Terada Kihei
Department of Pediatrics, Kawasaki Medical School, Okayama 701-0192, Japan.
Jpn J Infect Dis. 2003 Jun;56(3):81-7.
Rubella virus infection can lead to problems with congenital rubella syndrome (CRS) in the next generation due to fetal infection, but these problems are preventable with vaccination. In other words, rubella epidemics and the occurrence of CRS can be eliminated by vaccination. In Japan, until recently, rubella epidemics occurred every 5 years, and there were at least 1,600 CRS cases between 1965 and 1985. Following the 1994 revision of the Preventive Vaccination Law, national surveillance from approximately 3,000 clinics has shown that the number of rubella cases has dramatically decreased to a few thousand and the occurrence of CRS has decreased to only a few cases. However, the vaccination rate during a transitional period from 1995 to 2003 has been unsatisfactory. This has been especially true for junior high school students, because individual vaccination has replaced mass immunization in urban areas. As a result, the negative antibody rate in females below 18 years of age has increased to approximately 27%. If this trend continues, there is likely to be an increase in rubella epidemics and occurrence of CRS in the near future. Vaccination is not compulsory under Japanese law, and vaccination campaigns alone have proved unsuccessful in promoting vaccination. Another system of motivating individuals to seek vaccination will be needed in order to maintain a high vaccination rate without such campaigns.
风疹病毒感染可因胎儿感染导致下一代出现先天性风疹综合征（CRS）问题，但通过接种疫苗这些问题是可以预防的。换句话说，风疹流行和CRS的发生可通过接种疫苗消除。在日本，直到最近，风疹每5年流行一次，1965年至1985年间至少有1600例CRS病例。1994年《预防接种法》修订后，来自约3000家诊所的全国监测显示，风疹病例数已大幅降至数千例，CRS的发生也降至仅几例。然而，1995年至2003年过渡期间的接种率并不理想。初中学生尤其如此，因为在城市地区个人接种已取代了群体免疫。结果，18岁以下女性的阴性抗体率已升至约27%。如果这种趋势持续下去，近期风疹流行和CRS的发生可能会增加。根据日本法律，接种疫苗并非强制要求，仅靠接种疫苗运动在促进接种方面已证明不成功。为了在没有此类运动的情况下维持高接种率，将需要另一种激励个人寻求接种的制度。
