1例接种两种疫苗偶合ITP和EBV感染病例的调查  

Investigation of a case coupled to ITP and EBV infections after two vaccinations

作　　者：肖艳玲 马敬仓[2] 沙娜 刘景顺[2] 陶泽新[4] XIAO Yanling;MA Jingcang;SHA Na;LIU Jingshun;TAO Zexin(Heze Juye Center for Disease Control and Prevention,Heze,Shandong 274900,China)

机构地区：[1]菏泽市巨野县疾病预防控制中心,山东菏泽274900 [2]菏泽市疾病预防控制中心 [3]济宁市第一人民医院儿科 [4]山东省疾病预防控制中心

出　　处：《医学动物防制》2024年第11期1119-1122,共4页Journal of Medical Pest Control

基　　金：泰山学者青年专家计划项目(tsqn202103187)。

摘　　要：目的调查某受种者发生特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)、EB病毒(Epstein-barr virus,EBV)感染与接种吸附无细胞百白破联合疫苗(diphtheria,tetanus and acellular pertussis combined vaccine,adsorbed,DTaP)、麻疹-腮腺炎-风疹联合减毒活疫苗(measles,mumps and rubella combined attenuated live vaccine,MMR)是否存在因果关联。方法县、乡两级专业人员根据受种者的调查诊断申请,开展个案调查、收集受种者、接种方、疫苗生产企业相关资料;对菏泽市2022年4月—2023年4月疑似预防接种异常反应(adverse events following immunization,AEFI)数据、疫苗接种剂次进行统计,查询接种同批号疫苗受种者AEFI的发生情况,并进行描述性分析;菏泽市预防接种异常反应调查专家组对该AEFI案例开展调查诊断。结果某受种者于2023年4月2日16:21接种DTaP、MMR,观察30min无异常;2023年4月5日20:21该病例发现全身散在出血点,于2023年4—5月先后在乙、丙医院住院治疗,诊断为ITP、EB病毒感染。在2022年4月3日—2023年4月2日接种的379.21万剂次各类疫苗中,AEFI发生率为0.16/10万剂,低于2020年全国2.41/10万剂水平(u=8.925,P<0.05)。调查诊断结果为该病例不属于预防接种异常反应。结论该受种者接种DTaP、MMR与发生EBV感染、ITP无因果关联性,为偶合症。Objective To investigate whether there was a causal association between idiopathic thrombocytopenic purpura(ITP),Epstein-barr virus(EBV)infection and its vaccination with the diphtheria,tetanus and acellular pertussis combined vaccine,adsorbed(DTaP)and measles,mumps and rubella combined attenuated live vaccine(MMR).Methods A case study was conducted by county and village level professionals based on an application for investigation and diagnosis by the infected person.Related data on the vaccine recipient,vaccination providers,and vaccine manufacturers were collected.Data on adverse events following immunization(AEFI)and the number of vaccine doses administered in Heze from April 2022 to April 2023 were complied.The AEFI incidences among vaccine recipients of the same vaccine batch number were investigated,and a descriptive analysis was conducted.A investigation team of the abnormal reaction of vaccination in Heze investigated and diagnosed the AEFI case.Results A vaccine recipient was inoculated with DTaP and MMR vaccinations at 16:21 on April 2,2023,and no abnormalities were observed during a 30-minute observation period.At 20:21 on April 5,2023,the case was found to have scattered hemorrhagic spots all over the body and was hospitalized in Hospital B and Hospital C from April to May 2023,diagnosed with ITP,Epstein-Barr virus infection.Out of 3.7921 million doses of various types of vaccines were vaccinated from 3 April 2022 to 2 April 2023,the incidence of AEFI was 0.16/100000 doses,lower than the national level of 2.41/100000 doses in 2020(u=8.925,P<0.05).The investigation concluded that the case did not belong to AEFI.Conclusion There is no causality between the occurrence of EBV infection and ITP,and vaccination with DTaP and MMR in he vaccine recipient.It is a coincidental illness.

关 键 词：EB病毒 疫苗 偶合 吸附无细胞百白破疫苗 麻疹-腮腺炎-风疹联合减毒活疫苗 特发性血小板减少性紫癜 调查 

分 类 号：R186[医药卫生—流行病学]