摘要
目的分析北京市2009～2012年接种含麻疹成分疫苗（Measles-containing Vaccine，MCV）后，疫苗相关麻疹病例（vaccine-associated Measles Case，VAMC）的流行病学特征，进一步完善VAMC的诊断方法。方法对北京市2009~2012年通过麻疹监测信息系统报告的麻疹疑似病例，按照世界卫生组织VAMC定义进行分类诊断，使用多重实时荧光聚合酶链反应扩增病毒基因并测序，鉴别麻疹疫苗病毒与野病毒，采用描述流行病学方法对VAMC进行分析。结果北京市2009~2012年共报告VAMC52例，年发生率为3．0/10万剂～7．3/10万剂，51例为接种首剂麻疹．风疹联合减毒活疫苗后的小月龄婴儿，VAMC呈现时间均匀分布而无地区聚集性的特征，所用疫苗均为合格疫苗，预防接种门诊和疫苗批号均无聚集性。部分VAMC采集病原学标本基因分型为疫苗株A基因型。结论VAMC的流行病学特征与麻疹野病毒感染有所不同。在鉴别诊断方面，应对于接种MCV后一段时间发生出疹性疾病的病例开展病原学标本基因分型，为VAMC提供实验室诊断依据。
Objective To analyze the epidemiological characteristics of vaccine-associated measles case （VAMC） after measles-containing vaccine （MCV） inoculation in Beijing during 2009-2012, and to provide evidence for improvement of VAMC diagnosis. Methods Measles suspected cases were reported by measles surveillance system in Beijing. VAMC was diagnosed according to World Health Organization measles monitoring definition. Wild measles virus and vaccine virus were identified by detection nucleic acid through multiplex real-time fluorescent polymerase chain reaction technology. Descriptive epidemiological analysis was conducted to the incidence of VAMC. Results During 2009 to 2012, 52 VAMC were reported and the annual incidence was 3.0/100,000 doses-7.3/100,000 doses. 51 cases were infants receiving the first dose of measles and rubella combined attenuated live vaccine. No time and space clustering of the cases were observed. All vaccine used were qualified. No clustering of vaccination clinic and vaccine batches was observed. Genotype A vaccine strains were detected from parts of case specimens. Conclusion There were differences in epidemiological characteristics between measles case and VAMC. Nucleic genotype of specimens should be detected to identify measles vaccine virus and wild virus and provide laboratory evidence for VAMC diagnosis.
出处
《中国疫苗和免疫》
CAS
2013年第6期519-522,528,共5页
Chinese Journal of Vaccines and Immunization
关键词
疫苗相关麻疹病例
麻疹-风疹联合减毒活疫苗
流行病学特征
Vaccine-associated measles case
Measles and rubella combined attenuated live vaccine
Epidemiological characteristics.
