A 16-year review of seroprevalence studies on measles and rubella

The determination of the seroprevalence of vaccine-preventable diseases is critical in monitoring the efficacy of vaccination programmes and to assess the gaps in population immunity but requires extensive organisation and is time and resource intensive. The results of the studies are frequently reported in peer-reviewed scientific, government and non-government publications. A review of scientific literature was undertaken to advise the development of WHO guidelines for the assessment of measles and rubella seroprevalence. A search of the National Library of Medicine’s PubMed online publications using key words of ‘measles’, ‘rubella’, combined with ‘serosurvey’, ‘seroprevalence’, ‘immunity’ and ‘population immunity’ was conducted. A total of 97 articles published between January 1998 and June 2014 were retrieved, 68 describing serosurveys for measles and 58 serosurveys for rubella, conducted in 37 and 36 different countries respectively. Only 13 (19%) and 8 (14%) respectively were UN classified “least developed countries”. The study sample varied markedly and included combinations of male and female infants, children, adolescents and adults. The study sizes also varied with 28% and 33% of measles and rubella studies respectively, having greater than 2000 participants. Microtitre plate enzyme immunoassays were used in 52 (76%) measles studies and 40 (69%) rubella studies. A total of 39 (57%) measles and 44 (76%) rubella studies reported quantitative test results. Seroprevalence ranged from 60.8% to 95.9% for measles and 53.0% to 99.3% for rubella studies. The review highlighted that infants lost maternally-acquired immunity within 9 months of birth and were unprotected until vaccination. Two groups at higher risk of infection were identified: young adults between the ages of 15 and 30 years and immigrants.     

山东省中小学生麻疹爆发原因的病例对照研究

为探讨山东省中小学生麻疹爆发的原因 ,采用 1∶2配比的病例对照方法对中小学生麻疹疫苗 (MV)效力进行了研究 ,同时对近年来中小学生MV接种率进行了估算。结果显示 :中小学生MV效力为 74 % ,95 %可信区间为4 7%～ 88% ;小学生MV效力明显高于中学生 ,分别为 82 %和 6 8% ;1999～ 2 0 0 1年学龄儿童的估算接种率分别为75 4 %、75 6 %和 5 5 7%。较低的MV效力和接种率是计划免疫工作薄弱地区中小学生麻疹爆发的主要原因。     

陕西省2000～2002年麻疹流行病学分析及控制策略探讨

为了解陕西省麻疹流行状况 ,以加速控制麻疹 ,对陕西省 2 0 0 0～ 2 0 0 2年麻疹发病资料进行流行病学分析。结果显示 :陕西省 2 0 0 0～ 2 0 0 2年麻疹年平均发病率比 1997～ 1999年上升了 6 5 7%。病例分布广泛 ,流行模式为爆发和散发并存 ,局部麻疹爆发影响着全省的麻疹发病水平。 3～ 6月为麻疹高发季节 ,0～ 2岁和 6～ 8岁为麻疹高发年龄组。对麻疹病例的免疫史分析表明 ,2 5 %的麻疹病例未接种麻疹疫苗 (MV) ,2 4 %的病例免疫史不详。报告病例的年龄和免疫史状况说明 ,MV的初种和复种需加强 ,同时要在全省范围开展一定年龄组儿童的MV强化免疫 ,调整现行MV的免疫程序 ,健全麻疹监测系统。     

广东省2005-2007年麻疹病原学监测

目的 开展有效的麻疹病原学监测,分离麻疹病毒,了解广东省2005-2007年流行的麻疹野病毒分离株基因特征,为控制、消除麻疹提供科学依据.方法 用Veto/Slam细胞从暴发和散发麻疹疑似病例的咽拭子和尿液标本中分离麻疹病毒,并对所有分离到的麻疹病毒通过逆转录-聚合酶链反应(RT-PCR)方法,扩增出核蛋白(N)基因碳末端450个核苷酸片段,对其产物测定基因序列以定型.结果 2005-2007年共收到380份标本,包括咽拭子或尿液标本.共分离到82株麻疹野病毒.2005年病毒分离率为23.58%,2006年病毒分离率为17.11%,2007年病毒分离率为39.13%.病毒分离成功率与病例出疹天数和标本的采集质量有密切关系.结论 我省已经掌握了麻疹病毒的分离和分子生物学鉴定技术,分离率较高;我省多年来流行的麻疹毒株均为H1基因型,与国内流行的优势基因型一致.     

