上海市某小学水痘暴发调查及应急接种的血清学评价  

Epidemiological study and serological evaluation on post-exposure vaccination on an outbreak of varicella in elementary school in Shanghai

作　　者：庞红[1] 王晨[1] 汤素文[2] 吴美华[1] 

机构地区：[1]上海市长宁区疾病预防控制中心免疫预防科,上海200051 [2]上海市疾病预防控制中心免疫规划科

出　　处：《现代预防医学》2013年第14期2730-2732,2741,共4页Modern Preventive Medicine

摘　　要：目的对某小学水痘暴发疫情进行流行病学调查,并对水痘疫苗应急接种效果进行血清学评价,为学校水痘暴发控制提供参考。方法收集病例病史资料及病例所在年级学生疫苗接种史和既往水痘病史,对应急接种对象分别于接种前、接种后2周、4周采集手指末梢血,用定量酶联免疫吸附试验(Enzyme-linked Immunosorbent Assay,ELISA)检测水痘IgG。结果本次暴发共发生水痘13例,病例所在的年级罹患率为9.29%,有接种史的罹患率为7.58%,无接种史的罹患率为33.33%,无接种史的罹患率显著高于有接种史者,疫苗保护率(Vaccine Efficacy,VE)为77.26%。应急接种前接种对象抗体阳性率为72.73%,免后2周、4周抗体阳性率均为100%。免后抗体浓度明显高于免前抗体浓度,且免后2周抗体浓度明显高于免后4周抗体浓度。结论水痘疫苗能有效预防水痘,建议对接种1剂水痘疫苗的儿童间隔满3年后再推荐加强接种1剂。水痘疫苗的应急接种能迅速提高易感者体内的抗体水平,有助于水痘暴发的控制。OBJECTIVE To investigate an outbreak of varicella in elementary school and carry out serological evaluation on post-exposure vaccination so as to provide reference for varicella prevention and control in school. METHODS Medical record of varicella cases, vaccination status and history on varicella of children who were from the same classrooms were collected. Finger tip bloods from children with post-exposure vaccination were collected before vaccination , 2 weeks after vaccination and 4 weeks after vaccination. The level of varicella IgG antibody was tested by enzyme-linked immunosorbent assay （ELISA）. RESULTS There were 13 cases of varicella and the attack rate reached 9.29% in children from the same class. The attack rate in non-vaccinated children （33.33% ） was higher than those vaccinated （7.58% ）. Vaccine efficacy （ VE） was 77.26%. The positive rate of varicella IgG before post-exposure vaccination, 2 weeks after vaccination and 4 weeks after vaccination were 72.73%, 100%, 100% respectively. The geometric mean concentration after vaccination was higher than those before vaccination. Moreover the geometric mean concentration of 2 weeks after vaccination was higher than those 4 weeks af - ter vaccination. CONCLUSION Vaccination is effective in varicella prevention. It is suggested that children should have another 1 dose of varicella vaccination four years after the first dose. Post-exposure vaccination is effective in improving varicella IgG antibody level in short time and controlling of the disease.

关 键 词：水痘 暴发 应急接种 血清学 

分 类 号：R392.7[医药卫生—免疫学]