非麻疹疫苗免疫目标人群麻疹血清流行病学研究

Sero-Epidemiological Study on Non Measles Vaccine Trget Population

目的通过广州市白云区流行病学血清学研究,了解非麻疹疫苗免疫目标人群麻疹血清流行病学状况,为制定麻疹控制策略提供依据。方法选取新生儿、2～、4～、6～、8月龄未患过麻疹的常住婴儿及母亲配对作为研究对象,同时,在麻疹疫点应急接种时,采集15～35岁健康受种者免前及免后一个月血清。所有血清标本采用定量酶联免疫吸附试验检测麻疹抗体活性量(U/ml),≥200为阳性。结果新生儿麻疹抗体阳性率为100%,新生儿麻疹抗体活性量值是其母亲的1.66倍,婴儿麻疹抗体活性量水平的高低与母亲抗体活性量水平呈正相关(r=0.728,P=0.0032)。从2个月后婴儿母传抗体抗体活性量水平逐渐降低,6个月后抗体下降显著,至8月龄时,婴儿母传麻疹抗体几乎消失。128名健康成年人免前麻疹抗体阳性率为83.33%,麻疹抗体活性量值为2066.71±162.47,接种麻疹疫苗后,不同年龄段男女麻疹抗体水平显著高于接种前(P<0.001)。结论白云区近年来非麻疹疫苗免疫目标人群麻疹发病持续上升,与这类人群麻疹抗体水平低有关。对成人进行麻疹疫苗接种,能取得良好免疫效果,尤其重视对育龄妇女接种麻疹疫苗,是降低这类人群麻疹发病率的主要措施。为减少8月龄前儿童发病数,应急免疫时可考虑将起始月龄提前到6月龄。

Objective To obtain sero-epidemiological profile and develop optimal strategies to promote measles elimination among non measles vaccine target population in Baiyun District,Guangzhou. Method Those of newborns,2 months-、4 months-、6 months-and 8 months who have not received measles virus infection were enrolled,and their mothers were also enrolled aspairs.One sample before receiving measles vaccine and the other at one month after vaccination were gathered among healthy subjects during the measles outbreaks. Measles antibody activities were measured in serum by Enzyme-linked Immunosorbent Assay （ELISA）（U/ml）and an antibody activities of ≥1：200 was considered positive. Results With sero-positive rate for measles antibody 100%,antibody activities level in newborns is 1.66 times as their mothers. There was a positive corelation in measles antibody level between newborns and their mothers （r=0.728,p=0.0032）. Maternal antibody level decreased among infants of 2 months-,a dramatic decreased among those of 6 months-and almost disappeared among those of 8 months. The positive measles antibody rate before vaccination among 128 adults was 83.33%,with IgG level 2066.71±162.47. After receiving vaccination,the antibody level were much higher than before among different agegroups and genders（P〈0.001）. Conclusions Low measles antibody level led to the high incidence among those of non vaccine targeted population in Baiyun District. Good protection can be gained by adults vaccination,especially among fetile women. Adults vaccination is the key to decrease the incidence of this population. Vaccination for children of 6 months was recommended to decrease the measles incidence among those of 〈8 months.