Ryan Margaret A K, Smith Tyler C, Honner William K, Gray Gregory C
US Department of Defense Center for Deployment Health Research, Naval Health Research Center, PO Box 85122, San Diego, CA 92186-5122, USA.
J Med Virol. 2003;70 Suppl 1:S15-9. doi: 10.1002/jmv.10314.
Primary varicella infection, or chicken pox, is a threat to all young adults who join the United States (U.S.) military if they fail to develop immunity prior to enlistment. Historically, outbreaks of chicken pox have caused marked morbidity and impaired military readiness. In December 1996, the U.S. Navy began performing serologic testing for varicella among all new recruits, and vaccinating those found to be sero-negative. We evaluated results of the screening program in its first 4 years, and used multivariable logistic regression modeling to describe factors associated with varicella susceptibility. Cases of chicken pox were tracked among all military services before and after program implementation. More than 190,000 young adults enlisted in the U.S. Navy between 1997 and 2000. Recruits originated from all 50 states and several foreign countries; 84% were male, and their average age was 19 years. Seven percent were found to be susceptible (sero-negative) to varicella. In multivariable modeling, race/ethnicity was associated with susceptibility, but age, gender, and home state were not. The overall incidence of chicken pox in the Navy was reduced by more than 80% after initiation of the screening-vaccination program. A successful varicella screening-vaccination program has been implemented in the U.S. Navy. Results of serologic screening undertaken on this large number of young adults may be useful in tracking the changing epidemiology of varicella in the general population in the post-vaccine era.
原发性水痘感染，即水痘，对所有加入美国军队的年轻人构成威胁，前提是他们在入伍前未产生免疫力。从历史上看，水痘疫情曾导致明显的发病率并影响军事准备状态。1996年12月，美国海军开始对所有新兵进行水痘血清学检测，并为血清学检测呈阴性的新兵接种疫苗。我们评估了该筛查计划头4年的结果，并使用多变量逻辑回归模型来描述与水痘易感性相关的因素。在该计划实施前后，对所有军种中的水痘病例进行了追踪。1997年至2000年间，超过19万名年轻人加入了美国海军。新兵来自美国所有50个州和几个外国；84%为男性，平均年龄为19岁。7%的新兵被发现对水痘易感（血清学检测呈阴性）。在多变量模型中，种族/族裔与易感性相关，但年龄、性别和家乡州则不然。在启动筛查-疫苗接种计划后，海军中水痘的总体发病率降低了80%以上。美国海军已实施了一项成功的水痘筛查-疫苗接种计划。对大量年轻人进行血清学筛查的结果可能有助于追踪疫苗接种后时代普通人群中水痘流行病学的变化情况。
