摘要
目的通过检测麻疹、风疹疑似病例的IgG抗体亲和力水平,研究北京市麻疹、风疹疫苗高接种率人群中病例发病的原因。方法采用酶联免疫吸附试验对276例麻疹、风疹疑似病例血清分别进行麻疹、风疹IgG抗体检测,并测定IgG抗体亲和力,计算相对亲和力指数。结果麻疹、风疹疑似病例中,麻疹确诊病例104例,风疹确诊病例108例,麻疹、风疹排除病例64例。麻疹确诊病例中6例有免疫史,麻疹原发性免疫失败3例,继发性免疫失败3例。风疹确诊病例中12例有免疫史,风疹原发性免疫失败4例,继发性免疫失败8例。在无免疫史的确诊病例中,9例麻疹病例抗体为高亲和力,7例风疹病例抗体为高亲和力,提示为再次感染。在麻疹、风疹排除病例中,存在其他病原感染,以EB病毒为主,并存在混合感染。结论有疫苗接种史的病例中,原发性免疫失败和继发性免疫失败都存在。在无免疫史的麻疹、风疹成人病例中都存在再次感染的现象。排除病例中存在其他病原感染。其他病原感染可误诊为麻疹、风疹,这也是近年来麻疹、风疹疑似病例中有免疫史病例比例增多的原因。全程接种疫苗有助于产生麻疹、风疹高亲和力抗体。为阻断麻疹病毒循环,并且实现消除麻疹的目标,应建立完善的接种服务机制,对成人重点人群或高风险群体提供补充接种,巩固人群的免疫屏障。
Objective To investigate the causes of immune failure in the population with high vaccination rate of measles and rubella vaccine in Beijing by detecting the IgG antibody affinity in suspected cases of measles and rubella.Methods Serum samples of 276 suspected cases of measles and rubella were tested for IgM and IgG antibodies by enzyme-linked immunosorbent assay(ELISA).The affinity of IgG antibody was detected,and the relative affinity index was calculated.Results Among the 276 suspected cases,104 were measles and 108 were rubella.Six measles cases had vaccination history and were caused by primary immunization failure(n=3)and secondary immunization failure(n=3).Twelve rubella cases had vaccination history and were due to primary immunization failure(n=4)and secondary immunization failure(n=8).Specific high-affinity antibodies were detected in nine measles cases and seven rubella cases without vaccination history,which indicated that these cases were reinfected.In the cases without measles or rubella,other pathogenic infections including mixed infections were detected,which were mainly caused by EB virus.Conclusions Both primary and secondary immunization failure occurred in the population with immunization history.Reinfection was found in the patients who had not received vaccination against measles or rubella.Other pathogenic infections were existed among the cases without measles or rubella.Thus,misdiagnosis was responsible for the increased proportion of measles and rubella patients with immunization history in suspected cases in recent years.Full-course vaccination was conducive to produce high-affinity antibodies against measles and rubella.A supplementary vaccination campaign should be launched to consolidate the immune barrier against measles and rubella in key population or high-risk population,aiming to block the circulation of measles virus and achieve the goal of eliminating measles.
作者
高翔
高洁
张萍
周景林
邹林
张冲
佟玲
张国峰
王艳春
王建国
陈萌
Gao Xiang;Gao Jie;Zhang Ping;Zhou Jinglin;Zou Lin;Zhang Chong;Tong Ling;Zhang Guofeng;Wang Yanchun;Wang Jianguo;Chen Meng(Department of Central Laboratory,Tongzhou District Center for Disease Control and Prevention,Beijing 101100,China;Institute for Immunization and Prevention,Beijing Research Center for Preventive Medicine,Beijing Municipal Center for Disease Control and Prevention,Beijing 100013,China)
出处
《中华微生物学和免疫学杂志》
CAS
CSCD
北大核心
2020年第6期465-469,共5页
Chinese Journal of Microbiology and Immunology
关键词
麻疹
风疹
抗体亲和力
免疫失败
Measles
Rubella
Antibody affinity
Immunization failure
