雅安市适龄儿童麻疹疫苗强化免疫前后抗体水平分析

目的 了解雅安市适龄儿童麻疹疫苗(MV)强化免疫前后麻疹抗体水平,为制定免疫规划,实现消除麻疹目标提供科学依据.方法 采用ELISA(酶联免疫吸附试验)法对250人份MV强化免疫前后500份血清进行麻疹IgG抗体水平检测.结果 MV强化免疫前阳性率为94.40%,麻疹IgG抗体平均浓度为1524.24mlU/ml;MV强化免疫后阳性率为100%,麻疹IgG抗体平均浓度为1 893.14mlU/ml.强免前后抗体阳性率差异有统计学意义(x2=14.40,P<0.05)),有MV免疫史的免前麻疹抗体阳性率显著高于未接种者(x2=11.95,P<0.05)).结论 雅安市适龄儿童麻疹抗体水平较高,强化免疫能提高人群免疫覆盖率,消除免疫空白.     

2004年新疆麻疹初始强化免疫有效性分析

目的 评价新疆2004年麻疹初始强化免疫策略实施的有效性.方法 应用Excell和SPSS13.0进行数据统计,运用描述流行病学方法和卫生经济学评价方法中的成本-效果比较法进行分析.结果 强化免疫后麻疹报告发病率下降了94.85%;报告接种率为98.87%,快速评估接种率为98.60%;人群血清麻疹IgG抗体阳性率增长了8.5个百分点,人群麻疹抗体水平增加了18.51个百分点;每减少一例麻疹发病,需投入成本0.065 7万元,在经济上是合算的.结论 新疆麻疹初始强化免疫策略的实施取得了良好的社会和经济效益.     

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.     

病毒性传染病

山西省2003年正常人群血清麻疹IgG抗体检测分析——郑蕾等(山西太原市山西省疾病预防控制中心030012)《中华临床新医学》2004，4(12)：1077-1078[了解山西正常人群麻疹抗体水平。方法：随机选择4个县，4个年龄组正常人群，采集840份血清，用间接酶联免疫吸附实验(ELISA)测定血清中的IgG抗体。结果：不同县间麻疹抗体检出率和几何平均滴度均有显性差异；各年龄组间也有明显差异，2．4岁年龄组阳性率和几何平均滴度最低。结论：进一步加强麻疹的计划免疫，尤其免疫水平较低的地区更要加强对小年龄组的免疫，以控制麻疹的流行。]     

2008年广元市麻疹减毒活疫苗强化免疫效果评价

目的评估广元市2008年麻疹减毒活疫苗(MV)强化免疫效果。方法分析麻疹疫苗强化免疫实施情况及麻疹疫苗强化免疫前后发病率变化情况。结果各年龄组麻疹疫苗强化免疫接种率均达97%以上,强化免疫后全市总麻疹发病率较强化免疫前下降98.48%,为1985年以来最低水平,且2008-2009年已连续2年无暴发疫情。结论 2008年广元市麻疹疫苗强化免疫效果显著,麻疹发病显著降低。     

南京某单位新入职人员麻疹抗体现状调查

目的通过了解南京某单位新入职人员麻疹血清抗体情况,为制定免疫策略提供依据。方法采用ELISA检测南京某单位新入职人员麻疹Ig G抗体情况。结果共采样调查546人,年龄17~24岁,麻疹抗体阳性率为98.4%,抗体几何平均滴度(geometric mean titer,GMT)为1662 m IU/ml,抗体阳性率和GMT在各年龄段人群间两两比较差异无统计学意义(P均0.05);有麻疹疫苗接种史人群的麻疹抗体阳性率和GMT高于无接种史或接种史不详人群(P均0.05);不同地区及有无麻疹病史人群麻疹抗体阳性率之间差异无统计学意义(P均0.05)。结论该单位新入职人员麻疹血清抗体水平和阳性率较高,已基本形成了预防麻疹的免疫屏障。     

