例年龄集中在2岁以下儿童和10~40岁人群;无免疫史和免疫史不详者占84.82%(1 799/2 121)。结论开展强化免疫活动,可明显控制麻疹发病率;应继续加强<2岁和10~40岁人群的常规免疫及其查漏补种工作。  相似文献   

17.
Esteghamati A  Gouya MM  Keshtkar AA  Mahoney F 《Vaccine》2008,26(39):5058-5061
BACKGROUND: Case reports and epidemiologic studies have reported a relation between different vaccines including measles, rubella, mumps and Guillain-Barre syndrome (GBS). In this study we investigated relation between receiving measles and/or rubella vaccines and occurrence of GBS after national immunization campaign in 2003 in Iran. MATERIALS AND METHODS: We used the national surveillance system for acute flaccid paralysis from the beginning of 2002 to the end of 2004 and studied the incidence of GBS disease among 5-14-year-old children. The 3-year time span of the study was divided into fifteen 10 weeks intervals and the number of reported and confirmed GBS case reports in each time period was analyzed supposing their distribution was according to Poisson distribution. RESULTS: From 2002 through 2004 there were 370 patients confirmed GBS case reports among persons 5-14 years of age. The annual incidence in this age group remained relatively constant over the 3-year period and ranged from 0.65 per 100,000 population in 2004 to 0.76 in 2003. The estimated average annual incidence of GBS in persons <15 years of age was 1/100,000 (CI 95%: 0.88-1.13), and 0.7/100,000 in persons 5-14 years of age (CI 95%: 0.58-0.83). No obvious seasonal pattern in GBS occurrence was observed. The mean number of GBS patients during each 10 week study interval was 23.8. Twenty-five patients with GBS were reported in the time period which coincided with national immunization campaign. The probability of occurring >/=25 cases of GBS in that time period according to Poison distribution with expected case numbers of 23-8 is equal to 0.43 (p=0.43). CONCLUSION: The yearly incidence rate of GBS in this study was similar to other studies. According to our results, there was no increase in GBS Incidence in the 4 weeks national Immunization campaign and 6 weeks after it in comparison to other 10 weeks periods before or after this time period.  相似文献   

18.
目的 了解呼和浩特市2009 - 2015年麻疹流行特征,为今后制定科学合理的预防控制麻疹策略和措施提供依据。方法 对呼和浩特市2009 - 2015年麻疹疫情资料进行描述流行病学分析。结果 呼和浩特市近年来麻疹发病一直控制在较低水平,发病形式主要为散发。流动人口麻疹发病率高于本地人口,城区麻疹发病率(3.36/10万)高于农区(1.33/10万),且差异有统计学意义。发病高峰在4 - 6月份(占77.80%)。在518例确诊病例中,<8月龄和>20岁麻疹病例所占比例较大,占 55.79%。在确诊病例中,有免疫史者仅占17.95%,无免疫史者占44.02%,免疫史不详者占38.03%。结论 近几年该市麻疹发病年龄特征发生较大变化,<8月龄和>20岁麻疹发病增多。应提高2剂次麻疹减毒活疫苗(MV)接种率和满8月龄婴儿MV及时接种率,同时加强流动人群和成人麻疹防控工作,应适时开展成人麻疹疫苗的强化免疫和查漏补种。  相似文献   

19.
方学军  徐超  邹浩 《职业与健康》2012,28(5):566-567
目的了解河南省息县2009—2010年麻疹流行病学特征,探讨控制和消除麻疹策略。方法对息县2009—2010年麻疹监测系统报告的麻疹病例进行描述流行病学分析。结果息县有90%的乡镇有麻疹病例报告,2009年报告发病率11.31/10万,2010年发病率1.18/10万,无病例死亡。2009年较2007年、2008年有明显上升,春季高发,4月份达到高峰。2009—2010年8月龄发病数最高,3岁以下发病人数占病例总数的59.54%;男女比例为2.20∶1;2岁以下无免疫史病例占总无免疫史的80.85%;2010年3月在全县范围内开展麻腮风疫苗应急查漏补种,各乡镇适龄儿童报告接种率达95%以上,全县麻疹疫情得到有效控制,2010年麻疹发病率降至较低水平。结论麻疹发病向小月龄和大年龄段推移。主要与免疫缺漏和胎传抗体不足以及院内感染有关。加强适龄儿童和重点人群麻疹疫苗接种,提高疫苗接种率,提高麻疹监测质量加强院内感染控制是目前防制府疹的主要措施。  相似文献   

20.
目的分析中国(未包括香港、澳门特别行政区和台湾地区,下同)2012~2013年麻疹流行病学特征和消除麻疹的策略与措施,为消除麻疹提供参考。方法对中国2012~2013年麻疹发病、麻疹监测系统(Measles Surveillance System,MSS)运转指标,以及采取的消除麻疹策略与措施进行描述流行病学分析。结果中国2012年报告麻疹发病率为0.46/10万(6183例),报告死亡8例;2013年报告麻疹发病率为2.04/10万(27 646例),报告死亡24例。2013年报告发病率、病例数、死亡数分别较2012年增加343.48%、347.13%、200.00%。2012年未出现3~5月的麻疹发病季节高峰,但2013年较为明显。2012年和2013年,青海、广东省和新疆维吾尔自治区报告发病率均居全国前5位,2012年全国有1074个县(区、市、旗,下同)、2013年有1871个县有麻疹病例报告。两年均以8月婴儿麻疹发病率最高,其后依次为8~23月龄、2~6岁、15~34岁、7~14岁、≥35岁。2012年8月龄、8~23月龄、2~6岁、7~14岁、≥15岁麻疹病例分别占24.47%、33.92%、11.95%、2.41%、27.25%,2013年分别占30.81%、29.59%、10.34%、2.29%、26.97%。两年8~23月龄麻疹病例无含麻疹成分疫苗(Measles-containing Vaccine,MCV)免疫史的均70%,2~3岁麻疹病例中约50%无MCV免疫史。2012~2013年MSS各项运转指标中,排除麻疹病例报告发病率均2/10万,疑似麻疹病例48h内完整调查率、散发疑似麻疹病例血标本采集率、血清学检测结果 7d内报告率均97%,麻疹爆发疫情病原学标本采集率80%。2012~2013年共报告了2009例麻疹病例基因型鉴定结果,H1a基因亚型所占比例均96%。结论中国消除麻疹虽然取得了明显进展,但仍存在薄弱地区、薄弱人群,经过近年易感者的积累,麻疹疫情开始反弹。需要扎实地落实既定的消除麻疹策略与措施,包括以提高适龄儿童MCV及时、全程接种率为核心,重点地区必要时开展选择性或非选择性MCV补充免疫活动,加强麻疹监测,提高MSS敏感性,做好麻疹疫情调查与处置,并关注小月龄婴儿和成人易感者在麻疹病毒传播中的作用、探讨针对性的策略与措施。  相似文献   

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