Dourado I, Cunha S, Teixeira M G, Farrington C P, Melo A, Lucena R, Barreto M L
Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil.
Am J Epidemiol. 2000 Mar 1;151(5):524-30. doi: 10.1093/oxfordjournals.aje.a010239.
A mass immunization campaign with a Urabe-containing measles-mumps-rubella vaccine was carried out in 1997 in the city of Salvador, northeastern Brazil, with a target population of children aged 1-11 years. There was an outbreak of aseptic meningitis following the mass campaign. Cases of aseptic meningitis were ascertained through data collected from the records of children admitted to the local referral hospital for infectious diseases between March and October of 1997, using previously defined eligibility criteria. Vaccination histories were obtained through home visits or telephone calls. Eighty-seven cases fulfilled the study criteria. Of those, 58 cases were diagnosed after the vaccination campaign. An elevated risk of aseptic meningitis was observed 3 weeks after Brazil's national vaccination day compared with the risk in the prevaccination period (relative risk = 14.3; 95% confidence interval: 7.9, 25.7). This result was confirmed by a case series analysis (relative risk = 30.4; 95% confidence interval: 11.5, 80.8). The estimated risk of aseptic meningitis was 1 in 14,000 doses. This study confirms a link between measles-mumps-rubella vaccination and aseptic meningitis. The authors discuss the implications of this for the organization and planning of mass immunization campaigns.
1997年，在巴西东北部的萨尔瓦多市针对1至11岁儿童开展了一场使用含Urabe株的麻疹-腮腺炎-风疹疫苗的大规模免疫接种活动。大规模接种活动后出现了无菌性脑膜炎的暴发。通过收集1997年3月至10月间入住当地传染病转诊医院儿童的记录数据，并采用先前确定的入选标准来确定无菌性脑膜炎病例。通过家访或电话获取疫苗接种史。87例符合研究标准。其中，58例在疫苗接种活动后被诊断。与接种前时期相比，在巴西全国疫苗接种日3周后观察到无菌性脑膜炎风险升高（相对风险=14.3；95%置信区间：7.9，25.7）。这一结果通过病例系列分析得到证实（相对风险=30.4；95%置信区间：11.5，80.8）。无菌性脑膜炎的估计风险为每14000剂中有1例。本研究证实了麻疹-腮腺炎-风疹疫苗接种与无菌性脑膜炎之间存在关联。作者讨论了这对大规模免疫接种活动的组织和规划的影响。
