2014—2023年中国麻疹和风疹病例中血清IgM抗体和病毒核酸检测结果分析

Analysis of serum IgM antibody and viral nucleic acid test results in measles and rubella cases in China from 2014 to 2023

目的分析2014—2023年中国麻疹和风疹病例中血清IgM抗体和病毒核酸检测结果。方法于中国疾病预防控制信息系统获取2014—2023年麻疹和风疹病例数据,将开展麻疹/风疹IgM抗体检测和病毒核酸检测的病例纳入研究,收集病例数、疫苗接种状况、实验室检测结果等信息,并比较不同出疹(发病)时间和不同疫苗接种剂次病例的实验室检测情况。结果2014—2023年麻疹和风疹监测病例共计581746例,同时开展IgM抗体和病毒核酸检测的麻疹和风疹监测病例分别为39124例和21766例,其中IgM抗体和病毒核酸检测双阳性率为63.73%(麻疹)和41.68%(风疹);IgM抗体单阳性率为21.12%(麻疹)和27.15%(风疹);病毒核酸检测单阳性率为13.84%(麻疹)和28.19%(风疹)。根据不同的出疹(发病)时间(0~3、4~5、6~10和>10 d),24629例(62.95%)麻疹监测病例和15785例(72.52%)风疹监测病例标本采集自出疹(发病)3 d内,病毒核酸检测单阳性率为16.90%(麻疹)和32.07%(风疹);IgM抗体单阳性率随发病时间逐渐升高(麻疹:χ_(趋势)^(2)=314.098,P<0.001;风疹:χ_(趋势)^(2)=763.846,P<0.001),并在出疹(发病)10 d后达到31.66%(麻疹)和53.12%(风疹)。根据不同的疫苗接种剂次(1、2、≥3剂次),核酸检测单阳性率为12.93%~20.29%(麻疹)和25.30%~27.88%(风疹);IgM抗体检测单阳性率为36.89%~47.47%(麻疹)和22.81%~41.15%(风疹)。结论血清IgM抗体和病毒核酸联合检测有助于麻疹和风疹病例实验室证实,对于麻疹和风疹消除工作具有重要意义。

Objective To analyze the results of serum IgM antibody and viral nucleic acid testing in measles and rubella cases in China from 2014 to 2023.Methods Surveillance data on measles and rubella during 2014-2023 were obtained from the Chinese Disease Prevention and Control Information System,and cases that underwent measles/rubella IgM antibody testing and viral nucleic acid testing were included in the study.Information on the number of cases,vaccination status,and laboratory test results was collected,and laboratory test results were compared among cases with different times of rash or onset and different doses of vaccination.Results From 2014 to 2023,the total number of measles and rubella surveillance cases was 581746,and the number of measles and rubella cases that underwent both IgM antibody and viral nucleic acid testing was 39124 and 21766,respectively,with a double-positive rate of IgM antibody and viral nucleic acid testing of 63.73%(for measles)and 41.68%(for rubella).The single-positive rate for IgM antibody was 21.12%(for measles)and 27.15%(for rubella).The single-positive rate for viral nucleic acid tests was 13.84%(for measles)and 28.19%(for rubella).According to different days of rash or onset(0-3,4-5,6-10 and>10),samples of 24629(62.95%)measles cases and 15785(72.52%)rubella cases were from within 3 days of rash or onset,and the single positive rate of viral nucleic acid detection was 16.90%(for measles)and 32.07%(for rubella).The single positive rate of IgM antibody increased gradually with the time of onset(measles:χ_(trend)^(2)=314.098,P<0.001,rubella:χ_(trend)^(2)=763.846,P<0.001),and reached 31.66%(for measles)and 53.12%(for rubella)after 10 days of rash or onset.Depending on the number of vaccination doses(1,2,≥3),the single positive rate of viral nucleic acid detection ranged from 12.93% to 20.29%(for measles)and from 25.30% to 27.88%(for rubella).The single positive rate of IgM antibody detection ranged from 36.89% to 47.47%(for measles)and from 22.81 to 41.15%(for rubella).Conclusions Combined testing of serum IgM antibody and viral nucleic acids could facilitate laboratory confirmation of measles and rubella cases and was also important for measles and rubella elimination efforts.