2008—2012年武鸣县疑似预防接种异常反应监测分析

目的了解武鸣县疑似预防接种异常反应（AEFI）的发生特征,评价疫苗的安全性,改善预防接种服务质量。方法采用描述性分析方法对武鸣县发生的AEFI进行流行病学分析。结果武呜县在2008—2012年共报告AEFI病例76例,累计发生率为6．61／10万,男性多于女性,〈1岁儿童占47．36％。AEFI报告发生率居前3位的疫苗是两个不同公司生产的23价肺炎球菌多糖疫苗和卡介苗,其中一般反应占38．16％、异常反应占47．37％、心因性反应占3．95％。治愈病例占90．79％,好转病例占9．21％。AEFI监测系统及时报告率97．37％,个案报告完整率100．00％。结论疫苗自身安全性良好,全县AEFI疫情上报及时、完整,监测体系走上正轨,今后应继续加强预防接种人员在发生AEFI后合理解释、规范处置等方面的培训,提高预防接种服务质量。     

2000～2012年急性播散性脑脊髓炎与预防接种关系分析

目的了解急性播散性脑脊髓炎（Acute Disseminated Encephalomyelitis,ADEM）流行病学特点、临床特征,病因的特点,为预防接种后ADEM的调查诊断和处置提供参考。方法从中国医院知识数据库（2000～2012年）收集ADEM病例个案资料,采用描述性分析方法分析所有个案的性别、年龄、病因、潜伏期和转归等特征。结果1155例个案中男性占57.92%。61.56%为感染后脑脊髓炎（postinfectious encephalomyelitis,PIE）,14.29%为疫苗接种后脑脊髓炎（postvaccinal encephalomyelitis,PVE）、其中狂犬病疫苗排第一位。PIE和PVE在性别和病例转归上差异无统计学意义,在潜伏期和年龄上差异有统计学显著性意义。结论 ADEM主要是由感染和疫苗接种引起。PIE和PVE在潜伏期和发病年龄上差异有统计学显著性意义。应加强进一步研究ADEM与预防接种的因果关系,研究制订ADEM与预防接种因果关系的调查诊断和鉴定技术标准,减低误判的几率,减少相关纠纷的产生。     

湖北省部分地区2011--2012年度麻疹流行期间高发原因调查

目的探讨2011年11月湖北省部分地区麻疹发病率突然升高的原因。方法选取2011年11月至2012年2月“湖北省麻疹监测信息报告管理系统”中报告麻疹发病率突然升高的w市和H市所有麻疹病例, 通过查阅预防接种证了解病例麻疹疫苗接种史, 并估算适龄儿童疫苗接种率。运用病例交叉研究, 电话调查监护人, 了解病例在麻疹发病前7～21d(潜伏期内)和发病前37~51 d内就诊情况。结果调查两市共报告麻疹病例140例, 其中<8月龄和8～17月龄婴幼儿发病率较高(分别为69/10万和72/10万), 其他年龄组发病率为0-5.8/10万。8～17月龄婴幼儿麻疹疫苗估算接种率<75%, 18月龄至3岁组接种率<90%。58%的病例在发病前7～21 d内有就医史, 而发病前37~51 d内去医疗机构的病例占14%(RR=5.4, 95%CI：2.1~14.O)。结论在麻疹疫苗接种率不达标的情况下, 儿童的医院暴露可增加麻疹发病风险     

江西省、上海市、青海省儿童家长预防接种知识、态度、行为调查及结构方程模型分析

目的:了解江西省、上海市、青海省3地儿童家长预防接种知识水平及相关的行为,探究影响预防接种知识水平和相关行为的因素。方法:采用分层抽样的方法,在江西省、上海市、青海省各选择2个县（区）作为调查现场;采用连续抽样,在接种门诊对接种儿童家长使用结构化的调查问卷进行调查;使用结构方程模型探究家长知识水平、接种行为间的关系及影...     

