麻疹疫苗接种后发热出疹性疾病发生情况监测分析

Analysis on surveillance results of cases with rash and fever illness after measles vaccine inoculation

目的:调查接种麻疹疫苗(MV)后发生发热出疹性疾病(RFIs)的情况。方法:对靖江市2005年～2006年32例RFIs随访报告进行流行病学调查和分析。结果:RFIs的发生多呈散发状态,且相互之间无流行病学联系;以MV接种人次数进行估算,报告发生率为10.8/万;87.5%的病例发热>38.5℃,出疹时间在MV接种后7～12 d(平均为8 d),出疹顺序基本同麻疹病例,皮疹较为典型;全部病例均为8～10月龄首次接种MV者;风疹IgM阳性率为3.6%,麻疹IgM阳性率为39.3%,差异非常显著(χ2=8.59,P<0.01)。结论:接种MV可引起RFIs,其发生与疫苗首次接种有关。RFIs病例是否与接种MV有因果关系,有待进一步从病毒基因型别上加以确认。

Objective;To investigate the rash and fever illness （RFIs） cases after measles vaccine （MV） inoculation. Methods：There were 32 RFIs cases occurred after MV inoculation in Jingjiang during 2005 to 2006, which investigated and analyzed epidemiological in terms of following up reports. Results：All cases were sporadically distributed without epidemiological links; the incidence of reporting RFIs cases after MV inoculation was 10, 8/10 000 persons by estimating number and times of MV inoculation. Clinical symptoms showed that 87.5% of the 32 RFIs cases having ）38. 5℃ fever and all cases appeared typical rash after 7 to 12 days （the medium was 8 days） after MV inoculation. The order of rash onset among RFIs cases was consistent with that of regular measles cases caused by wild virus. All cases had fist time MV inoculation and were 8 to 10 month-olds, IgM sera antibody test from RFIs cases were 3.60% positive for rubella and 39.3% positive for measles. There was significant difference of IgM positive rates （Х^2 = 8.59,P〈0. 01）. Conclusion：RFIs due to measles vaccine virus infection might occur after MV inoculation. There seemed to be a correlation between RFIs incidence and the first time of MV inoculation. Measles virus genotype analysis needs to be carried out to confirm if the onset of the RFIs cases is etiologically associated with MV vaccine virus infection.