Hanratty B, Holt T, Duffell E, Patterson W, Ramsay M, White J M, Jin L, Litton P
Nuffield Institute for Health, Leeds, UK.
Epidemiol Infect. 2000 Oct;125(2):377-83. doi: 10.1017/s0950268899004525.
We describe the epidemiology of the first nationwide outbreak of measles infection in the UK since the implementation of a mass vaccination campaign. Notifications of infectious diseases, interview and postal questionnaire identified 293 clinical cases, 138 of which were confirmed by salivary IgM, measles virus isolation and PCR. Twelve were epidemiologically linked to confirmed cases. The outbreak began in London, after contact with measles infection probably imported from Italy. Measles genotyping determined by sequence analysis confirmed spread to other unimmunized anthroposophic communities in the north, south west and south coast of England. Only two cases had been vaccinated against measles infection, and 90% of cases were aged under 15 years. Measles virus can selectively target non-immune groups in countries with high vaccine uptake and broader herd immunity. Without harmonization of vaccination policies and uniform high coverage across Europe, the importation and spread of measles virus amongst non-immune groups may prevent the elimination of measles.
我们描述了英国自开展大规模疫苗接种运动以来首次全国性麻疹感染疫情的流行病学情况。通过传染病通报、访谈和邮政问卷调查确定了293例临床病例，其中138例经唾液IgM、麻疹病毒分离和聚合酶链反应确诊。12例在流行病学上与确诊病例有关联。此次疫情始于伦敦，可能是在接触了从意大利输入的麻疹感染源之后。通过序列分析确定的麻疹基因分型证实疫情已蔓延至英格兰北部、西南部和南海岸其他未接种疫苗的人智学社区。只有两例曾接种过麻疹疫苗，90%的病例年龄在15岁以下。在疫苗接种率高且群体免疫范围更广的国家，麻疹病毒可选择性地针对非免疫群体。如果欧洲各国不统一疫苗接种政策且不能实现统一的高覆盖率，麻疹病毒在非免疫群体中的输入和传播可能会阻碍麻疹的消除。