Herd immunity effect of the HPV vaccination program in Australia under different assumptions regarding natural immunity against re-infection

Deterministic dynamic compartmental transmission models (DDCTMs) of human papillomavirus (HPV) transmission have been used in a number of studies to estimate the potential impact of HPV vaccination programs. In most cases, the models were built under the assumption that an individual who cleared HPV infection develops (life-long) natural immunity against re-infection with the same HPV type (this is known as SIR scenario). This assumption was also made by two Australian modelling studies evaluating the impact of the National HPV Vaccination Program to assist in the health-economic assessment of male vaccination. An alternative view denying natural immunity after clearance (SIS scenario) was only presented in one study, although neither scenario has been supported by strong evidence. Some recent findings, however, provide arguments in favour of SIS.     

Campagne de vaccination hors centre contre la rougeole des populations précaires en période de pic épidémique,Marseille 2011

BackgroundFrom 2008 to the end of 2011, Europe experienced a major outbreak of measles. The outbreak hit France especially hard, with measles hotspots in the South-East of France. It is known that people living in precarious socio-economic conditions are more exposed to infectious diseases. Regarding the local situation, the NGO “MdM-Marseille” decided to conduct a vaccination campaign among the Roma community living in camps.MethodsThe campaign was planned with two injections of a combined measles, mumps and rubella vaccine (MMR) in a one month interval for all young people born since 1980 and over the age of one year, regardless of antecedents. Twenty-four camps were selected. The target population was estimated at 720 people. Each site was the subject of an information visit. A letter was sent to the Prefecture to inform them and ask for a moratorium on evictions for the identified camps.ResultsBetween May 15th and September 15th 2011, 326 primary immunizations were performed during 34 visits (covering 45.3% of the target population). Over the same period, almost all the camps were evacuated, forcing teams to stop the vaccination campaign. The second injection campaign covered only 37 persons.ConclusionThe vaccination campaign among Roma populations in Marseilles was organized in a context of a major national outbreak of measles in the general population. Although the Prefecture was informed, camp evictions were not interrupted. This highlights the discrepancy between public health policy and security policy. In the context of an epidemic, innovative actions should be focused on vulnerable populations in partnership with health authorities. The main objective is to find procedures that can protect populations at risk in the event of a health crisis but which are also useful for routine prevention.     

儿童疫苗接种率调查抽样方法的评价

目的比较三种接种率调查抽样方法的结果,以期选择最适宜现阶段的接种率调查抽样方法。方法分别采用PPS法、系统抽样法和分层整群抽样法对天津市1～2岁儿童建卡率、建证率、卡证符合率、计划免疫疫苗接种率,以及乙肝首针及时接种率、麻疹疫苗及时接种率进行调查比较,计算率进行χ2检验。结果 PPS法调查适龄儿童2 695人、系统抽样法调查适龄儿童1 073人、分层整群抽样法调查适龄儿童192人。PPS法、系统抽样法和分层整群抽样法调查的建证率两两比较差异无统计学意义(χ2=0.794,P>0.05;χ2=0.003,P>0.05;χ2值=0.15,P>0.05),建卡率比较差异有统计学意义(χ2=12.25,P<0.05;χ2=194.85,P<0.05;χ2=24.652,P<0.05)。系统抽样法调查的儿童建卡率、建证率、卡证符合率、五苗合格接种率、卡介苗接种率、脊灰疫苗接种率、百白破疫苗接种率、麻疹疫苗接种率、乙肝疫苗接种率、乙肝首针及时接种率、麻疹疫苗及时接种率与PPS法结果进行比较,除脊灰疫苗接种率差异有统计学意义外,其他差异均无统计学意义。而分层整群抽样法调查的结果与PPS法相比较,除百白破疫苗接种率和麻疹疫苗首针及时接种率差异无统计学意义以外,其他差异均有统计学意义。系统抽样法和分层整群抽样法调查结果比较,除脊灰疫苗接种率、百白破疫苗接种率和麻疹疫苗首针及时接种率差异无统计学意义意外,其他差异均有统计学意义。PPS法和系统抽样法调查的结果一致率达到87.5%。结论与抗体水平监测相比接种率调查也能相对客观的反映儿童的接种水平。在高接种率状态下,系统抽样法和PPS法所得结果一致,为节省人力物力能用系统抽样法替代PPS法。分层整群抽样法更能发现工作中存在的问题和不足,可用于考核基层工作。     

