Measles,mumps, and rubella: A cross-sectional study of susceptibility to vaccine-preventable diseases among young people in India

BackgroundGlobal elimination of vaccine preventable diseases, such as measles, mumps and rubella is a priority. Many countries have reported diminishing of antibody titres against these diseases among young population as immunization coverage of adolescents and adults in not monitored. The objective of this study was to determine the susceptibility against measles, mumps and rubella among young adults.MethodsIn this cross-sectional study serological evidence of susceptibility to measles, mumps and rubella was determined by qualitative detection of IgG antibody titres by commercially available enzyme linked florescence assay (VIDAS, bioMerieux) in serum samples young adults.ResultsA total of 335 young individuals (mean age: 20.54 ± 1.37 years) participated voluntarily between May 2017 to September 2018, of which 183 (54.63%) were males. Seroprotection against measles, mumps and rubella were 87.16%, 82.69% and 79.10% respectively.ConclusionSerological surveillance is important to monitor immune status in population. Susceptibility of young adults to measles, mumps, and rubella indicates need for booster vaccination. With the recent launch of measles-rubella vaccination campaign in India, country specific data will be required to plan periodicity of such campaign, which in turn would be based on accumulation of susceptible individuals in a community. Lastly, inclusion of mumps vaccine in the national universal immunization program needs consideration.     

合肥市 2011 年健康人群麻疹、风疹、流行性腮腺炎抗体水平调查

目的研究人群麻疹、风疹、流行性腮腺炎免疫状况,为制定免疫对策提供科学依据。方法随机抽取1422名0～30岁健康人员及部分育龄期女性,用酶联免疫吸附试验检测麻疹、风疹、流行性腮腺炎IgG抗体水平,并进行分析。结果1422名健康人员麻疹抗体阳性1071人,抗体阳性率为75．3％;风疹抗体阳性1149人,抗体阳性率为80．8％;流腮抗体阳性1097人,抗体阳性率为77．1％。结论合肥市麻疹有出现散发和小范围流行的可能,风疹和流行性腮腺炎学龄组出现暴发的可能性较高。在认真完成麻疹疫苗的常规接种的前提下,对大年龄组儿童进行MMR疫苗的强化免疫或查漏补种是消除麻疹和控制风疹及流行性腮腺炎的有效方法和途径。     

营山县2014年健康人群麻疹、风疹、腮腺炎抗体水平监测结果分析

目的:了解营山县健康人群麻疹、风疹、腮腺炎抗体水平,评价疫苗接种效果和人群免疫状况,为制定免疫规划策略和相应传染病防制措施提供依据。方法:按照分层随机抽样的原则,分<1岁、1岁~、3岁~、5岁~、7岁~、15岁~、≥20岁7个年龄组,每个年龄组随机抽取30人作为监测对象,共210人,采用酶联免疫吸附实验(enzyme-linked immunosorbent assay,ELISA)法检测麻疹IgG、风疹IgG、腮腺炎IgG。结果:共检测210份血清标本,麻疹IgG阳性率为86.19%,风疹IgG阳性率为80.48%,腮腺炎IgG阳性率为63.81%。结论:营山县健康人群麻疹IgG抗体水平1岁以上年龄组人群均达到《预防接种规范》要求的85%免疫成功率指标,建立了有效免疫屏障。风疹IgG抗体和腮腺炎IgG抗体水平较低,不足以达到有效免疫屏障,提示我们要加强风疹、腮腺炎接种率和接种质量。     

Antibody response following measles-mumps-rubella vaccine under conditions of customary use

A study of 301 children who had been immunized two to 19 months previously with measles, mumps, and rubella (MMR) vaccine at 36 different sites in San Antonio, Tex, including physicians' offices and clinics, revealed that 99.7% had antibody against rubella and 98.3% had antibody against measles and mumps. None of the 49 infants who were tested prior to receipt of MMR vaccine had antibody against any of these viruses, indicating that the antibody found after immunization was unlikely to be due to false-positive results. The lack of antibody in these infants confirmed that there had not been a significant number of cases of these diseases that could contribute to the high frequency of antibody found after immunization. A single dose of MMR vaccine administered under customary conditions appears to be an effective method of conferring immunity against these diseases.     

