宜良县2012年麻疹IgG抗体水平监测分析

目的了解宜良县健康人群中的麻疹抗体水平,为控制和消除麻疹提供科学依据。方法对365例≤5岁组和〉5岁组人群采用酶联免疫吸附法分别进行麻疹抗体IgG定性和定量监测。结果 17月龄~19岁人群抗体阳性率均为100%,为免疫人群。其余人群麻疹IgG抗体较低,是麻疹免疫空白人群,极易引起麻疹病例发生。结论〈17月龄以及〉20岁人群均容易发生麻疹,应重点进行综合防治。     

A global perspective of vaccination of healthcare personnel against measles: Systematic review

Measles transmission has been well documented in healthcare facilities. Healthcare personnel who are unvaccinated and who lack other evidence of measles immunity put themselves and their patients at risk for measles. We conducted a systematic literature review of measles vaccination policies and their implementation in healthcare personnel, measles seroprevalence among healthcare personnel, measles transmission and disease burden in healthcare settings, and impact/costs incurred by healthcare facilities for healthcare-associated measles transmission. Five database searches yielded 135 relevant articles; 47 additional articles were found through cross-referencing. The risk of acquiring measles is estimated to be 2 to 19 times higher for susceptible healthcare personnel than for the general population. Fifty-three articles published worldwide during 1989–2013 reported measles transmission from patients to healthcare personnel; many of the healthcare personnel were unvaccinated or had unknown vaccination status. Eighteen articles published worldwide during 1982–2013 described examples of transmission from healthcare personnel to patients or to other healthcare personnel. Half of European countries have no measles vaccine policies for healthcare personnel. There is no global policy recommendation for the vaccination of healthcare personnel against measles. Even in countries such as the United States or Finland that have national policies, the recommendations are not uniformly implemented in healthcare facilities. Measles serosusceptibility in healthcare personnel varied widely across studies (median 6.5%, range 0–46%) but was consistently higher among younger healthcare personnel. Deficiencies in documentation of two doses of measles vaccination or other evidence of immunity among healthcare personnel presents challenges in responding to measles exposures in healthcare settings. Evaluating and containing exposures and outbreaks in healthcare settings can be disruptive and costly. Establishing policies for measles vaccination for healthcare personnel is an important strategy towards achieving measles elimination and should be a high priority for global policy setting groups, governments, and hospitals.     

An animal component free medium that promotes the growth of various animal cell lines for the production of viral vaccines

IPT-AFM is a proprietary animal component free medium that was developed for rabies virus (strain LP 2061) production in Vero cells. In the present work, we demonstrated the versatility of this medium and its ability to sustain the growth of other cell lines and different virus strains. Here, three models were presented: Vero cells/rabies virus (strain LP 2061), MRC-5 cells/measles virus (strain AIK-C) and BHK-21 cells/rabies virus (strain PV-BHK21). The cell lines were first adapted to grow in IPT-AFM, by progressive reduction of the amount of serum in the culture medium. After their adaptation, BHK-21 cells grew in suspension by forming clumps, whereas MRC-5 cells remained adherent. Then, kinetics of cell growth were studied in agitated cultures for both cell lines. In addition, kinetics of virus replication were investigated.     

云南省华宁县健康人群麻疹抗体水平分析

目的掌握云南省华宁县健康人群麻疹疫苗接种率和麻疹IgG的抗体水平,探索免疫薄弱环节,为提高该县免疫规划工作提供科学依据。方法采取分层整群抽样方法,在华宁县辖区内随机抽取9个接种点,分8个年龄组（8—17和18—23月龄,2—3、4—5、6—9、10～13、14—17和≥18岁）进行麻疹疫苗接种率调查和麻疹IgG抗体水平检测,每个年龄组40—50人,共检测394人。采用酶联免疫吸附试验检测血清中的麻疹IgG抗体水平。结果调查的394人中麻疹疫苗接种率为85．53％,有效保护率为85．02％,抗体阳性率为98．48％,GMT为1：643;不同接种点麻疹疫苗接种有效保护率、GMT差异有统计学意义（P〈0．01）;各年龄组间麻疹疫苗接种率、抗体阳性率、有效保护率、GMT差异均有统计学意义（P〈0．01）,低龄组相对较低。结论华宁县健康人群麻疹疫苗接种已取得理想的免疫效果,但须进一步提高低龄组婴儿及时接种率,关注流动儿童和大龄儿童,特别是非免疫规划人群的保护。     

乙肝疫苗首针及时接种与乙肝疫苗百白破疫苗和麻疹疫苗全程免疫关系的研究

目的研究及时接种乙肝疫苗首针与完成乙肝疫苗、百白破疫苗和麻疹疫苗全程免疫的关系。方法利用2006年全国乙肝血清流调福建省资料,采用χ2检验比较组间各因素差异,logistic回归分析探讨影响完成3种疫苗全程免疫的影响因素,分层分析研究乙肝疫苗政策对上述关系的影响。结果本研究共有1 443名儿童纳入分析,χ2检验显示,乙肝疫苗首针接种不及时与及时组间（〉24hvs.≤24h）儿童完成3种疫苗全程免疫不同,及时组儿童显著高于不及时组儿童（χ2值分别为457.29,、42.96和74.95,P值均〈0.001）。logistic回归分析显示,及时接种乙肝疫苗首针者完成乙肝、百白破和麻疹疫苗全程免疫的OR值（95%CI）分别为24.36（14.46～41.05）、1.71（1.28～2.29）和2.35（1.68～3.30）。城区儿童完成百白破、麻疹疫苗的OR值分别为0.59（0.45～0.77）和0.36（0.26～0.48）。分层分析显示,乙肝疫苗政策有效降低了及时接种乙肝首针与完成乙肝全程免疫的关系（政策实施前后OR分别为68.09和5.67,差异有统计学意义P〈0.001）。结论及时接种乙肝首针能提高乙肝、百白破和麻疹疫苗全程免疫。     

