【摘要】 目的探讨云南省麻疹高发的原因,制定控制麻疹对策。方法应用现场流行病学调查和实验室检测方法,进行冷链运转对麻疹减毒活疫苗(Measles Vaccine,Live;MV)效价的影响,云南本土麻疹病毒分子流行病学研究以及MV免疫效果评价。结果MV跟踪监测、定点监测和动态监测,平均效价≥3.0lgCCID50/ml。不同爆发现场采样标本分离出的21株麻疹病毒,基因型别鉴定为H1型。免疫前麻疹抗体阴性儿童85人和74人,分别接种不同剂量(0.2ml、0.5ml)MV,免疫成功率分别为88.24%、97.30%(χ2=4.656,P<0.05)。检测3815人份1~20岁人群血标本,麻疹IgG抗体阳性率96.02%,几何平均滴度(GMT)1∶843,血清抗体≥1∶800的占71.85%,该人群MV初免接种率75.05%,复种接种率46.53%。结论云南省现有冷链系统规范运转,能保障MV效价不降低;所分离出的麻疹病毒是中国麻疹流行的优势基因型别;麻疹高发的主要原因是MV有效接种率低于阻断麻疹病毒传播所要求的95%指标,因此提高MV有效接种率并适时开展MV补充免疫,是目前云南省控制麻疹的主要策略。更多还原

【Abstract】 Objective To analyse the reason of high measles incidence in Yunnan,and formulate strategy of Measles Control. Methods To study the impact of cold chain running to the efficiency of Measles Vaccine and evaluate vaccine effect to the Measles vaccine by field epidemiological investigation and Lab test. Results The average efficiency of measles vaccine from five levels monitoring, fixed site monitoring, and two levels monitoring are 3.0 1g CCID50/ml. 21 strain of measles virus isolated from the sample collected from different outbreak places are H1 by genotype identification. 85 and 74 chiblren with of measles antibody negative were administrated 0.2ml and 0.5ml measles vaccine respectively before immuniration. The measles vaccine immunization success rates were 88.24% and 97.30% (P<0.05).The study collected 3815 blood samples,population aged from 1-20years old.Among them,3663 was measles IgG positive (96.02%).The measles antibody geometric mean titer (GMT) was 1∶843.The measles antibody protection rate (>1∶800) was 71.85%.The coverage rates of measles vaccine (MV) based on immunization was 75.05%,and the second dose of MV 46.53%. Conclusion The existed cold chain system can ensure the measles vaccine efficacy during normal transportation in yunnan province.Separates H1 type measles virus in Yunnan is consistent with China as primary measles pathogen.The reason of high measles incidence in Yunnan was due to effective coverage rate of measles vaccine lower than 95% targets which blocks measles transmission in Yunnan Province.To raise the measles vaccine effective vaccination coverage and develop the measles vaccine with supplementary immunization activities (SIAs) are the main strategy of measles control at present in Yunnan Province.更多还原