郑州市2004～2005年几种急性传染病流行特征分析

目的 分析郑州市2004-2005年麻疹、流行性腮腺炎、风疹几种急性传染病的流行特征和趋势，为修订防治措施提供依据。方法 对郑州市2004-2005年麻疹、流行性腮腺炎、风疹的流行情况和预防控制措施的实施效果进行调查分析。结果 郑州市2004与2005年麻疹、流行性腮腺炎及风疹的发病率分别为6．28％/10万、34．19/10万和4．38/10万与22，17/10万、16．86/10万和2．07/10万。流行性腮腺炎、风疹发病总体呈下降趋势，但局部地区和个别年龄段发病显著上升。结论 提高常规免疫接种率，及时对适龄儿童进行麻疹疫苗复种，并有计划的开展麻疹疫苗强化免疫，加强流动人口管理，消除免疫空白，以达到迅速控制麻疹，是控制麻疹需要解决的问题。     

Swedish experience of two dose vaccination programme aiming at eliminating measles, mumps, and rubella

In 1982 a two dose regimen was introduced in Sweden for the combined vaccination against measles, mumps, and rubella of children aged 18 months and 12 years. Since 1977 about half of the preschool children were vaccinated against measles annually, and since 1974 about 80% of 12 year old girls were vaccinated against rubella. During the period 1982 to 1985 90-93% of the eligible age cohorts of 18 month old children and 88-91% of the 12 year old children were immunised with the new combined vaccine. A study in 1982 of about 140 18 month old children who were nearly all seronegative before vaccination showed that 96%, 92%, and 99% seroconverted against measles, mumps, and rubella, respectively. A second study was carried out in 1983 of 247 12 year old children, of whom 11% lacked antibodies to measles, 27% to mumps, and 45% to rubella. This showed seroconversion in 82% and 80% against measles and mumps, respectively, and all children seroconverted against rubella. In the latest study in 1985 of 496 12 year olds 9% and 13% were seronegative against measles and mumps before vaccination, and 41% against rubella. Of these, 88% seroconverted to measles and 80% to mumps, and all converted to rubella when sera were tested by the haemolysis in gel method. After a neutralisation test against measles as well all children showed immunity to the disease. A low incidence of measles and declining figures for mumps and rubella were reported in 1984 to 1986. An outbreak of rubella during 1985 affected mainly boys in age cohorts in which only the girls had been vaccinated during the 1970s.     

Measles, mumps, and rubella: the need for a change in immunisation policy

There is growing evidence that the present policy of childhood immunisation in the United Kingdom is inadequate. It is unlikely ever to achieve complete eradication of the congenital rubella syndrome and measles, and the problem of mumps has not even begun to be addressed. After a coordinated campaign to increase uptake of immunisation in Fife the uptake of rubella immunisation in teenage girls increased from 75% in 1981 to 94% in 1985 and the uptake of measles vaccination in preschool children from 55% in 1981 to 81% in 1985. There are a few girls each year who do not accept rubella immunisation, whose immune state is unknown, and who are consequently at risk of rubella during future pregnancies. Despite the increased uptake of measles vaccine over the past four years there is currently an epidemic of measles in Fife, with 544 notified cases in the first quarter of 1986. In 1984, 19 Fife residents were admitted to hospital because of complications of mumps. The time is ripe for a complete reassessment of the national immunisation policy.     

南宁市麻疹、风疹流行病学监测

目的对2007～2008年南宁市麻疹、风疹疑似病例进行IgM抗体检测,分析其流行特征,探讨适合南宁市的控制策略。方法采用酶联免疫吸附法（ELISA）对日常监测到的麻疹、风疹疑似病例血清标本进行IgM抗体检测,结果用SPSS13.0进行统计学分析。结果 2007～2008年检测的813份疑似麻疹病例样本中,麻疹抗体阳性率为31.49%,风疹为14.76%。麻疹、风疹发病时间仍在2～8月份之间。城区麻疹发病率比县份高,风疹以个别县份居高。8月龄～2岁仍是麻疹主要发病年龄,但2008年麻疹出现＂双向位移＂的现象。麻疹主要在散居儿童中高发,占62.2%,风疹则集中在学生中多发,占79%。有明确麻疹和风疹免疫史的分别为14.6%和2.8%。出疹后4～7d采血检测麻疹IgM抗体阳性率最高,为61.39%。结论本地发热出疹性疾病以麻疹为主;发病年龄分布提示疫情控制欠佳;采血时间与检出率密切相关;发病人口免疫率低。     

