麻疹风疹联合减毒活疫苗的稳定性观察

目的  观察麻疹风疹联合减毒活疫苗（麻风二联）的稳定性。方法  将17批北京生物制品研究所有限责任公司（北京公司）2012—2017年生产的麻风二联存放于（5±3）℃,分别在0、9、12、18和24个月按照企业注册标准和中国药典2010或2015年版三部要求进行相关检测。同时对新、旧车间生产的各3批疫苗进行主要质量指标比对。结果  随着存放时间延长,疫苗的病毒滴度呈逐渐下降趋势,麻疹病毒滴度波动于3.9~4.8 lg半数细胞培养感染量（CCID₅₀)/ml,风疹病毒滴度波动于4.0~4.8 lgCCID₅₀/ml,热稳定病毒滴度下降均不超过1.0 lg,疫苗水分不高于3.0%,疫苗的其余各项指标均符合企业注册标准和中国药典要求。新、旧车间生产的疫苗质量没有差别。结论  北京公司生产的麻风二联的质量稳定。     

2012至2013年南通地区麻疹的流行病学分析

目的：探讨南通地区2012～2013麻疹的临床特点、预防接种及治疗转归,为进一步防治麻疹,控制并发症提供依据。方法收集并分析2012～2013年我院传染科麻疹患者的资料并进行回顾性分析。结果近年南通地区麻疹发病率显著升高,年龄分布呈两极分化,婴幼儿（32.6%）及成人（48.8%）所占比率增大。麻疹临床症状典型,黏膜斑较多见;成人麻疹患者全身中毒症状重,多见肝功能损害（57.2%）;婴幼儿麻疹患者支气管炎、支气管肺炎（51.1%）并发症显著高于成人。结论目前麻疹仍以典型性麻疹为主,幼儿发病率较往年明显升高且并发症多见,非典型皮疹病例较往年有所增加。为控制麻疹流行,建议加强麻疹抗体滴度监测及疫苗接种。     

2020-2022年全球消除麻疹面临的挑战

近年来麻疹发病率呈现上升趋势且免疫覆盖率一直停滞不前,难以达到消除麻疹的目标。新型冠状病毒（新冠病毒）大流行后虽然采取的公共卫生措施使同为呼吸道传播的麻疹病例大幅下降,但也导致2020-2021年全球免疫覆盖率进一步下降、疫苗犹豫加剧、监测情况恶化等问题。本文总结各地消除麻疹的最新进展,以及目前需要克服的困难,重点分析了新冠病毒流行对消除麻疹工作的影响,为科学研判麻疹疫情形势和加强新冠病毒流行背景下麻疹的科学防控提供参考。     

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.     

Trend of immunity against measles and varicella zoster virus in healthcare workers in Korea

ObjectiveTo examine the seroprevalence of measles and varicella zoster virus (VZV) among healthcare workers (HCW) and evaluate the concordance between self-reported history of previous disease or vaccination and seropositivity.DesignA seroprevalence study and survey.SettingA university-affiliated tertiary care hospital.ParticipantsAll HCWs working in high-risk services in 2017 underwent serologic tests and survey; all new HCWs employed in the subsequent years, serologic tests only.MethodsA serologic study was conducted using chemiluminescence immunoassay (2017) or enzyme immunoassays (2018 and later). HCWs who underwent serological testing in 2017 completed a self-administered questionnaire on their history of infection and vaccination.ResultsA total of 10,278 and 9607 HCWs underwent serologic tests for measles and VZV IgG, respectively, from 2017 to 2022. The overall seropositivity rates for measles and VZV were 78.1 % and 92.8 %, respectively. Measles seropositivity declined gradually from >90 % in the HCWs born in the 1960s to <80 % in those born in the 1990s. There was a significant difference in measles seropositivity between the birth cohorts (BCs) 1967–1984 and 1985–1999 (P < 0.001; odds ratio, 1.16; 95 % confidence interval, 1.14–1.18). The seropositivity for VZV was stable, at >90 % in all BCs. The self-reported vaccination history was not independently associated with seropositivity, and the negative predictive value of the survey was very low (9.6 % and 13.1 %, respectively).ConclusionsMeasles seropositivity showed a substantial decline among HCWs born in 1985 or later, while varicella seropositivity remained high. The self-reported vaccination history was not sufficiently reliable for screening HCWs.     