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。     

陇南市麻疹及风疹疑似病例IgM抗体检测分析

目的分析2013年甘肃省陇南市疑似麻疹、风疹病例血清学检测结果,了解其流行特征,为促进免疫规划工作提供科学依据。方法用ELISA法检测麻疹、风疹疑似病例血清标本的IgM抗体。结果全年共检测麻疹、风疹IgM抗体266份,检出麻疹IgM抗体阳性141份,阳性率53.00%;检出风疹IgM抗体阳性57份,阳性率21.43%;麻疹发病以4岁以内儿童及20岁以上成人为主,风疹以青少年居多;流行季节主要为3─6月。结论提高易感人群的免疫力仍是免疫规划工作的重点;城镇流动人口的增加是引起麻疹流行的重要原因,应加强流动人口的管理,为易感人群接种免疫疫苗,以建立和保持人群高水平的免疫屏障,同时做好疫情监测,预防疾病的暴发流行。     

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。     

福建省新丙五价钩端螺旋体菌苗接种后反应与免疫效果的观察

目的对观察对象接种“福建新丙五价”钩体菌体苗基础免疫和一年后加强免疫的反应及效果进行观察。方法观察记录各针次疫苗接种后的反应并采集观察对象免疫前及免疫后20d,90d,180d,360d及再加强免疫后20d的6份血清,用显微镜凝集试验(MAT)测定各群抗体滴度,以抗体滴度≥1∶10为阳性判别标准,计算疫苗接种前后各次各群抗体阳转率和几何平均滴度GMT。结果观察对象均未出现全身反应,局部反应以复种为多,女性复种后反应比男性更严重,差异具有显著性意义。免疫后血清抗体阳转率及几何平均滴度(GMT)均比免疫前有显著的增长,且在免疫后3个月阳转率达高峰为95%以上,一年后维持50%左右,几何平均滴度(GMT)在基础免疫后1个月为1∶:60左右,半年后降为1∶20,一年后为1∶10。再次强化免疫,抗体阳转率迅速上升,高达100%,几何平均滴度(GMT)上升到1∶100。结论“福建新丙五价”钩体菌体苗的安全性及免疫效果是肯定的,只要加强钩体病的监测,菌苗的菌型与当地流行菌群吻合并按照规定程序免疫接种,完全可以预防钩体病的流行。     

Prevalence of measles antibodies in asymptomatic human immunodeficiency virus-infected adults.

One hundred five asymptomatic human immunodeficiency virus-seropositive adults were screened for measles antibody. Ages ranged from 21 to 59 years (mean, 35.7). CD4+ lymphocyte counts (range, 76-1137/mm3), percentage of CD4+ cells (6-42), CD4:CD8 ratio (0.08-1.3), measles antibody titers by EIA, and undocumented history of prior measles or immunization were obtained. Forty-six patients gave a history of measles but no immunization, 18 of immunization but no measles, 26 of immunization and measles, and 15 of neither measles nor vaccination. Only one patient (less than 1%) lacked levels of antibody considered protective. Neither the presence nor the level of antibody were predictable from patient age, history of measles or immunization, CD4+ lymphocyte count, percentage of CD4+ cells, or CD4:CD8 ratio. Nearly all subjects had antibody to measles, regardless of immunization or measles history. Whether these antibodies are truly protective is unknown.     

Investigation of antibodies against measles antigen in institutionalized patients with severe motor and intellectual disability

Neutralizing antibody (NA), hemagglutination inhibition antibody (HI), and antibody assayed by IgG-enzyme immunoassay (EIA) against measles were tested as a set on sera of 119 out of 120 patients institutionalized for severe motor and intellectual disability and correlations among the 3 types of antibody titers were examined. 1) NA, HI, and EIA titers correlated positively. 2) If NA, HI, and EIA antibody titers were 4 (2(2)) or more, NA, HI, and EIA serum titers were positive. If they were 8 (2(3)) or more, all sera were positive for NA. If light absorption was 4 or more, serum HI was also positive for EIA. 3) Nine cases were certified as positive for measles infection, and 3 of these were vaccinated 2-3 years after infection. All 9 had positive NA and EIA even 15 years or more after infection. Of 29 cases certified as negative for measles infection and injected with measles vaccine, 21 (72.4%) had positive NA and 16 (72.4%) had positive HI. In EIA, 28 of the 29 (96.6%) showed positive. The only EIA-negative case was also the only one negative for both NA and HI, i.e., an 18-year-old man suffering from chromosomal aberration, 21-ring trisomy, and suspected of being a low responder to measles antigens, including NA, HI and EIA antigens. 4) The above facts suggest that EIA is a more sensitive test for positive history of wild measles virus or measles vaccine virus contact, making it possible to detect measles or measles vaccine injection. To prevent nosocominal infection, it is important to know whether institutionalized individuals are immune to measles, but many have no clear history of measles or measles vaccine injection, especially those 40 years old or older. 5) Institutionalized individuals 40 years old or more numbered 45. Their antibody titers against measles were positive, 82.2% in NA, 48.9% in HI and 91.1% in EIA. The high positive EIA rate suggests that most would sufferered from measles before institutionalization, because they had little chance of measles vaccination as children and little possibility of measles infection in the institution at nosocomial infection currence in 1983, which was limited in other ward, and no nosocomial infection of measles has been experienced in this institution during this more than 20 years.     

