Mass vaccination programme aimed at eradicating measles, mumps, and rubella in Sweden: first experience

General vaccination with a combined measles, mumps, and rubella vaccine was introduced in Sweden in 1982. The immunisation schedule comprises two vaccine injections, given at 18 months and 12 years of age, respectively. A controlled field study was carried out in 150 children aged 18 months using two different batches of the vaccine. Seroconversion was seen in 96% against measles, 93% against mumps, and 99% against rubella--the same rates with both vaccine lots. Nevertheless, a difference was noted between the two batches with respect to postvaccination reactions. Fever and rash were recorded mainly five to 12 days after vaccination. Moderate fever (38.5-39.4 degrees C) was observed in 22 children, high fever (greater than or equal to 39.5 degrees C) in 33, and rash in 35. Preliminary results obtained by follow up of routinely vaccinated schoolchildren aged 12 indicated considerably lower rates of fever and rash during the postvaccination period, occurring in 3-10% of cases only. These findings show that complete eradication of measles, mumps, and rubella in Sweden is entirely practicable by the mass vaccination programme and that side effects of vaccination are likely to be few and mild.     

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.     

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。     

2005～2011年广西浦北县流行性腮腺炎流行病学特征分析

目的：了解广西山区人口密度较大的浦北县近几年流行性腮腺炎的流行病学特征,为今后制定防治措施提供科学依据。方法：收集该县2005～2011年报告的流行性腮腺炎病例及儿童麻疹-腮腺炎-风疹疫苗（MMR）的接种资料,采用Excel软件进行统计分析。结果-该县过去的7年中共发现流行性腮腺炎364例,尽管全县腮腺炎年均人群发病率为6．04／10万,但2～14岁少儿发病率在（58．20～358．03）／10万,超过广西的腮腺炎人群平均发病率41．20／10万。男女之比为2．03：1。该县腮腺炎病例全年均有出现,高峰期分别在3—5月和11～12月,5个月的病例占总病例数的65．93％。全县除一个镇无腮腺炎病例报道外,其它15个镇均有病例报道。腮腺炎病例中有29．40％曾经接种过MMR疫苗。结论：该县需进一步加强人学前后儿童MMR的接种及补种工作并提高疫苗接种的质量。     

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.     

Optimal age for measles and mumps vaccination in Australia

Trivalent measles-mumps-rubella vaccine has recently replaced measles-mumps vaccine in Australia and is recommended as a single dose at the age of 12 to 15 months, with the exception of Aboriginal children in central Australia who are vaccinated at 9 months. The timing of measles vaccination has been controversial not only in Australia but also in the United States, where measles outbreaks continue to occur. This study aimed to determine seroconversion rates for measles-mumps vaccine in children aged 12 to 18 months and to make a recommendation for the timing of vaccination based on seroconversion rates and attack rates. The parents of 425 children aged 12 to 18 months gave consent for their children to have serum collected at the time of measles-mumps vaccination and three months later. The mean age at vaccination of the children who had two serum samples for measles and mumps antibody estimations was 13.9 months (mode, 13.1). The seroconversion rate for measles was 95% (314/329) (95% confidence interval (CI), 92.5% to 97.3%) and for mumps 97% (309/320) (95% CI, 93.8% to 98.1%). There were no statistically significant differences in the rates of seroconversion for measles or mumps related to age in months at the time of vaccination or in post-vaccination measles antibody titres related to age at vaccination. Post-vaccination mumps antibody titres tended to be lower in older vaccinees. None of the children who presented for vaccination had serological evidence of prior measles infection but five had evidence suggestive of prior mumps. As the seroconversion rates for measles and mumps vaccines were very high in these children it was concluded that no advantage resulted from delaying vaccination until 15 months and that the current National Health and Medical Research Council recommendations for vaccination at age 12 to 15 months should remain.     

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。     

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。     

2005—2012年大化瑶族自治县流行性腮腺炎流行病学特征分析

目的 了解广西山区大化瑶族自治县近几年流行性腮腺炎的流行病学特征,为今后制定防治措施提供科学依据,、方法收集该县2005—2012年报告的流行性腮腺炎病例及儿童麻疹一腮腺炎一风疹疫苗（measles,mumps,an—drubella,MMR）的接种资料,采用Excel2003、SPSS11．5软件进行统计分析。结果该县过去的8年中共发现流行性腮腺炎病例535例,腮腺炎年均人群发病率为15．99／10厅,健康人群MMR接种率平均为2．78％,而腮腺炎病例均未进行过MMR接种。该县腮腺炎病例全年均有出现,高峰期分别在初夏和冬季;4～7岁学龄前儿童发病率占44．86／10万;伞县病例男女之比为1．82：1;全县16个乡镇均有病例报告,病例数最多的大化镇,年均人群发病率为39．90／10月,占总病例数的49．72％。结论尽管该县人群腮腺炎疫苗接种逐年增多,但近两年腮腺炎病例呈现增多趋势,需进一步加强对重点乡镇及重点人群特别是入学前后儿童MMR的接种及补种工作并提高疫苗接种的质量。     

Measles, immunisation and disease: rapid epidemiological assessment in two trans-Yamuna villages of Delhi

A community investigation was conducted in 2 villages of east Delhi, having 15,000 population. Ten per cent households were selected from both the villages by systematic random sampling and all the under 3-year children in selected households were included in the study. A total of 126 under 3-year children from 360 households were investigated. Total children immunised against measles were 86. Most of the 86 immunised children were vaccinated between 9 and 11 completed months. Of the 80 children aged 12 months or above, 12(15%) were unimmunised. Main reason behind non-immunisation was parental apathy. Of the total 126 surviving under 3-year children, 12(9.52%) had a history of probable measles. Two of these children had already measles before they could be eligible for measles vaccination as per the current schedule.     

