Cross sectional survey of Varicella-Zoster virus and measles seropositivity in people living with HIV in a Parisian suburb and a review of current immunization guidelines

According to evidence-based guidelines, vaccines against measles and varicella are generally recommended to susceptible HIV-positive patients, as long as they are not severely immunocompromised. However, routine screening to determine serologic status is not recommended. We conducted a seroprevalence study of anti-measles and anti-Varicella-Zoster virus (VZV) antibodies in adults living with HIV (PLWHA) consulting at Avicenne University Hospital in a Parisian suburb. Sera were collected in years 2018–2020 and tested by commercial immunoassays in 268 patients. Most of the patients were born in Sub-Saharan Africa (55 %) and only 23 % in Europe. Measles and varicella seropositivity were present respectively in 91.4 % and 96.2 % of patients. One patient in ten was seronegative to at least one of tested diseases. In the univariate analysis, only younger age (p = 0.027) was associated with a higher risk of measles seronegativity, while shorter time since arrival in France (p < 0.001) and shorter time since HIV discovery (p = 0.007) were associated with a higher risk of VZV seronegativity. In multivariate analysis no association was found. This study highlights the absence of specific risk factors for VZV and measles seronegativity in PLWHA and supports the importance of routine screening, in order to increase immunization rates and reduce risk of complications.     

2003-2008年沿滩区流行性腮腺炎流行病学特征分析

目的分析沿滩区2003-2008年流行性腮腺炎的流行特征。方法对2003-2008年沿滩区流行性腮腺炎疫情资料进行描述性流行病学分析。结果沿滩区2003-2008年共报告流行性腮腺炎病例454,无死亡病例,年平均发病率21.30/10万;发病季节常年均有发病,以4～7月份居多,占总发病数的56.61%;发病年龄14岁以下占94.49%;幼托儿童、散居儿童、学生占96.92%。结论沿滩区流行性腮腺炎发病人群主要为14岁以下的幼托儿童、散居儿童和学生。     

国产与进口流行性腮腺炎联合疫苗(MMR)免疫原性与安全性系统评价

目的比较国产与进口含流行性腮腺炎成分的联合疫苗(MMR)接种后的抗体阳转率和副反应发生率,评价二者免疫学效果和安全性的差异,为应对流行性腮腺炎高发病率的情况,甄选安全性强、高效能和经济适用的流行性腮腺炎疫苗提供依据。方法全面收集国内外已发表的研究数据,对国产麻疹风疹腮腺炎联合疫苗(MMR)与进口联合疫苗(MMR)在免疫原性和安全性上进行系统差异性比较。结果经纳入和排除标准筛选,最终提取6篇关于含流行性腮腺炎疫苗成分的国产联合疫苗(MMR)与进口联合疫苗(MMR)免疫原性的文献资料,以接种后腮腺炎抗体阳性率为分析指标,结果显示:国产MMR接种组和进口MMR接种组的抗体阳性率差异无统计学意义[RR=0.99,95%CI(0.96,1.03),P=0.671];入选的5篇文献报告了含腮腺炎疫苗成分的国产MMR组和进口MMR组接种后副反应发生率,研究发现:国产MMR接种组和进口MMR接种组在副反应发生率上差异无统计学意义[RR=1.05,95%CI(0.87,1.27),P=0.620]。结论在选择联合疫苗预防腮腺炎疾病时,国产MMR和进口MMR具有相同的优势,国产MMR在免疫原性和免疫安全性方面和进口疫苗无明显差异。     

Immunologic characterization of a novel inactivated nasal mumps virus vaccine adjuvanted with Protollin

