2019年北京市海淀区接种麻疹风疹联合减毒活疫苗发生相关麻疹病例的调查分析  

Investigation and analysis of measles-related cases after vaccination with measles and rubella combined attenuated live vaccine in Haidian district of Beijing,2019

作　　者：史如晶[1] 于霞丽[2] 徐若辉[1] 蔡润[1] 赵慧[3] SHI Ru-jing;YU Xia-li;XU Ruo-hui;CAI Run;ZHAO Hui(Haidian District Center for Disease Prevention and Control,Beijing 100094,China;不详)

机构地区：[1]北京市海淀区疾病预防控制中心,100094 [2]北京市疾病预防控制中心 [3]中国食品药品检定研究院

出　　处：《首都公共卫生》2022年第2期105-109,共5页Capital Journal of Public Health

摘　　要：目的调查2019年北京市海淀区在接种麻疹风疹联合减毒活疫苗(measles and rubella combined attenuated live vaccine,MR)后发生麻疹事件与注射疫苗之间的关联性。方法采用个案病例调查方法结合实验室基因序列测定和病毒分离鉴定结果,对该预防接种异常反应病例进行调查诊断。结果海淀区2019年接种MR后发生麻疹事件1例,该病例于接种MR后第4天出现发热,接种后第8天出现皮疹,入院查体发现疑似麻疹黏膜斑。出疹后第4天和第6天分别采集静脉血,检测麻疹IgM均为阳性,风疹IgM阴性,出疹后第5天采集咽拭子样本,检测麻疹核酸PCR阳性,经鉴定基因型别为疫苗株。该区疾病预防控制中心组织预防接种异常反应调查诊断专家组进行诊断,疾病诊断结论为麻疹,结合实验室检查结果,根据WHO相关麻疹病例诊断标准,明确为麻疹疫苗株感染病例,不除外预防接种异常反应。结论在对病例进行流行病学调查基础上结合实验室检测结果,可科学快速明确减毒活疫苗引起的疫苗相关麻疹病例(vaccine associated measles case,VAMC),对麻疹的疾病监测和预防接种异常反应调查诊断具有实际指导意义。Objective To investigate the association between measles events and vaccinated with measles and rubella combined attenuated live vaccine(MR)in Haidian district of Beijing,2019.Methods Adverse events following immunization was investigated and concluded by case investigation combining with laboratory gene sequencing and virus isolation and identification result.Results There was one case of measles event after MR vaccination in Haidian district,2019.This case developed fever on the 4th day and rash on the 8th day after MR inoculation.The physical examination revealed mucosal plaques suspected of measles.Blood samples were collected on the 4th and 6th day after the patient developed rashes.The test result were positive for measles IgM and negative for rubella IgM.Throat swab specimen was collected on the 5th day after the onset of rash,and the measles nucleic acid PCR was positive.The genotype was identified as a vaccine strain.The diagnosis of measles was made by an expert group on investigation and diagnosis of the adverse events following immunization,organized by the District Center for Disease Prevention and Control.Combined with the result of laboratory tests,it was determined to be a case of measles vaccine strain infection and abnormal reaction to inoculation was not excluded.Conclusions On the basis of epidemiological analysis combined with result of laboratory tests,vaccine-associated measles cases caused by live attenuated vaccines can be scientifically and quickly identified.This can provide practical guiding significance on surveillance of measles and the investigation and diagnosis of adverse events following immunization.

关 键 词：麻疹风疹联合减毒活疫苗 疑似预防接种异常反应 麻疹 

分 类 号：R186[医药卫生—流行病学]