王健, 秦伟, 顾君, 杨辉, 孟祥梅, 王瑶. 2018-2019年安徽省某学校一起流行性腮腺炎暴发现场调查及疫苗保护效果评估[J]. 疾病监测, 2020, 35(2): 177-181. DOI: 10.3784/j.issn.1003-9961.2020.02.020
引用本文: 王健, 秦伟, 顾君, 杨辉, 孟祥梅, 王瑶. 2018-2019年安徽省某学校一起流行性腮腺炎暴发现场调查及疫苗保护效果评估[J]. 疾病监测, 2020, 35(2): 177-181. DOI: 10.3784/j.issn.1003-9961.2020.02.020
Jian Wang, Wei Qin, Jun Gu, Hui Yang, Xiangmei Meng, Yao Wang. Field investigation of a mumps outbreak and vaccination effect evaluation in a school in Anhui, 2018–2019[J]. Disease Surveillance, 2020, 35(2): 177-181. DOI: 10.3784/j.issn.1003-9961.2020.02.020
Citation: Jian Wang, Wei Qin, Jun Gu, Hui Yang, Xiangmei Meng, Yao Wang. Field investigation of a mumps outbreak and vaccination effect evaluation in a school in Anhui, 2018–2019[J]. Disease Surveillance, 2020, 35(2): 177-181. DOI: 10.3784/j.issn.1003-9961.2020.02.020

2018-2019年安徽省某学校一起流行性腮腺炎暴发现场调查及疫苗保护效果评估

Field investigation of a mumps outbreak and vaccination effect evaluation in a school in Anhui, 2018–2019

  • 摘要:
    目的分析2018 — 2019年安徽省某学校流行性腮腺炎(流腮)暴发原因,利用暴发现场评估含腮腺炎成份疫苗(MuCV)的保护效果,为优化免疫程序提供参考。
    方法采用描述流行病学方法分析2018 — 2019年安徽省某学校流腮的暴发原因和流行特征,并利用回顾性队列研究方法评估MuCV的保护效果。
    结果本次疫情共报告流腮病例78例,罹患率为11.24%。 首发病例有2剂MuCV免疫史,42.31%的病例未进行规范隔离。 91.03%的病例集中在学校1号楼,1号楼和2号楼病例的接种率分别为90.25%和68.38%,但1号楼学生的发病风险是2号楼的3.71倍(RR=3.71,95% CI:1.74~7.88)。 1剂、2剂和3剂MuCV的保护效果分别为30.94%、32.69%和100.00%。 随着接种疫苗时间间隔的推移,学生罹患率呈上升趋势,差异有统计学意义(趋势χ2=24.472,P<0.001)。 MuCV保护效果随接种时间推移而出现下降趋势,5年内疫苗保护效果最好,为86.38%(95% CI:40.29%~96.89%),>5年组与未接种组的保护效果差异无统计学意义(RR=0.76,95% CI:0.41~1.41,P>0.05)。
    结论接种2剂MuCV的患者也可能成为暴发的传染源,本次暴发主要与学校传染病报告管理不规范及MuCV疫苗保护效果衰减有关。 MuCV接种后5年内保护效果较好,接种时间>5年,1剂和2剂MuCV的保护效果差,3剂MuCV具有较好的保护效果和免疫持久性。

     

    Abstract:
    ObjectiveTo understand the cause of a mumps outbreak and evaluate the vaccination effect (VE) of mumps-containing vaccine (MuCV) in a school in Anhui province during 2018–2019, and provide scientific basis for the improvement of immunization programs against mumps.
    MethodsDescriptive epidemiology method was used to analyze the cause and characteristics of this mumps outbreak. A retrospective cohort study was conducted to evaluate the vaccination effect of MuCV.
    ResultsA total of 78 mumps cases were identified during the outbreak, and the overall attack rate was 11.24% (78/694). The initial case had a history of a two-dose MuCV vaccination before the outbreak, and no standard isolation was performed for 42.31% of the cases. 91.03% cases were students in No.1 teaching building. The coverage of MuCV in students from No.1 and 2 teaching buildings were 90.25% and 68.38%, respectively. The incidence risk of student from No.1 teaching building was 3.71 times higher than that of students from No.2 teaching building (RR=3.71, 95% CI: 1.74–7.88). The protection rate of one-dose, two-dose and three-dose of MuCV were 30.94%, 32.69% and 100.00%, respectively. The longer the interval between onset and vaccination was, the higher the attack rate was. The difference was significant (χtrend2=24.472, P<0.001). The protection effect of MuCV decreased as time pass by, and the protection rate against mumps within 5 years after vaccination was 86.38% (95% CI: 40.29%–96.89%), but the difference in protective effect between vaccination group (>5 years) and non-vaccination group was not significant (RR=0.76, 95% CI: 0.41–1.41, P>0.05).
    ConclusionThe cases with a two-dose MuCV vaccination might be the infection source in this outbreak too. Non-standard management of the mumps cases in this school and waning immunity conferred by MuCV were likely contributors to this outbreak. Patients with two-dose of MuCV vaccination are still contagious. MuCV only provide effective protection against mumps within 5 years after vaccination. If the vaccination time is longer than 5 years, the protection effects of both one-dose and two-dose of MuCV are poor, however, three-dose of MuCV has better protection and immune persistence.

     

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