鄂尔多斯市1起麻疹暴发的流行病学调查分析

目的分析麻疹暴发流行病学特征及发生原因,指导麻疹防控工作,加速控制麻疹进程。方法对暴发和疫情资料进行流行病学分析,采用酶联免疫吸附试验(ELISA)抗体捕捉法监测麻疹IgM抗体。应用Excel软件进行统计处理。结果发病从2006年11月18日至2007年4月20日,持续148天,疫情波及全市8个旗、区,发病835例,罹患率55.13%。病例年龄最小8天、最大46岁,0~7岁占53.9%,小于8月龄、大于25岁占34.7%。病例中无麻疹疫苗(MV)接种史的占37.0%,接种史不详的占45.9%,查验首发病例所在学校83名学生预防接种证,接种过2计次MV者仅占3.6%,1计次的占81.9%,接种史不详的占13.2%。实施MV应急接种,疫情得到有效控制。结论MV接种率低,造成易感者积累,没有及时发现和上报疫情,是导致暴发的主要原因。     

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.     

Sero-response to measles vaccination at 12 months of age in Saudi infants in Qassim Province

OBJECTIVE: To evaluate the sero-response to measles component of the first measles, mumps and rubella MMR dose given at 12 months by measuring measles antibody before and one month after the vaccination. METHODS: A follow-up study where, 57 children at the age of 12 months were recruited randomly from the Primary Health Care Centers in Qassim, Saudi Arabia using a multistage sampling techniques. Fieldwork was conducted from October until December 2006. Blood samples were collected to measure measles IgG antibody before, and one month after giving MMR using enzyme linked immunosorbent assay. Data were compared before and after vaccination using geometric mean titer GMT and seroconversion. RESULTS: In the 57 infants, positivity rate increased significantly from 3.5% (2/57) pre-vaccination to 100% one month after p=0.0001, and with a sero-conversion of 96.5% (55/57). Also, GMT increased significantly from 0.014-2.172 IU/ML, after vaccination p=0.0001. CONCLUSION: Sero conversion and GMT are significantly high after the first MMR given at 12 months and this is supported by the surveillance data in Qassim.     

Analysis of a measles epidemic; possible role of vaccine failures.

A measles epidemic occurred in the Greensville (Ont.) Unit schools during January and February 1975. There were 47 cases of measles in 403 students: 26 (55%) of the children had a history of being vaccinated and 18 (38%) had not been vaccinated. Among children known to have been vaccinated at less than 1 year of age 7 of 13 contracted measles, while among the 48 children who had not been vaccinated 18 contracted measles. The attack rate among vaccinees increased with increasing time since vaccination. The observations of this study as well as those of similar studies suggest that vaccine failures contributed to the genesis of the epidemic. It is recommended that all children initially vaccinated at less than 1 year of age should be revaccinated with live attenuated measles virus vaccine.     

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.     

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.     

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.     

一起小学风疹麻疹混合爆发的调查

目的 分析郴州市宜章县莽山乡某小学2005年的一起风疹麻疹爆发流行情况，探讨风疹麻疹防治措施。方法采用描述性流行病学调查分析。结果该小学共发生出疹病人53例，罹患率27．32％，最小发病年龄7岁，最大年龄15岁，确诊为麻疹8例，风疹39例。病例多为11．13岁学生，53例病人无风疹免疫史，48例接种过1针麻疹疫苗。结论本起为风疹麻疹混合爆发疲情，主要由于免疫措施未落实造成。对未发病学生应急接种麻风二联疫苗有防控效果。     

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.     

梅县西阳镇发生18例麻疹的流行调查

目的 通过对西阳镇发生的麻疹流行的调查，分析发生流行的原因，以便采取有效防治措施控制流行。方法 对18例麻疹病例进行流行病学调查，采血检测麻疹IgM抗体，对西阳镇中心小学学生和移民新村散居儿童进行麻疹疫苗应急接种。结果 这次流行共有18例麻疹病例发生，患最小年龄7个月，最大年龄12岁，其中17例患均为西阳镇中心小学学生，全部治愈，无并发症发生。发生麻疹流行的原因是存在免疫空白人群和报告不及时。在对西阳镇中心小学学生和移民新村散居儿童进行麻疹疫苗应急接种和采取有关防治措施后，流行得到有效控制。结论 在部分人群中存在麻疹免疫空白，一旦传染源传人即易发生流行。发生麻疹流行时，及时采取麻疹疫苗应急接种和其他防治措施可有效控制麻疹流行。