麻疹防治的研究进展

麻疹是由麻疹病毒引起的急性呼吸道传染病。麻疹传染性强,传播迅速,主要侵袭婴幼儿。随着麻疹疫苗的应用,该病的发病率及病死率明显减低,但是近年来,麻疹在我国某些地区仍有流行,而且在流行病学及临床表现上呈现出一些新特点。及时了解现阶段麻疹的流行特征及临床表现,监测人群中麻疹抗体水平,对达到消除麻疹的目标起着重要作用。该文对近期麻疹的流行病学及临床特征作一综述。     

Suppression of NF-kappaB and AP-1 activation in monocytic cells persistently infected with measles virus

HIV-1 evolution in the envelope gene (env) was analyzed in four asymptomatic antiretroviral therapy na?ve patients with typical and slow disease progression rates. In typical progressors, viral populations were monophyletic and two distinct evolutionary patterns were observed. In one patient, HIV-1 evolution displayed a strong temporal structure similar to the consistent pattern previously described. In the other, viral evolution displayed a lack of temporal structure with no increase in genetic heterogeneity and divergence over time. In slow progressors, several clades were observed in viral populations. However, analysis within the major sub-population revealed the same two evolutionary patterns described for typical progressors. Synonymous and non-synonymous substitution rate analyses indicated that positive selection was the major force driving HIV-1 evolution in viral populations with temporal structure, while evolution in viral populations with an atemporal structure was dominated by genetic drift and purifying selection. These results support the existence of distinct patterns of env evolution in untreated HIV-1-infected patients.     

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。     

4种疫苗引起小鼠异常毒性检查中腹膜刺激症状的原因探讨

目的:探讨4种疫苗引起小鼠异常毒性检查中腹膜刺激症状的原因。方法:按照2010年版《中国药典》(三部)"异常毒性检查法"项下规定,除阳性对照组(0.6%冰醋酸溶液)的给药剂量为每只0.2 ml外,其余组剂量均为每只0.5 ml,每组5只小鼠,给药方式为腹腔注射。分别进行甲型肝炎灭活疫苗(简称甲肝疫苗)、重组乙型肝炎疫苗(CHO细胞,简称乙肝疫苗)、流感病毒裂解疫苗(简称流感疫苗)、麻疹风疹联合减毒活疫苗(简称麻疹疫苗)、阴性对照(0.9%氯化钠注射液)、阳性对照的ICR小鼠异常毒性检查;甲肝疫苗、流感疫苗的ICR和昆明种小鼠异常毒性检查;甲肝疫苗、吸附前甲肝疫苗、吸附后甲肝疫苗、氢氧化铝佐剂、0.1%甲醛溶液、阳性对照、阴性对照的ICR小鼠异常毒性检查。观察出现腹膜刺激的动物数、出现时间、消失时间、其他异常表现以及7 d后体质量变化情况。结果:甲肝疫苗、乙肝疫苗和阳性对照均致3⁵只小鼠出现腹膜刺激,出现时间在15只小鼠出现腹膜刺激,出现时间在1¹5 min,消失时间除阳性对照外均在30 min内,麻疹疫苗和阴性对照均未引起腹膜刺激;甲肝疫苗和流感疫苗均致所有ICR和昆明种小鼠出现腹膜刺激,出现时间在115 min,消失时间除阳性对照外均在30 min内,麻疹疫苗和阴性对照均未引起腹膜刺激;甲肝疫苗和流感疫苗均致所有ICR和昆明种小鼠出现腹膜刺激,出现时间在1⁵ min,消失时间在85 min,消失时间在8¹0 min;甲肝疫苗、吸附后甲肝疫苗、氢氧化铝佐剂和阳性对照均致所有小鼠出现腹膜刺激,出现时间在110 min;甲肝疫苗、吸附后甲肝疫苗、氢氧化铝佐剂和阳性对照均致所有小鼠出现腹膜刺激,出现时间在1⁵ min,消失时间除阳性对照外均在12 min内,全部小鼠均无其他异常表现且体质量正常。结论:疫苗中的氢氧化铝佐剂可能是导致小鼠腹膜刺激症状出现的原因。     

宜春市麻疹强化免疫前后发病状况的研究

目的 了解宜春市2006年1月～2012年12月麻疹强化免疫前后麻疹流行病学的特征,为更好地制订消除麻疹措施提供依据.方法 根据中国疾病预防控制信息系统及宜春市疾控中心麻疹强化免疫接种率报表,采用描述性流行病学方法,分析宜春市麻疹强化免疫前后的发病状况.结果 宜春市2006～2012年共报告麻疹病例1107例,男女性别比为2.2∶1,以散发为主,年平均发病率为2.88/10万;以散居儿童居多;发病年龄以＜15岁为主,其中,＜2岁发病例数最多（x2=52.64,P＜0.05）;麻疹强化接种前年平均发病率与强化接种后相比下降率为95.49％（x2=709.48,P＜0.05）;麻疹强化接种前后均以4～8月份为发病高发季节,且4月份为高峰期.年平均发病率排在前5位分别是万载县、丰城市、高安市、靖安县、袁州区;麻疹强化接种前后各县市区麻疹年平均发病率的下降率均＞75％,其中铜鼓县2010～2012年连续3年发病率为0％.结论 宜春市麻疹以散发为主,麻疹强化接种后,各年龄段、各地区麻疹发病率显著下降,部分儿童接种麻疹疫苗后仍有发病,0～2岁儿童发病率最高;建议在常规免疫的基础上,间隔2～3年对全市范围大规模实施麻疹强化免疫,保护易感人群,形成较牢固的免疫屏障,使麻疹发病率保持低态势.