福建省2015—2019年麻疹实验室确诊病例免疫失败类型分析  

Analysis on types of vaccination failure in laboratory-confirmed cases of measles in Fujian Province,2015-2019

作　　者：尤娜 李东[2] 郑凝旋 张苏晗 陈致飞[2] 张海荣 张梦萍 杨秀惠[2] YOU Na;LI Dong;ZHENG Ningxuan;ZHANG Suhan;CHEN Zhifei;ZHANG Hairong;ZHANG Mengping;YANG Xiuhui(School of Public Health,Fujian Medical University,Fuzhou,Fujian 350102,China;Fujian Provincial Center for Disease Control and Prevention(Fujian Priority Laboratory for Zoonoses),Fuzhou,Fujian 350012,China.)

机构地区：[1]福建医科大学公共卫生学院,福建福州350122 [2]福建省疾病预防控制中心(福建省人兽共患病重点实验室),福建福州350012

出　　处：《海峡预防医学杂志》2023年第4期11-13,59,共4页Strait Journal of Preventive Medicine

摘　　要：目的 分析福建省2015—2019年麻疹实验室确诊病例免疫失败类型分布特征,探讨麻疹疫苗高接种率人群发病的危险因素。方法 用酶联免疫吸附试验,检测330例8月龄以上麻疹病例的急性期血清IgM和IgG抗体水平,以判定免疫失败类型。结果 330例中34.2%(113例)为原发性免疫失败(primary vaccination failure, PVF)、65.8%(217例)为继发性免疫失败(secondary vaccination failure, SVF);2015—2019年SVF占比呈上升趋势(趋势χ^(2)=15.24,P<0.01),尤其2018—2019年SVF占82.9%(63/76)高于2015—2017年的60.6%(154/254,χ^(2)=12.88,P<0.01);含麻疹成份疫苗(MCV)接种病例中,1剂次和2剂次SVF占比(89.3%和80.0%)高于无免疫史病例(49.1%,χ^(2)=113.86,P<0.01);IgM阴性的42例中66.7%(28例)为SVF。结论 SVF是免疫接种人群麻疹发病的主要原因;输入基因型和接种时间延长与SVF病例增加有关,建议加强麻疹病毒学和免疫水平监测。Objective To analyze distribution characteristics of vaccination failure types among laboratoryconfirmed cases of measles in Fujian Province during 20152019,and to explore risk factors of measles virus infection among the population with high vaccination coverage.Methods The enzymelinked immunosorbent assay was used to detect acutephase serum IgM and IgG antibody levels in 330 measles cases over eight months of age.Results Among the total 330 cases,113(34.2%)were primary vaccination failure(PVF)and 217(65.8%)were secondary vaccination failure(SVF).During 20152019,there was an increasing trend of SVF proportion(trendχ^(2)=15.24,P<0.01).The proportion of SVF was especially high in the period of 20182019 at 82.9%(63/76)compared to 60.6%(154/254)in the period of 20152017(χ^(2)=12.88,P<0.01).Furthermore,proportion of SVF was higher among cases with vaccination history of 1 dose(89.3%)or 2 doses(80.0%)than those without vaccination history(49.1%)(χ^(2)=113.86,P<0.01).Among the 42 IgMnegative cases,66.7%(n=28)were SVF.Conclusion SVF was the main cause of measles infection in population vaccinated with measlescontaining vaccine.Imported genotype and prolonged vaccination time were associated with increased cases of SVF.It is recommended that monitoring of measles virology and immunization levels should be strengthened.

关 键 词：麻疹 实验室确诊病例 含麻疹成份疫苗 原发性免疫失败(PVF) 继发性免疫失败(SVF) 

分 类 号：R511.1[医药卫生—内科学]