An inactivated, mucosal mumps virus (MuV) vaccine would address many of the problems associated with current live-attenuated formulations. Protollin (Prl)-based adjuvants (containing TLR2 and TLR4 ligands) are well-suited for nasal administration. We sought to develop an inactivated whole-virus nasal vaccine for MuV using the Prl adjuvant/delivery vehicle and to test tolerability and immunogenicity in a mouse model. BALB/c mice exhibited signs of transient reactogenicity (hunched posture, erect fur, weight loss ≤10% of total body weight) following administration of intranasal MuV-Prl vaccines, though most of these manifestations resolved within 24 h. Compared to high-dose unadjuvanted vaccine (8 μgMuV), administration of high-dose adjuvanted formulation (8 μgMuV-Prl) induced greater MuV-specific serum IgG (3.26E6 ng/mL vs. 2.2E5 ng/mL, 8 μgMuV-Prl vs. 8 μgMuV, p < 0.001) and mucosal IgA (128 ng/mL vs. 45 ng/mL, 8 μgMuV-Prl vs. 8 μgMuV, p < 0.05). Serum IgG isotypes and splenocyte cytokine secretion induced by MuV-Prl suggested a predominant T helper cell (Th)1-type immune response. This response was characterized by: (1) ≥four-fold increase of IgG2a levels compared to IgG1; and (2) high IL-2 (644 pg/mL)/IFN-γ (228 pg/mL) and low IL-5 (31 pg/mL) secretion in MuV-restimulated splenocytes from animals receiving MuV-Prl formulations. MuV-Prl vaccination induced higher levels of serum antibodies capable of neutralizing MuV in vitro than MuV alone, particularly for high-dose 8 μg formulations (357 neutralizing units (NU)/mL vs. 32 NU/mL, 8 μgMuV-Prl vs. 8 μgMuV, p < 0.001). Thus, nasal MuV-Prl vaccines are fairly well-tolerated and highly immunogenic in mice.     

Mumps vaccine effectiveness and risk factors for disease in households during an outbreak in New York City

Background and objectives

Mumps outbreaks have been reported among vaccinated populations, and declining mumps vaccine effectiveness (VE) has been suggested as one possible cause. During a large mumps outbreak in New York City, we assessed: (1) VE of measles-mumps-rubella vaccine (MMR) against mumps and (2) risk factors for acquiring mumps in households.

Methods

Cases of mumps were investigated using standard methods. Additional information on disease and vaccination status of household contacts was collected. Case households completed follow-up phone interviews 78–198 days after initial investigation to ascertain additional cases. Mumps cases meeting the study case definition were included in the analysis. Risk factors for mumps were assessed, and VE was calculated using secondary household attack rates.

Results

Three hundred and eleven households with 2176 residents were included in the analysis. The median age of residents was 13 years (range <1–85), and 462 (21.2%) residents met the study mumps case definition. Among 7–17 year olds, 89.7% received one or more doses of MMR vaccine, with 76.7% receiving two doses. Young adults aged 10–14 years (OR = 2.4, CI = 1.3–4.7) and 15–19 years (OR = 2.5, CI = 1.3–5.0) were at highest risk of mumps. The overall 2-dose VE for secondary contacts aged five and older was 86.3% (CI 63.3–94.9).

Conclusions

The two-dose effectiveness of MMR vaccine against mumps was 86.3%, consistent with other published mumps VE estimates. Many factors likely contributed to this outbreak. Suboptimal MMR coverage in the affected population combined with VE may not have conferred adequate immunity to prevent transmission and may have contributed to this outbreak. Achieving high MMR coverage remains the best available strategy for prevention of mumps outbreaks.     

2005~2013年四川省通江县流行性腮腺炎流行特征分析

目的:了解四川省通江县流行性腮腺炎流行病学特征,给上级主管部门决策提供科学依据。方法:采用Excel2003进行数据处理,采用描述流行病学进行流行性腮腺炎流行病学特征分析。结果:2005~2013年通江县流行性腮腺炎年平均发病率为18.03/10万,2012年、2013年发病率较其它各年度均明显上升。流行性腮腺炎各月均可发病,全年出现春末夏季发病高峰(51.05%)和秋末冬季发病小高峰(28.91%);以人口密集度大、流动人口较多的乡镇尤其是诺江镇(38.71%)为高发地区;以男性发病为主(60.20%);14岁及以下儿童尤其是5~9岁儿童(36.91%)为主要发病人群;以学生和幼托儿童发病为主(80.96%)。结论:2010~2013年通江县流行性腮腺炎疫情有升有降但总体上呈增高态势,学校及托幼机构是防控的重点场所,应当进一步加强落实健康教育、适龄儿童预防接种、疫情监测报告、聚集性和暴发疫情早期识别与处置、病人隔离治疗、学生及幼托儿童预防接种证查验与漏种疫苗补种、学校及托幼机构传染病防控指导、监督检查等综合性防控措施。     

Long-term survivors following autologous haematopoetic stem cell transplantation have significant defects in their humoral immunity against vaccine preventable diseases,years on from transplant

Current international guidelines recommend routinely vaccinating haematopoetic stem cell transplant (HSCT) recipients. Despite significant infection-related mortality following autologous HSCT, routine vaccination programmes (RVP) completion is poor. For recovered HSCT recipients, it is uncertain whether catch-up vaccination remains worthwhile years later.To determine potential susceptibility to vaccine preventable infections, we measured antibody titres in 56 patients, a median of 7 years (range 0–29) following autologous HSCT, who had not completed RVP. We found that almost all participants had inadequate titres against diphtheria (98.2%) and pneumococcal infection (100%), and a significant proportion had inadequate titres against measles (34.5%). Of those subsequently vaccinated according to available guidelines, many mounted adequate serological responses.These data suggest a pragmatic catch-up approach for autologous HSCT recipients who have not completed RVP is advisable, with universal vaccination against some pathogens (e.g. Streptococcus pneumoniae and diphtheria) and serologically-guided approaches for others (e.g. measles and varicella zoster virus).     