匹多莫德对麻疹患儿的临床疗效及其对淋巴细胞亚群的影响

目的探讨麻疹患儿中应用匹多莫德的临床疗效及其对淋巴细胞亚群的影响。方法将2011年12月至2013年12月间我科收治的76例麻疹患儿随机分为两组各38例,对照组予以抗病毒、防感染以及对症处理等常规干预措施,观察组在常规干预措施的基础上给予匹多莫德治疗,观察两组患儿的临床疗效,观察两组治疗前后的CD3+、CD4+、CD8+变化情况。结果观察组痊愈8例,显效13例,好转15例,无效2例,总有效率为94.74%;对照组痊愈5例,显效10例,好转13例,无效10例,总有效率为73.68%,观察组总有效率显著高于对照组,差异具统计学意义(P<0.05)。治疗前,两组患儿的CD3+、CD4+、CD8+检测水平比较,差异无统计学意义(P>0.05);治疗后,观察组的CD3+、CD4+显著高于对照组,CD8+则显著低于对照组,差异均具统计学意义(P<0.05)。结论匹多莫德治疗麻疹患儿疗效较佳,有助于恢复被抑制的免疫能力,提高机体细胞的免疫功能,具有临床推广价值。     

麻疹发病危险因素的Meta分析

目的探讨消除麻疹发病的主要危险因素,为麻疹防治提供科学依据。方法采用Meta分析对2006—2010年国内文献报道的麻疹发病危险因素病例对照研究资料进行综合分析。结果共检索到麻疹发病危险因素病例对照研究文献10篇,经同质性检验,分别采用固定效应模型和随机效应模型进行OR值合并,并计算95%CI。5个危险因素的合并值分别是发热出疹病人接触史6.75(4.37～10.43)、未接种麻疹疫苗6.69(3.74～11.94)、医院暴露史5.47(3.04～9.87)、外来流动人口3.25(2.25～4.70)、家庭经济收入2.18(1.51～3.16)。结论发热出疹病人接触史、未接种麻疹疫苗、医院暴露史、外来流动人口、家庭经济收入相对较低是当前麻疹发病的主要危险因素,应采取有针对性的防治策略,以实现消除麻疹目标。     

萧山区麻疹的空间自相关分析

目的探测麻疹空间分布特征,为麻疹控制提供科学依据。方法应用ArcV iew 3.3软件空间自相关分析萧山区2007—2009年麻疹发病资料,再用MapInfo 8.5软件绘制标化G值地图,并进行Moran散点图分析。结果全局空间自相关系数Moran’s I、Getis-O rd G分别为0.4722、0.3479,P均小于0.01。局部空间自相关分析显示,高值聚集区在中部地区,低值聚集区在东部地区。在Moran散点图中,低-低型、高-高型为主要空间聚集类型。结论萧山区麻疹发病的空间格局非随机分布,存在明显的聚集区。     

神经网络在麻疹预测预警中的应用

探讨神经网络在麻疹发病数预警中的应用,以武汉市1986年1月至2006年8月麻疹病例数为依据,分别以月和周为单位,应用神经网络建立模型进行预测.结果 表明,在用两层反向传播(BP)神经网络建立时间序列动态模型时,当p=9时,网络的收敛速度可以接受,相关系数达到0.85,接近l,按月预测较准确;用概率神经网络(PNN)按周分类预测较好.数据积累较多时,用两层BP神经网络预测作早期预警较为可行;对于某些疾病因数据的积累时间较短,利用时间序列精确预测不能得到令人满意的结果时,可以用PNN预测.该方法有望在疾病暴发早期预警系统的建立中得到应用.

Abstract：

To discuss the effects on early warning of measles, using the neural networks.Based on the available data through monthly and weekly reports on measles from January 1986 to August 2006 in Wuhan city. The modal was developed using the neural networks to predict and analyze the prevalence and incidence of measles. When the dynamic time series modal was established with back propagation(BP) networks consisting of two layers, if p was assigned as 9, the convergence speed was acceptable and the correlation coefficient was equal to 0.85. It was more acceptable for monthly forecasting the specific value, but better for weekly forecasting the classification under probabilistic neural networks (PNN). When data was big enough to serve the purpose, it seemed more feasible for early warning using the two-layer BP networks. However, when data was not enough, then PNN could be used for the purpose of prediction. This method seemed feasible to be used in the system for early warning.     

青岛市麻疹流行病学分析与监测状况评价

目的 分析2003年青岛市麻疹流行现况及麻疹监测系统报告资料，获得青岛市麻疹的流行特点并探索麻疹发病的主要影响因素，初步评价青岛市麻疹监测系统运转情况，为改善青岛市麻疹防制和监测工作提供依据。方法 采用酶联免疫吸附试验(ELISA)检测IgM和IgG抗体。结果 青岛市2003年各区市麻疹发病以散发为主，麻疹病例相对集中的4个地区分别是位于城乡结合部的黄岛区、崂山区、李沧区和城阳区，麻疹病例占总数的66．67％，发病高峰主要为3、4月，病例多集中于15-24岁年龄段人群。结论 青岛市麻疹发病以成人为主，城乡结合部发病较集中，其中拥挤程度和人员流动性是影响青岛市麻疹发病的主要因素。今后青岛市麻疹的防制和监测工作重点应进行相应的调整，加强对成年麻疹发病的免疫干预，并进一步完善监测样本采集和流调信息的完整。