Pogorzelska Małgorzata, Ołdak Elzbieta, Sulik Artur
Klinika Obserwacyjno-Zakaźna Dzieci Akademii Medycznej w Białymstoku.
Przegl Epidemiol. 2005;59(4):841-9.
Mumps is a viral infection primarily affecting the salivary glands. Although disease is usually mild about 10-15% of patients can develop aseptic meningitis. Rare but more serious complication is encephalitis, which can result in death. Orchitis, pancreatitis, deafness are other complications of mumps. In the countries where there is no vaccination for mumps, its incidence remains high, usually >100 per 100,000 population with epidemic peaks every 2-5 years. Peak incidence is found among children 5-9 years of age. The mumps morbidity in Poland is in the range 50-560 per 100,000 population. Up to 2003, 107 countries reported using mumps vaccine in their national immunization programmes. Countries that have achieved high coverage have shown rapid decline in mumps morbidity (for a one-dose schedule > or = 80%, for two-dose schedule > or = 97%). This review analyses the clinical manifestation, epidemiology of mumps as well as immunogenicity, effectiveness and safety of different types of mumps vaccines. It also provides information about epidemiological situation for mumps in Poland in the context of national mumps immunization programmme. There is low seroprevalence among the children population in Poland--up to 2003, about 75% children population in the 1 to 4 age group was seronegative for mumps. The childhood mumps vaccination should aim at an 80% coverage rate, or more. An insufficient childhood vaccination coverage may result in an epidemiological shift in the incidence of mumps to older age groups. If a large proportion of the population remains seronegative for mumps, vaccination of adults should be also considered.
腮腺炎是一种主要影响唾液腺的病毒感染。虽然该病通常症状较轻,但约10%-15%的患者会发展为无菌性脑膜炎。罕见但更严重的并发症是脑炎,可导致死亡。睾丸炎、胰腺炎、耳聋是腮腺炎的其他并发症。在未接种腮腺炎疫苗的国家,其发病率仍然很高,通常每10万人中>100例,每2-5年出现一次流行高峰。发病高峰出现在5-9岁的儿童中。波兰的腮腺炎发病率为每10万人50-560例。截至2003年,107个国家报告在其国家免疫规划中使用了腮腺炎疫苗。实现高接种率的国家腮腺炎发病率迅速下降(单剂接种率≥80%,两剂接种率≥97%)。本综述分析了腮腺炎的临床表现、流行病学以及不同类型腮腺炎疫苗的免疫原性、有效性和安全性。它还提供了波兰在国家腮腺炎免疫规划背景下的腮腺炎流行病学情况信息。波兰儿童人群中的血清阳性率较低——截至2003年,1至4岁年龄组中约75%的儿童人群腮腺炎血清学检测呈阴性。儿童腮腺炎疫苗接种的目标覆盖率应为80%或更高。儿童疫苗接种覆盖率不足可能导致腮腺炎发病率的流行病学转变至年龄较大的人群。如果很大一部分人群腮腺炎血清学检测仍为阴性,也应考虑对成年人进行疫苗接种。