城乡结合部社区学龄前儿童基础免疫状况调查

目的了解北京市城乡结合部社区学龄前儿童免疫规划疫苗基础免疫情况,为查漏补种、传染病防控提供依据。方法采用普查的方法对北京市某城乡结合部社区学龄前儿童进行调查。自行设计问卷,通过入户调查填写调查表,了解儿童基本信息;免疫接种信息由《儿童预防接种信息管理系统》导出。结果 1 315例本社区管理儿童的卡介苗(BCG)、乙肝疫苗(HepB)、脊髓灰质炎疫苗(OPV)、百白破疫苗(DPT)及麻疹疫苗基础免疫的合格率分别为99.0%、97.0%、95.4%、96.8%和93.5%,及时率分别为90.3%、90.4%、83.4%、79.4%和79.7%。"五苗"全程接种合格率为87.2%,及时率为57.9%。A群流脑疫苗(A-MCV)、甲肝疫苗(HepA)、乙脑疫苗(JEV)、风疹疫苗、流行性腮腺炎疫苗基础免疫合格率分别为93.7%,88.4%,92.7%、92.1%和92.4%。本市户籍儿童的麻疹疫苗、A-MCV、HepA、JEV、风疹疫苗及流行性腮腺炎疫苗的基础免疫合格率明显高于外地户籍儿童(P<0.05);不同年龄组的儿童接种率总体上无显著差异。结论北京市城乡结合部社区学龄前儿童基础免疫状况存在一定问题,应加大管理力度。     

银川市0~7岁流动儿童8种传染病血清抗体水平监测分析

目的：了解银川市0~7岁流动儿童的免疫水平,评价疫苗免疫效果,为制定银川市免疫规划策略和措施提供科学依据。方法于2013年采用分层随机抽样调查方法对银川市195名0~6岁儿童进行HBsAg、HbsAb、脊髓灰质炎、麻疹、白喉、百日咳、破伤风、风疹及腮腺炎IgG抗体8种血清抗体水平检测,并进行统计学分析。结果195名儿童中,HbsAg和HbsAb阳性率分别为0和69.7%,8种血清抗体阳性率最高为脊髓灰质炎,占97.4%,最低为百日咳,占15.4%;不同地区间,0~7岁儿童白喉和破伤风抗体阳性率比较差异具有统计学意义(P<0.05);不同年龄组间0~7岁儿童HbsAb、风疹和麻疹抗体阳性率比较差异有统计学意义(P<0.05);不同性别间0~7岁流动儿童8种血清学抗体阳性率比较差异无统计学意义(P>0.05);不同民族间0~6岁流动儿童麻疹和腮腺炎抗体阳性率回族高于汉族,差异有统计学意义(P<0.05)。结论银川市0~7岁流动儿童免疫状况良好,但部分种类疫苗抗体水平较低,存在薄弱地区与人群,应加强重点地区、重点疫苗种类及重点年龄段儿童的预防接种技术规范化管理,并根据监测结果,必要时开展强化免疫。     

天津保税区外来务工人员麻疹、风疹IgG抗体水平及知识知晓状况调查

目的：了解天津市保税区外来务工人员麻疹、风疹免疫水平以及相关知识知晓状况,为区域疾病防控提供依据。方法：采用随机抽样方法在天津保税区外来务工人员集中住宿的蓝领公寓抽取294人进行问卷调查并采血检测抗体。结果：保税区外来务工人员麻疹、风疹血清抗体阳性率分别为95．92％和96．6％,麻疹、风疹血清几何平均滴度倒数（GMRT）分别为1161．7和112．3,不同性别间麻疹GMRT的差异具有统计学意义（t=2．53,P=0．01）。麻疹保护性抗体（滴度〉1：800）阳性率为64．97％。同时该人群相关知识水平较低,卫生习惯不良。结论：在该地区开展成人麻疹疫苗免疫接种和相关知识宣传对预防麻疹暴发有重要意义。     