Cross-neutralization between vaccine and circulating wild-type mumps viruses in Korea

Mumps is a contagious disease caused by the mumps virus. It can be prevented using mumps vaccines, administered as a measles-mumps-rubella (MMR) vaccine. For first and second dose immunization, children aged 12–15 months and 4–6 years have been administered this vaccine since 1997 in Korea. Nevertheless, mumps outbreaks still occur in vaccinated populations worldwide. Hence, immunity against these diseases may be attenuated, or there are antigenic differences between currently available vaccine strains and circulating wild-type viruses. After the introduction of national immunization programs in Korea, mumps cases became sporadic. Viral genotypes F, H, and I have emerged since 1998 whereas the vaccine strains belong to genotype A. Here, we compared the amino acid sequences of the haemagglutinin-neuraminidase (HN) gene from wild-type viruses and the mumps vaccine and measured the cross-neutralization titers between them. We selected the F, H, and I wild-type mumps strains circulating in Korea from 1998 to 2016 and analyzed changes in the amino acid sequence of the protein encoded by the HN gene. We measured mumps virus-specific IgG and rapid focus reduction neutralization test (FRNT) titers in Korean isolates and sera obtained from 50 children aged 1–2 years who had been administered a single dose of MMR vaccine. Analysis of the HN protein sequences disclosed no changes in the glycosylation sites but did reveal 4–5 differences between the Korean isolates and the genotype A vaccine strain in terms of the neutralizing epitope sites on their HN proteins. Post-vaccination FRNT titers were significantly lower against genotypes F, H, and I than they were against genotype A. This finding highlights the possibility of a recurrence of mumps outbreaks in vaccinated populations depending on the degree of genetic conservation of the HN gene. Further research into this issue is needed to prevent the resurgence of mumps.     

2009年福建省部分健康人群腮腺炎血清抗体水平分析

[目的]了解福建省健康人群流行性腮腺炎基础抗体水平,评价疫苗接种需求。[方法]2009年3月,在福建省沿海和山区各机械随机选取4个县(区)、在当地居住3个月以上的0~63岁健康人群检测流行性腮腺炎IgG抗体。[结果]检测2 092人,腮腺炎病毒IgG抗体阳性率为61.23%,抗体几何平均滴度为103.03 IU/ml。腮腺炎病毒IgG抗体阳性率,沿海地区为61.90%,山区为59.74%(P>0.05);男性为58.85%,女性为63.44%(P<0.05);0岁为22.90%,1岁为26.00%,2岁为56.00%,3岁为60.00%,4岁为71.80%,5~9岁为66.50%,10~14岁为66.70%,15~19岁为81.50%,20~29岁为87.80%,30~63岁为86.20%。不同年龄IgG抗体阳性率与2009年该地区腮腺炎发病率不存在相关关系(r=0.11,P>0.05)。[结论]福建省健康人群流行性腮腺炎抗体水平较低。     

2008-2012年深圳市宝安区流行性腮腺炎流行病学特征分析

目的分析深圳市宝安区2008-2012年流行性腮腺炎流行病学特征。方法根据中国疾病预防控制信息系统流行性腮腺炎报告信息,对深圳市宝安区流行性腮腺炎发病情况进行统计分析。结果 2008-2012年宝安区共报告流行性腮腺炎10 680例,年均发病率为33.17/10万,2008-2011年发病率逐年升高,2012年有所下降;发病高峰集中在4-7月;不同性别、年龄组发病差异有统计学意义(χ2=257.91、3 203.29,P=0.000),男性发病高于女性,15岁以下少儿发病最多(占77.00%);职业构成以学生为主(占33.01%)。结论宝安区流行性腮腺炎的发病存在明显的季节性和人群差异。针对流行季节和重点人群做好健康教育和预防接种,是宝安区流行性腮腺炎防控工作的重点。