Waning immunity to plasma-derived hepatitis B vaccine and the need for boosters 15 years after neonatal vaccination

Neonatal immunization with hepatitis B (HB) vaccine is highly effective; however, more needs to be learned about the duration of protection and indications for boosters. We measured antibody to HB core antigen (anti-HBc), HB surface antigen (HBsAg), and pre- and postbooster titers of HBsAg antibody (anti-HBs) 15 years after primary neonatal immunization with plasma-derived HB vaccines in 2 cohorts of 15-year-old children. Group A consisted of 78 children who were born to HB e antigen-positive HBsAg carrier mothers and had developed protective levels of anti-HBs antibodies (> or =10 mIU/mL) following HB immunization. Group B consisted of 113 apparently healthy children whose anti-HBs titers after vaccination were unknown. Anti-HBs was undetectable (antibody titer <10 mIU/mL) in 29.9% in group A and 62.4% in group B (P < .001). Anti-HBc was detected in 33.3 % in group A and 4.4 % in group B (P < .001). After a single booster dose of HB vaccine, 2.7% in group A and 3.3% in group B remained anti-HBs-negative. A blunted serological response was noted in approximately 20% in both groups. One HBsAg carrier was detected in group A (1.3%) and 4 in group B (3.5%). Fifteen years after neonatal immunization with plasma-derived HB vaccine, a large proportion of children exhibited waning immunity. This poses the risk of breakthrough infection. A single booster augmented the serological response to the vaccine in most but not all subjects. In conclusion, our findings suggest that one or more booster immunizations are needed in seronegative subjects by at least 15 years following neonatal immunization with plasma-derived HB vaccine.     

Safety and immunogenicity of Escherichia coli O157 O-specific polysaccharide conjugate vaccine in 2-5-year-old children

BACKGROUND: Escherichia coli O157:H7 causes severe enteritis and hemolytic-uremic syndrome, mostly in young children and older adults. Similar to the case with Shigella, serum IgG against the O-specific polysaccharide of E. coli O157:H7 may confer immunity by lysing the inoculum in the intestine. A phase 1 trial in adults showed that a vaccine of E. coli O157:H7 O-specific polysaccharide conjugated to recombinant exotoxin A of Pseudomonas aeruginosa (O157-rEPA) was safe and immunogenic. METHODS: A phase 2 trial of the O157-rEPA vaccine was conducted in 49 children 2-5 years old who were divided randomly into groups receiving 1 or 2 doses of vaccine. Adverse reactions were monitored. Serum IgG lipopolysaccharide (LPS) antibodies were determined. RESULTS: No significant adverse reactions were observed. At 1 week after the first dose was administered, most children (81%) responded with a >4-fold increase in serum IgG LPS antibodies. At 6 weeks after the first dose was administered, all children responded with a >8-fold increase; a second dose did not elicit a booster response. At 26 weeks after the first dose was administered, the geometric mean titer of serum IgG LPS antibodies was ~20-fold higher than was the prevaccination titer. These serum samples had high titers of bactericidal activity that were correlated roughly with serum IgG LPS antibody titers (r = .78). CONCLUSIONS: The O157-rEPA vaccine was safe and immunogenic in young children. A phase 3 trial of the administration of this conjugate vaccine concurrently with routine immunization in infants is planned.     

