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.     

某部队麻疹、腮腺炎和风疹发病分析及其疫苗接种效果

目的了解某部队2011-2017年麻疹、流行性腮腺炎和风疹发病情况,及疫苗接种前后3年该部队3种传染病的发病差异,为部队科学制定相关免疫规划提供参考。方法通过收集全军疫情直报系统和军区医疗日报系统上报的传染病资料对某部队2011-2017年麻疹、流行性腮腺炎和风疹疫情进行分析,并比较疫苗接种前后该部队这3种传染病的发病差异。结果 2011-2017年某部队共报告麻疹、流行性腮腺炎和风疹病例665例,其中麻疹237例、流行性腮腺炎326例、风疹102例,病例以≤30岁为主,占81. 80%;士兵是发病数最多的,占发病总数的55. 04%(366/665),其次是学员,占25. 56%(170/665),再次是现役干部,占18. 20%(121/665),三者合计657例,占发病总数的98. 80%;麻疹和风疹有明显的季节性发病高峰,分别在4月和5月。接种麻疹-流行性腮腺炎-风疹三联疫苗后,该部队这3种传染病的发病数均少于接种前,差异有统计学意义(u=6. 86、15. 80、20. 65,P <0. 01),风疹和麻疹的发病数迅速下降,2017年发病数降为1例,腮腺炎在接种疫苗后发病数虽有所下降,但最低年发病数为22例。结论某部队接种麻疹-流行性腮腺炎-风疹三联疫苗取得了显著的防控效果,但流行性腮腺炎仍需进一步加强防控。     

上海市虹口区麻风腮疫苗接种前后腮腺炎发病流行病学分析

目的 为了解麻风腮疫苗接种前后腮腺炎发病流行病学变化，为腮腺炎免疫策略提供科学依据。方法 采用前后比较的方法，对虹口区疫苗接种前（1992～1996年）与疫苗接种后（1997～2005年）腮腺炎发病情况进行分析比较。结果 腮腺炎发病率以学龄前儿童最高，平均1899．51／10万，其次是学生，186．84／10万，其中学龄前儿童中，幼托儿童发病率2376．79／10万显著高于散居儿童501．20／10万；疫苗接种后1997～2000年腮腺炎发病率逐年明显下降到最低水平，2000～2004年发病率维持在最低水平，年均发病率22．05／10万，较疫苗接种前腮腺炎年均发病率216．04／10万，下降约90％，经比较差异有非常显著性；同时接种后腮腺炎病例中，学生比例由接种前的20％增加到50％；接种后腮腺炎季节性高峰不明显，呈全年发病；在腮腺炎暴发疫情病例中，（10～69）％的儿童有1针麻风腮疫苗史。结论 对儿童推荐接种麻风腮疫苗，能有效控制腮腺炎野毒株的传播；并且12～18月龄儿童接种1剂麻风腮疫苗后，4～6岁时（学龄前）有必要再加强1剂。     

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。     

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。     

接种麻腮风联合减毒活疫苗引起一例病毒性脑炎的调查分析

接种疫苗是预防、控制针对传染病的有效措施,但是任何一种疫苗都不是绝对安全的,极个别人在获得免疫的同时,会发生一些除正常反应之外的预防接种异常反应。本文报告接种麻腮风减毒活疫苗引起病毒性脑炎病例比较罕见,由此提示我们接种任何疫苗都应考虑到不良反应的存在,特别是少见或罕见反应,接种人员必须引起足够的重视,掌握预防接种不良反应的知识,切实落实预诊、告知制度。     

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。     

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.