7例首剂麻疹风疹联合减毒活疫苗相关麻疹病例分析

Analysis of 7 measles cases associated with the first dose vaccination of measles and rubella combined attenuated live vaccine

目的调查麻疹风疹联合减毒活疫苗(measles and rubella combined attenuated live vaccine,MR)相关麻疹病例(a vaccine-associated measles case)的特点,与麻疹病例进行鉴别。方法采用描述流行病学方法,对丰台区2011年MR相关麻疹病例进行分析。结果 2011年丰台区实验室确诊7例MR相关麻疹病例,均为8～9月龄幼儿首次接种MR,所用疫苗均为合格疫苗,无批号聚集。发病率为2.5/万剂。病例发病无时间、地点聚集性,与麻疹病例无流行病学联系,亦无二代病例出现,临床表现无咳嗽及呼吸道卡他症状,发热与出疹间隔期短。结论疫苗相关病例与麻疹病例在临床表现、实验室检测和流行病学特征上有所不同,基层工作者应在实际工作中加以鉴别。

Objective To understand the characteristics of measles cases associated with the immunization of measles and rubella （MR） combine vaccine and provide evidence for differential diagnosis of measles and MR vaccine associated measles. Methods Descriptive epidemiological analysis was conducted on the incidence data of MR vaccine associated measles in Fengtai in 2011. Results Seven MR vaccine associated measles cases were laboratory confu＇med in 2011. All the cases were infants aged 8 - 9 months receving the first dose of MR vaccine injection. All the vaccines used were qualified and in different batches. The incidence was 2. 5 per 10 000 doses. No time and space clustering of the cases was observed, and no second cases occurred. The clinical manifestations of the cases were characterized by respiratory symptom and short interval between fever and rash. Conclusion There are differences in clinical manifestations, laboratory detection results and epidemiological characteristics between measles cases and MR vaccine associated measles cases. Close attention should be paid in differential diagnosis.