郑州市二七区2006-2008年呼吸道传染病流行病学特征分析

目的了解郑州市二七区2006—2008年重点呼吸道传染病的流行病学特征,为制定有效的防病措施提供科学依据。方法采用描述流行病学方法对2006～2008年二七区疾病监测信息报告管理系统和公共卫生突发事件报告系统的疫情资料进行分析。结果二七区2006～2008年共报告呼吸道传染病3595例,年均发病率为189．61／10万,肺结核、麻疹发病率呈逐年下降之势,流行性腮腺炎、风疹发病率表现为明显上升趋势。结论加大二七区儿童免疫规划工作力度,加强对流动儿童的管理,尽快贯彻落实国家扩大免疫工作,降低可免疫性传染病的发生。接受“DOTS”治疗是对结核病诊治和管理的最有效方法。     

四种呼吸道传染病单中心10年回顾性调查

目的 总结10年来我院收治的主要呼吸道传染病:麻疹、风疹、流行性腮腺炎、流行性脑脊髓膜炎的流行病学特征和临床特点,为疾病控制和临床诊治提供科学依据.方法 对1996年1月至2006年4月我院收治的以上4种疾病进行描述性流行病学分析.结果 总计入选病例1480例,其中麻疹808例、风疹159例、流行性腮腺炎388例、流行性脑脊髓膜炎125例.麻疹于2000年1月至2002年12月和2005年1月至2006年4月存在两个发病高峰.发病年龄较集中于18～35岁;风疹于2001年1月至2002年12月病例数较多,以18～25岁的集体生活人群多发;流行性腮腺炎各年病例数及全年病例分布较均衡;流行性脑脊髓膜炎以散发为主,患者主要是农民和进城务工人员.除流行性腮腺炎无明显季节性外,其他3种疾病均多发于3～5月份.流行性腮腺炎并发症发生率较高;4种疾病的疗效和预后均良好.结论 目前麻疹、风疹、流行性腮腺炎、流行性脑脊髓膜炎发病仍维持在较高水平,且呈现新的特点,采取必要措施进一步降低发病率、控制暴发性流行十分必要.     

Immunization

Vaccines have eliminated or substantially reduced the incidence in Canada of smallpox, poliomyelitis, measles, mumps, rubella, diphtheria, tetanus and pertussis. The Canadian Medical Association (CMA) advocates a single immunization schedule, complete for all age groups and diseases where immunization is indicated and available. CMA has endorsed in principle (1984), the second edition of the Guide to Immunization for Canadians compiled by the National Advisory Committee on Immunization and requested that it be disseminated to all practising physicians in Canada. CMA also firmly endorses the concept of a readily accessible nationwide method of recording immunization status. In keeping with the World Health Organization's commitment to global control of measles, CMA (1981) supports and encourages mandatory vaccination against measles for children. The association advocates a much more aggressive and sustained public education program to promote public awareness and acceptance of immunization.     

海南省脊髓灰质炎野病毒输入和传播风险评估

目的评估海南省脊灰野病毒输入和传播的风险,科学指导制定预防控制策略,防范和应对脊灰野病毒输入疫情。方法对全省适龄儿童脊灰疫苗接种率、疑似病例（AFP）、脊灰抗体水平及流动人员等监测资料的综合分析,评估海南省脊灰野病毒输入与传播的风险。结果海南省适龄儿童建卡率、建证率均达到98.00%以上,三个地区（18个市县）脊灰疫苗报告接种率和调查接种率均达到了99.00%以上,适龄儿童脊灰Ⅰ、Ⅱ、Ⅲ型IgG抗体阳性率均达到98.00%以上,AFP病例报告发病率等7项监测指标均达到国家要求。结论海南省存在脊灰野病毒输入的风险,但输入脊灰野病毒在海南省扩散传播的风险较低,需要重点防范脊灰野病毒输入后在免疫状态薄弱的流动儿童当中引发二代个案病例。     

某战区部队1996-2005年麻疹疫情特征分析

目的对1996-2005年某战区部队麻疹疫情进行分析,为针对性地制定科学防控措施提供参考。方法根据1996-2005年收到的该部队所属各级医疗卫生机构上报的病例报告卡和传染病日报进行统计分析。结果1996-2005年该部队入伍新兵麻疹发病301例,占发病总数的84.79%(301/355)。2002-2005年麻疹发病数占近10年来麻疹发病总数的48.73%(173/355)。结论控制麻疹的发生和流行,应进一步提高免疫覆盖率,尤其对入伍新兵和入校新生等集体生活的青年人实施麻疹疫苗接种。     

Immunization policies in Canadian medical schools.