Electron microscopic evidence of a viral nature for osteoclast inclusions in Paget's disease of bone

Circumstantial evidence from electron microscopic and immunological studies support the view that Paget's disease of bone represents a slow virus infection. However, there is only limited information available regarding its electron microscopic, enzyme and immunocytochemical characteristics. Two cases were studied using electron microscopy with particular emphasis on the inclusions in osteoclasts. Detailed ultrastructural and cytochemical studies including immuno-electron microscopy were performed. Some osteoclasts demonstrated specific virus-like structures composed of aggregations of microtubules in the nucleus and cytoplasm. The structures were easily digested by trypsin or protease, and were sensitive to RNase, which provided substantial evidence of a proteinaceous nature and inclusion of ribonucleic acid. Immunocytochemical examination identified binding of anti-respiratory syncytial virus and anti-measles virus antibodies in the tissue obtained from one of the two cases examined. The presence of viral antigens in structures in the cytoplasm of Pagetic osteoclasts supports the theory of paramyxovirus involvement in this disease.     

30例麻疹暴发疫情的调查分析

目的调查本地某乡镇一次麻疹疫情的流行强度,描述其三间分布,分析暴发原因及影响因素。方法现场流行病学调查,酶联免疫捕获法检测麻疹IgM抗体,作免疫空白与麻疹发病关联的病例对照研究。结果2006年5月～7月,该乡镇发生30例麻疹局部暴发,其中29例儿童麻疹,1例成人麻疹,5例麻疹IgM抗体阳性。发病地点主要为小学和和幼儿园,罹患率分别为7.94%、7.87%。免疫空白与发病关系研究表明,初种免疫空白OR=7.2,X2=6.84,复种免疫空白OR=11.0,X2=9.48;影响免疫空白形成的社会因素调查,未接受麻疹疫苗初种或复种儿童的父母双亲常年在外务工占82.4%(28/34),有麻疹疫苗接种史儿童的父母常年在外务工占35.3%(12/34),二者有统计学差异(X2=15.54)。结论免疫空白是麻疹暴发形成的重要因素,农村儿童的父母常年在外务工形成隔代抚养教育对计免工作有负面影响。     

Membranous laryngotracheobronchitis,a complication of measles

Membranous laryngotracheobronchitis is a very serious infection which affects the larynx, trachea and bronchi, requiring aggressive therapeutic measures. It has been recently rediscovered as a cause of disease in children. However, it is a very unusual complication of measles. Two infants with measles and membranous laryngotracheobronchitis are reported.     

病毒唑治疗成人麻疹临床疗效观察

目的 了解病毒唑治疗成人麻疹的效果及安全性。方法 随机对照试验。结果 治疗组退热时间较对照组缩短２天,有显著性差异（Ｐ＜０．０１）,治疗组开始退疹时间较对照组缩短０．７天,差异有统计学意义（Ｐ＜０．０５）,治疗组住院时间对照组缩短２天,无血液学、肾脏或肝脏方面的毒副反应。结论 病毒哇治疗成人麻疹有改善成人麻疹患者病情和缩短退热时间和病程的作用,且无毒副作用。     

Trends in the uptake of pediatric measles-containing vaccine in the United States: A Disneyland effect?

BackgroundThe measles outbreak that began in December 2014 at the California Disneyland theme park in the United States (U.S.) received a high amount of media attention. Media attention can influence health-related behaviors. We investigated the effect of the Disneyland outbreak on measles-containing vaccine (MCV) uptake among U.S. children.MethodsWe used 2012–2017 National Immunization Survey-Child (NIS-Child) data to examine MCV uptake among U.S. children by 19 months of age. We classified MCV coverage among birth cohorts as exposed based on age at the time of the outbreak. A difference-in-differences design with adjustment for categorical birth cohort was implemented in base models to estimate the exposure effect on the outcomes, ≥1-dose MCV coverage or age at first MCV dose, with pneumococcal conjugate vaccination as a control. Primary analyses included this model adjusted for geographic region, maternal education, race/ethnicity, household income, and insurance status, and an exposure-interaction term with maternal education. All analyses included sampling weights.ResultsThe study population represented 34,471,357 children. In base models, the Disneyland outbreak was associated with a 1.0% (95% CI: 0.2%, 1.8%) increase in ≥1-dose MCV coverage and a 6.6 (95% CI: 4.8, 8.5)-day decrease in MCV administration age. In primary analyses, the outbreak was associated with a 3.9% (95% CI: 3.1%, 4.8%) increase in ≥1-dose MCV coverage among children of college-educated mothers, and a 3.2% (95% CI: 0.6%, 5.9%) decrease among children of mothers earning less than a high school degree. Decreases in MCV administration age ranging from 5.9 (95% CI: 3.3, 8.5) to 9.1 (95% CI: 6.8, 11.4) days were observed across maternal education categories.ConclusionsThe Disneyland outbreak was associated with differential effects on MCV coverage by maternal education and decreases in MCV administration age among U.S. children. These findings may provide useful insights to inform methods to address pediatric MCV undervaccination.