江苏省健康人群流行性脑脊髓膜炎血清学监测

Serology surveillance of epidemic cerebrospinal meningitis in the health population of Jiangsu province

目的了解江苏省健康人群流行性脑脊髓膜炎A群、C群抗体水平及脑膜炎奈瑟菌(Nm)带菌分布情况,评价江苏省流脑多糖菌苗的接种状况、工作质量,为制定控制措施提供依据。方法采用酶联免疫吸附试验(ELISA法)检测流脑A群、C群血清抗体水平和流脑免疫成功率,咽拭子用于脑膜炎奈瑟菌(Nm)的分离。结果检测流脑A群抗体1964人,抗体阳性率为86.56%,GMT为1∶5.84;检测流脑C群抗体932人,抗体阳性率为57.51%,GMT为1∶2.68;流脑A群抗体阳性率(χ2=222.51,P<0.05),GMT(F=39.44,P<0.05)均有显著性差异;流脑C群抗体阳性率(χ2=194.12,P<0.05)、GMT(F=42.86,P<0.05)均有显著性差异。健康人群A群、C群流脑带菌率<1%。A群流脑多糖菌苗基础免疫成功率为88.98%,GMT为1∶5.58,抗体4倍增长率为71.65%。结论近期内江苏省不会发生流脑A群流行,存在暴发或散发流脑C群的可能。应加强流脑监测,大力推广A+C群流脑疫苗的接种,逐渐将其纳入计划免疫。

Objective To understand the distribution of the antibody level of group A and group C epidemic cerebrospinal meningitis and the carrier of Nm in the health population of Jiangsu province. The quality of vaccination and the immune persistent level of vaccination were evaluated, so as to provide evidence for decision making. Methods ELISA was used to exam the antibody level of group A and group C epidemic cerebrospinal meningitis in blood serum and successful immune persistence rate after vaccinated with group A meningococcal capsular polysaccharide vaccine. Throat swab was used to separate Nm. Results 1964 people were examined for antibody of group A, （ positive rate 86.56% ）, the GMT was 1 ： 5.84 ; 932 for group C, （ positive rate 57.51% ）, and the GMT was 1 ： 2.68. There was significant difference in the positive rate （ X^2 = 222.51, P 〈 0.05 ） and GMT （ F = 39.44, P 〈 0.05 ） of group A, and the positive rate （ X^2 = 194.12, P 〈 0.05 ） and GMT （ F = 42.86, P 〈 0.05 ） of group C. The rate of carrier was less than 1%. Successful immune persistence rate after vaccination with group A meningococcal capsular polysaccharide vaccine was 88.98%, GMT was 1：5.58, and the d-fold increasing rate of the antibody level was 71.65%. Conclusion It is predicted that the outbreak of epidemic cerebrospinal meningitis of group A might not occur, however, the outbreak or sporadic epidemic of the epidemic cerebrospinal meningitis of group C might happen. Therefore, the surveillance of the epidemic cerebrospinal meningitis should be strengthened and the vaccination of the A ＋C group epidemic cerebrospinal meningitis vaccine should be gradually brought into the programmed immunization.