中国2004-2015年不同预防接种阶段甲型肝炎和戊型肝炎流行病学特征比较

目的 比较甲型肝炎（甲肝）和戊型肝炎（戊肝）在不同预防接种阶段的流行病学特征,并结合疫苗使用情况,为优化戊肝疫苗使用建议提供参考。方法 将2004-2015年分为2004-2007、2008-2011和2012-2015年3个阶段,年龄划分为0~、20~、30~和≥ 40岁组,比较不同时段、不同年龄组报告发病率的差异;同时描述疫苗批签发及甲肝疫苗使用情况。结果 2004-2015年,中国甲肝报告发病率呈逐渐下降趋势（t=-12.15,P<0.001）,戊肝报告发病率呈逐渐升高趋势（t=6.63,P<0.001）。甲肝和戊肝月均报告发病数分别由2004-2007年的6 515、1 491例变化为2012-2015年的1 986、2 277例,戊肝每年3月出现发病峰值且持续出现。东、中、西部地区甲肝报告发病率均下降明显,但西部（3.46/10万）仍明显高于东部（1.13/10万）和中部（1.14/10万）（χ²=32 630,P<0.01）;中、西部地区戊肝上升明显,东部地区较为平稳（2.66/10万）,但仍高于中部（1.74/10万）和西部（1.58/10万）（χ²=6 009,P<0.01）。甲肝0~19岁人群下降84.36%;戊肝≥ 20岁人群报告发病率逐渐上升,且年龄越高、报告发病率越高。甲肝疫苗接种率由62.05%提高到93.54%,接种率与甲肝报告发病率呈负相关（F=10.69,χ²<0.05）。结论 2004-2015年中国甲肝发病快速下降,戊肝发病仍在上升,应推动戊肝疫苗在人群中的使用。     

Successful reproduction of adenoviral gizzard erosion in 20-week-old SPF layer-type chickens and efficacious prophylaxis due to live vaccination with an apathogenic fowl adenovirus serotype 1 strain (CELO)

Recently, outbreaks of adenoviral gizzard erosion (AGE) have been documented in pullets and layers housed free range and in enriched cage systems characterized by increased mortality and a negative impact on egg production. In the present study the pathogenicity of a fowl adenovirus serotype 1 (FAdV-1) field strain as well as the aetiological role of a FAdV-8a strain, both isolated from AGE affected pullets, were investigated in vivo in 20-week-old specific-pathogen-free (SPF) layer-type chickens. Furthermore, the efficacy of a single (week 17) and double (week 14 and 17) application of a live vaccine consisting of an apathogenic FAdV-1 (CELO strain) against challenge with virulent FAdV-1 was investigated.For the first time, AGE was successfully reproduced in adult birds after oral infection of 20-week-old SPF birds with a virulent FAdV-1 field isolate, characterized by pathological changes of the gizzard from 7 days post challenge onwards. In addition, a negative impact of the FAdV-1 infection on the development of the reproductive tract was observed. Thus, confirming the pathogenicity and aetiological role of FAdV-1 in the development of AGE and economic losses due to AGE in layers. In contrast, no pathological changes were observed in birds infected with FAdV-8a.Independent of a single or double application of the live FAdV-1 vaccine strain CELO, no gross pathological changes were observed in gizzards post challenge with the virulent FAdV-1, indicating that complete protection of layers against horizontal induction of AGE was achieved. Nonetheless, virulent FAdV-1 was detected in cloacal swabs and gizzards in both vaccinated groups post challenge determined by the application of an amplification refractory mutation system quantitative PCR used to differentiate between vaccine and challenge strains.     

A prospective,double-blind,randomized, placebo-controlled study on the efficacy and safety of influenza vaccination in myasthenia gravis

Objective

To investigate the efficacy and safety of an influenza vaccination in patients with myasthenia gravis with acetylcholine receptor antibodies (AChR MG).