Phases 3 and 4 immunization immunogenicity with combined measles-rubella vaccine

A two-phase combined measles-rubella vaccine (MR) immunization schedule was introduced for age 1 and prior to primary school entry in Japan in April 2006. Further immunization was also introduced for 13 (Phase 3) and 18-year-old (Phase 4) cohorts for the 5-year period from April 2008 to March 2013. We surveyed Phases 3 and 4 MR immunization immunogenicity and safety. From August 2007 to December 2009, we conducted 3 Phase 3 and 15 Phase 4 immunizations. We then took paired serum samples (pre- and 4-6 weeks post-immunization), and measured measles antibody titers using hemagglutination inhibition (HI) and neutralizing test (NT), and rubella antibody titers using HI. Pre-positive measles HI antibody titer (> or = 8) was 72% (13/18) and pre-positive measles NT antibody titer (> or = 2) was 100% (18/18). Post-positive measles HI and NT antibody titers were 94% (17/18) and 100% (18/18). Mean post-immunization measles HI and NT antibody titers were significantly higher than pre-titers, with four-fold or greater increases seen in 9 (50%) and 6 (33%) subjects. Pre-positive rubella HI antibody titer (> or = 8) was 94% (17/18), and post-positive rubella HI antibody titer 100% (18/18). Mean post-immunization rubella HI antibody titer was significantly higher than pre-titer, with four-fold or greater increases seen in 8 subjects (44%). Paired HI antibody titers were measured in pre- and post-Phase 1 immunization for measles in 3 subjects and for rubella in 2 subjects. Those with post-Phase 1 measles HI antibody titers of 32, 64, and 128 yielded titers of 16, 8, and < 8 pre-Phase 3 or Phase 4 immunization, showing antibody reduction or seronegative conversion. Those with post-Phase 1 rubella HI antibody titers of 128 and 256 yielded titers of 64 and 32 in pre-Phase 4 immunization, showing antibody reduction. Seroconversion or four-fold or greater increases in titer were seen post-immunization in 60% (3/5) of these subjects. A clinical reaction survey of all subjects 4 weeks post-immunization, showed only 1 case of mild fever and no local or systemic adverse reactions such as generalized urticaria or anaphylaxis. In conclusion, Phases 3 and 4 MR immunogenicity was satisfactory.     

婴儿麻疹风疹减毒活疫苗联合免疫血清流行病学研究

目的为探讨麻疹、风疹减毒活疫苗联合免疫的可行性。方法于1997年4～12月随机选择了342名8月龄婴儿进行研究,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,分别在左右臂同时皮下接种风疹疫苗和麻疹疫苗;第3组132人,皮下接种沪191株冻干麻疹疫苗。结果在免疫前,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(GMI)均为1:1.06,第2组与第3组麻疹HI抗体阳性率分别为2.86％和5.30％,GMT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。结论研究结果表明:风疹、麻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。     

Measles IgG seroprevalence prior to mass vaccination in Taiwan.

OBJECTIVES: Measles vaccine was licensed for use in Taiwan in 1968 and mass vaccination has been implemented since 1978. Serological surveys were conducted to characterize measles seroepidemiology prior to mass vaccination. METHODS: Measles IgG was quantitatively measured in 1564 serum samples collected from four populations (nationwide, urban, rural, and mountain areas) during 1974-80 with a commercial EIA kit. The nationwide samples covered age groups from 3 months to 19 years, but the other three samples only covered school-aged children. The cut-off value of seropositivity was set at 100 mIU/ml. RESULTS: In the nationwide samples, measles IgG seroprevalence decreased from 50% at 3-5 months to 13% at 6-11 months, then increased rapidly to 55% at 1-1.9 years and reached 98% at 7-7.9 years of age; this was maintained to young adulthood. In all four samples, seroprevalence also reached >97% in individuals >10 years of age. Semiquantitative analysis found that 24%(10/42) of 1-1.9-year-old children but only 4%(1/24) of 15-19-year-old adolescents had low level measles IgG (100-399 mIU/ml). In addition, the distribution of measles IgG level in 1-1.9-year-old children had two peaks at 200-399 and 1600-3199 mIU/ml, whereas only one peak at 1600-3199 mIU/ml had been found in 15-19-year-old adolescents. The median age of measles infection (i.e. 50% seroprevalence) in Taiwan was 1.4 and 2.1 years, respectively, before and after excluding individuals with measles IgG 100-399 mIU/ml that may have resulted from vaccination. CONCLUSIONS: Measles seroepidemiology in Taiwan in the 1970s seemed to be more similar to that in a developing country rather than in an industrialized country, and there was a low median age of infection.     

