Study on factors related to immunization effect of measles cases
摘要: 目的分析麻疹病例的免疫史状况，探讨其免疫效果的影响因素和控制措施。 方法根据实验室检测结果，在河南省2007年麻疹监测病例中筛选实验室确诊病例，根据疫苗接种情况进行分组，针对初免月龄前病例和具有免疫史的病例，讨论影响免疫效果的相关因素，并提出相关麻疹控制策略。结果有根据筛选要求，共选出3912例麻疹确诊病例，其中有1079例病例有麻疹疫苗接种史，未到麻疹疫苗接种年龄而发病679例，到接种年龄未接种疫苗而发生麻疹1325例，麻疹疫苗接种史不详829例。在699例有明确麻疹疫苗接种时间的病例中，有336例在麻疹疫苗接种1年内发病，111例在接种疫苗1～2年内发病，60例在接种疫苗2～3年内发病，有59例在接种疫苗3～4年内发病，有133例在接种麻疹疫苗4年以上发病。结论随着麻疹疫苗免疫的实施，出现了接种疫苗后发病的病例和未到接种月龄发病两种情况，其产生原因可能是由于疫苗免疫原性改变或母传抗体的影响，针对这两个因素提出不同的控制措施，一是提高常规免疫接种覆盖率和免疫成功率阻断麻疹野病毒循环，二是将针对育龄期妇女麻疹疫苗接种，提高母传抗体的保护能力。Abstract: ObjectiveTo analyze the immunization status of measles cases, explore the factors related to the immunization effect and the measles control measures. MethodsAccording to the laboratory results of surveillance cases, the laboratory confirmed measles cases were selected in Henan province in 2007, and the cases were divided into subgroups according to the immunization status. The factors related to the immunization effect were analyzed on the phenomenon that some cases occurred before the first dose of immunization or after immunization and measles control measures were suggested. ResultsA total of 3912 confirmed measles cases were selected, among which 1079 had vaccination history, 679 aged less than 8 months (the time to start the first dose of immunization), 1325 were age suitable but not immunized and 829 had unknown immunization history. Among 699 measles cases with known date of immunization, 336 occurred within one year after immunization, 111 occurred during 1-2 years after immunization, 60 occurred during 2-3 years after immunization, 59 occurred during 3-4 years after immunization and 133 occurred 4 years later after immunization. ConclusionWith the implementation of measles vaccination, two type cases were observed, I.e. the case occurred after immunization and the case occurred before the first dose of immunization. The reasons for which might include the change on immunogenicity of the vaccine and the level of maternal antibody. So the control measures were suggested, I.e. improving routine measles immunization coverage and successful rate to interrupt the circulation of wild measles virus, and vaccination of the women of childbearing age to improve the protection of maternal antibody.
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