流行性脑脊髓膜炎的流行病学监测与预防

Epidemiological Surveillance and Prophylaxis of Epidemic Cerebrospinal Meningitis

流行性脑脊髓膜炎 (流脑 )仍然是一种常见的急性传染病 ,它严重地威胁着儿童的健康。文章介绍了最近在非洲、欧洲、大洋洲、美国和我国出现的流脑流行情况 ,在上述地区和国家中脑膜炎球菌血清群、血清型与血清亚型的分布 ,脑膜炎球菌对抗菌药物的耐药性。为了有效地控制流脑的流行 ,必须加强对流脑的监测与预防。为此 ,提出了在流脑流行病学监测中 ,不仅监测流脑一般的发病率与病死率 ,还应监测它的年龄组发病率。还必须检查脑膜炎球菌血清群的变迁与该菌对抗菌药物的耐药性 ,以及该菌在健康人群中的带菌率与人群的抗体水平。给儿童注射脑膜炎球菌多糖疫苗是预防流脑的主要措施。为了增强脑膜炎球菌多糖疫苗对幼儿的预防效果 ,有的国家正在使用C群脑膜炎球菌多糖与载体蛋白结合所制成的结合疫苗。关于B群脑膜炎球菌疫苗的研究近况在此文中亦做了介绍。当缺乏疫苗时 ,给病人密切接触者口服抗菌药物作为辅助的预防措施 ,对于减少流脑第

Epidemic cerebrospinal meningitis(ECM) is still a common acute infectious disease which is a great threaten to children's health This article introduced the prevalent status of ECM recently presented in Africa,Europe,the Atlantic continents,the United States and China,and also suggested the distributions of meningococcal serogroups,serotypes and serosubtypes and meningococcal resistance to antibiotic drugs in the above countries In order to effectively control the prevalence of ECM,the surveillance and prophylaxis of the disease must be strengthened For this reason, it was suggested in this article that not only the general morbidity and case fatality rate of the disease should be studied but the morbidity by age groups also should be included in epidemiological surveillance of ECM In addition,the study about changes of meningococcal serogroups and meningococcal resistance to antibiotic drugs as well as carriage rates of meningococci and antibody levels in the healthy populations also must be detected Injecting meningococcal capsular polysaccharide vaccine to children is a main prophylactic measure against ECM For enhancing the prophylactic effect of this vaccine to young children,some countries were making use of serogroup C meningococcal conjugated vaccine which is a conjugation of capsular polysaccharide with carrier protein The recent researches on vaccine of meningococcal serogroup B were introduced in this article In case of shortage of vaccine, it would be some effect to administer oral antibiotic drugs to the close contacts as a secondary prophylactic measure to decrease secondary coses