Efficacy of measles and rubella vaccination one year after the nationwide campaign in Shiraz, Iran.

BACKGROUND: The World Health Organization target for measles elimination in the Eastern Mediterranean Region was established in 2010. In Iran, the national measles-rubella campaign, targeting individuals aged 5-25 years, was initiated in December 2003. METHODS: To evaluate the impact of the campaign after one year, 909 serum samples were collected in Shiraz, southern Iran, from a population aged 6-26 years, divided into five groups according to age. IgG antibodies were tested using ELISA for the measles and rubella antibodies, and the plaque reduction neutralization test (PRNT; measles) was used for samples with equivocal results. RESULTS: Measles protective immunity reached 80.6%, 72.7%, 84.9%, and 87.5% and rubella immunity reached 91.0%, 99.6%, 99.6%, and 97.0% for the age groups 6-10, 11-15, 16-20, and 20-26 years, respectively. Seropositivity to the rubella virus in this population was high, especially in women of childbearing age (98.9%), thereby preventing congenital rubella infections. However for measles, it was significantly lower than the rate required to achieve >or=95% coverage for elimination. CONCLUSIONS: These data indicate that an increase in immunization coverage by supplementary administration of a second dose of measles vaccine is needed to interrupt the endemic transmission of the measles virus.     

新疆克拉玛依市独山子区人群麻疹抗体检测分析

目的了解新疆克拉玛依市独山子区麻疹流行特点和人群麻疹抗体水平分布,为制定独山子区免疫策略提供理论依据。方法采用随机分层整群抽样的方法,抽取调查对象691人,用酶联免疫吸附实验检测麻疹IgG抗体,分析比较各年龄组麻疹抗体水平。结果 4~8月龄儿童麻疹IgG抗体的阳性水平与其他年龄组相比最低,其余各年龄组麻疹抗体水平OD值均大于200,麻疹抗体免疫水平较高,19~22岁最高(t=2.46,P<0.05);不同年龄组人群麻疹抗体水平的阳性率虽有波动,但总体呈随着年龄的增长而上升的趋势。结论克拉玛依市独山子区人群麻疹抗体水平较高,通过强化免疫或常规免疫实施第二针接种,消除免疫空白,做好后续免疫,减少易感人群,是抵御麻疹输入和防止麻疹在本地流行的重要措施。     

Measles vaccine coverage and immune response in children of Caiabi and Metuktire Indian tribes living in malarial endemic area: Parque indígena do Xingu, Central Brazil.

Measles vaccination efficiency was evaluated in children from two Indian tribes - Caiabi and Metuktire - living in the Amazon region, in the Parque Indigena do Xingu (PIX).The population sample, selected at random, made up 37 Caiabi and 28 Metuktire children, aged from 20-75 months (40%). For operational and epidemiological reasons, measles vaccine is given from 6 months of age.The average age of children when they received the vaccine was 11.5 months for the first dose and 20 months for the second.The search for IgG antibodies against measles virus and Plasmodium falciparum was made through immunofluorescence assay (IFA). Measles vaccine coverage has reached 60% at 12 months of age and 92% at 18 months, whereas post-vaccine serum conversion was 95% in Caiabi children (geometric mean of titres (GMT) 126) and 89% in Metuktire (GMT 109).The difference in GMT is not statistically significant. Seventy-three per cent of Caiabi children (GMT 101) and 100% of Metuktire children (GMT135) were plasmodium antibody positive, showing they had been exposed to malarial infection. Despite the differences detected, the immune response to measles vaccine was satisfactory in both groups, with a positive percentage consistent with that achieved in non-malarial areas in Americas.The results show the efficiency of a vaccination programme in an indigenous area despite the difficulties in reaching the villages and maintaining the cold chain, and also despite the malaria endemicity.