OBJECTIVE: To determine the policies of Canadian medical schools concerning immunization of students and the methods used to promote these policies. DESIGN: Mail survey with the use of a 12-item, self-administered questionnaire; telephone follow-up to ensure response. SETTING: All 16 medical schools in Canada. PARTICIPANTS: Deans of Canada's 16 medical schools or their designates. All of them responded to the questionnaire. MAIN OUTCOME MEASURES: Policies on vaccination of students against diphtheria, hepatitis B, influenza, measles, mumps, poliomyelitis, rubella, tetanus and typhoid fever; recommended or required timing of such vaccination; methods for making students aware of immunization policies and for making vaccinations available to students; responsibility for payment for vaccination; compliance rates; methods used to monitor compliance; problems associated with noncompliance; policies for compensating students infected with hepatitis B or other vaccine-preventable diseases; and future plans for vaccination of medical students. RESULTS: Vaccination against rubella was required in 11 (69%) of the 16 medical schools, and vaccination against tetanus, diphtheria and hepatitis B was required in 10 (63%). Nine schools (56%) required vaccination against measles and poliomyelitis, and eight (50%) required mumps vaccination. Only three schools (19%) required or recommended influenza vaccination, and only one recommended vaccination against typhoid fever. The authors identified various methods used to promote student awareness of immunization policies, make vaccinations available, pay for vaccinations and monitor compliance. CONCLUSIONS: Each medical school has a unique set of requirements and recommendations for the vaccination of medical students. National guidelines on immunization for medical students and a comprehensive and nationally coordinated vaccination program would help to ensure that students receive proper protection from disease.     

洛阳市涧西区2005-2006年麻疹监测与控制分析

目的解洛阳市涧西区麻疹流行病学特征和麻疹监测系统运转状况。方法对2005-2006年麻疹监测和预防接种资料进行分析、评价。结果涧西区2005-2006年共报告疑似麻疹病例247例,较法定传染病报告系统(218例)多13·30%,其中诊断麻疹152例。麻疹发病有明显春未夏初季节高峰。疑似麻疹病例的及时报告、及时调查、合格血清标本采集率分别为69·44%、78·29%。2005-2006年麻疹减毒活疫苗(MV)常规免疫,强化免疫的报告接种均(90%。结论接种MV是控制麻疹的基础,适时开展MV强化免疫,消除免疫空白,提高麻疹监测质量是加速控制麻疹的关键。     

疑似麻疹、风疹病例血清学监测结果分析

目的了解麻疹风疹的流行病学特征,探讨麻疹与风疹之间的血清学鉴别诊断。方法通过网络直报系统与麻疹日常监测,揭示麻疹发病的流行病学特征;采用酶联免疫吸附法(ELISA)对431例麻疹疑似病例的血清标本进行麻疹IgM和风疹IgM抗体检测。结果431例麻疹风疹疑似病例,疑似麻疹血清检测率为92.43%,疑似风疹血清检测率为100%。麻疹抗体IgM(+)检出率为42%(181/431),风疹抗体IgM(+)检出率为17.63%(76/431),麻疹风疹抗体IgM双(+)检出率为1.86%(8/431)。麻疹发病主要集中在8月龄～2岁,占41.15%(86/209),其次是小于8月龄的婴幼儿占21.05%(44/209)。在出疹后第0～3d、4～7d、8～14d、15～28d前采集的血清标本其麻疹IgM抗体阳性检出率之间经检验有统计学意义(χ2=19.017,P0.001)。结论本地发热出疹性疾病以麻疹为主;发病年龄分布主要在2岁前,而16岁以后仍然占相当大比例;采血时间与检出率密切相关。     

Immunisation before school entry: should there be a law?

An epidemiologist questions whether laws mandating vaccination of children before school entry are necessary in Britain to reduce the incidence of diseases such as measles, mumps, and rubella. Using vaccination against measles as his example, Noah compares the coverage rate in the United States, where 46 states have school immunization laws, with coverage rates in Norway, the Netherlands, Sweden, Finland, and England and Wales, where immunization before school entry is not required. The United States has achieved a high vaccination rate for school age children, as have the Scandinavian countries and the Netherlands without enforcement laws. Noah concludes that better organization of health services and increased promotion of vaccination among health personnel and the public may be sufficient to raise Britain's overall immunization rate without legislation.