摘要
目的 调查接种麻疹疫苗(MV)后发热出疹性疾病(RFIs)的发病情况。方法 对山东省1999~2002年通过麻疹监测专报系统报告的150例接种MV后RFIs病例进行流行病学调查和分析。结果 接种MV后RFIs多呈散发状态,且相互之间无流行病学联系;以MV投入量进行估算,报告发生率为0.14/10 000ml~0.25/10 000ml,年均报告发生率为0.20/10 000ml,且各年份发生率之间差异有统计学意义(X^2=10.13,P<0.05);88.67%的病例发热在38.5℃以上,75.33%的病例接种MV后4~11天出疹(中位数为8天),皮疹较为典型;出疹顺序基本与野病毒引起的麻疹病例一致;68.67%的病例为首次接种MV,其中8~12月龄组占94.17%;风疹IgM均为阴性,麻疹IgM阳性率为45.65%。结论 接种MV可引起RFIs,主要原因是疫苗接种后的过敏反应和减毒活疫苗引起的疫苗相关病例,其发生率与疫苗接种剂次有关;RFIs病例是否与接种麻疹疫苗有因果关系,今后应从病毒的基因型上加以鉴别。
Objective To study the incidence of cases with rash and fever illness (RFIs) after
measles vaccine (MV) inoculation. Methods During 1999 to 2002, 150 RFIs cases reported by the special
measles surveillance system in Shandong province,China, were investigated and analyzed epidemiologically.
Results 7 674 690 ml MV were distributed during 1999 to 2002 and the annual average incidence of RFIs
cases after MV inoculation was 0. 20/10 000 ml(0. 2 ml per dose). There was significant difference of
incidences each year (X^2=10.13, P<0.05). All RFIs cases were sporadically distributed without
epidemiological links. Clinical symptoms showed that 88. 67% of the 150 RFIs cases having>38.5℃
fever and 75. 33% of all cases appeared typical rash after 4 to 11 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. 68. 67% of the RFIs cases had first MV inoculation and 94. 71% were 8 to 12
montholds. IgM sera antibody test from RFIs cases were rubella negative and 45. 65% positive for
measles. Conclusion RFIs due to allergic reaction or measles vaccine virus infection might occur after MV
inoculation. There seemed to be a correlation between RFIs incidence and the doses of MV. Measles virus
genotype analysis needs to be carried out to confirm if the onset of some RFIs cases is aetiologically
associated to MV vaccine virus infection.
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2004年第5期417-420,共4页
Chinese Journal of Epidemiology
基金
山东省卫生厅资助项目(9908)