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在西澳大利亚金伯利地区疫苗接种率很高的原住民中,腮腺炎疫情持续爆发。

A prolonged mumps outbreak among highly vaccinated Aboriginal people in the Kimberley region of Western Australia.

作者信息

Bangor-Jones Revle D, Dowse Gary K, Giele Carolien M, van Buynder Paul G, Hodge Meredith M, Whitty Mary M

机构信息

WA Department of Health, Perth, WA, Australia.

出版信息

Med J Aust. 2009 Oct 5;191(7):398-401. doi: 10.5694/j.1326-5377.2009.tb02850.x.

Abstract

OBJECTIVE

To describe a prolonged outbreak of mumps in the Kimberley region of Western Australia in 2007-2008.

DESIGN

Descriptive analysis of all mumps cases notified to the WA Notifiable Infectious Diseases Database for the period 1 July 2007 to 30 June 2008.

MAIN OUTCOME MEASURES

Notified cases of mumps by patients' place of residence, age, Indigenous or non-Indigenous ethnicity, vaccination status and method of diagnosis.

RESULTS

84% (153/183) of mumps notifications in WA over the study period occurred in the Kimberley region or were directly linked to Kimberley cases. Median age of patients was 18 years (range, 2-63 years), and 54% of patients were aged less than 20 years. Almost all (92%) were Australian Aboriginal people; 67% (102/153) had received at least one dose of mumps vaccine, and 52% had received two doses. The highest notification rate (1816 cases per 100,000 population) was in the Aboriginal 15-19-years age group, and 92% of these patients had received at least one dose of mumps vaccine. Almost all outbreak cases (94%) were laboratory confirmed. Genotyping was performed on 20 mumps virus isolates: all were genotype J.

CONCLUSION

A prolonged outbreak of mumps occurred in a well defined, highly vaccinated, predominantly young Aboriginal population in the remote Kimberley region of WA. This outbreak raises questions about the effectiveness and scheduling of the current vaccine (which is genotype A-derived), especially for Aboriginal people. Surveillance of circulating mumps virus genotypes and neutralisation studies will help in evaluating the protection provided by the current vaccine against genotypically different strains.

摘要

目的

描述2007 - 2008年西澳大利亚金伯利地区腮腺炎的长期暴发情况。

设计

对2007年7月1日至2008年6月30日期间通报给西澳大利亚法定传染病数据库的所有腮腺炎病例进行描述性分析。

主要观察指标

按患者居住地、年龄、原住民或非原住民种族、疫苗接种状况及诊断方法通报的腮腺炎病例。

结果

在研究期间,西澳大利亚84%(153/183)的腮腺炎通报病例发生在金伯利地区或与金伯利地区的病例直接相关。患者的中位年龄为18岁(范围2 - 63岁),54%的患者年龄小于20岁。几乎所有患者(92%)为澳大利亚原住民;67%(102/153)至少接种过一剂腮腺炎疫苗,52%接种过两剂。最高通报率(每10万人中1816例)出现在15 - 19岁的原住民年龄组,这些患者中92%至少接种过一剂腮腺炎疫苗。几乎所有暴发病例(94%)均经实验室确诊。对20株腮腺炎病毒分离株进行了基因分型:均为J基因型。

结论

在西澳大利亚偏远的金伯利地区,一个明确界定、疫苗接种率高且主要为年轻原住民的人群中发生了腮腺炎的长期暴发。此次暴发引发了关于当前疫苗(源自A基因型)的有效性和接种计划的问题,尤其是对原住民而言。监测流行的腮腺炎病毒基因型及中和研究将有助于评估当前疫苗对基因型不同毒株的保护作用。

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