Sabin A B
Am J Clin Pathol. 1978 Jul;70(1 Suppl):114-27.
The present measles problem in the United States, an estimated 918,500 cases in 1977, is attributed to the failure of the 14-year vaccination program to immunize enough children to prevent continued circulation of the virus and recurrent outbreaks. A new strategy for rapidly overcoming this problem is recommended. There appears to be no current congenital rubella syndrome problem against which the rubella vaccination program in the United States is directed. However, the continued annual infection of an estimated two million children conceivably could again bring fourth a rubella virus with a greater capacity for producing congenital rubella syndrome, and a modification of the present program is recommended. About 80 to 90% of the annual 60-70 million cases of severe enough to confine the victim to bed influenza are not caused by the influenza viruses. Except for the few thousand additional deaths directly attributed to influenza A virus during the epidemic years, mortality rates for pneumonia, heart diseases, chronic bronchopulmonary diseases, and other former "high-risk" conditions have continued to decrease in recent years, and have not risen during the 12-month periods of epidemic years. A re-evaluation of the current influenza vaccination policy is recommended. Prospects for hepatitis B and varicella-zoster vaccines are discussed.
美国目前的麻疹问题，1977年估计有918,500例病例，归因于长达14年的疫苗接种计划未能使足够多的儿童获得免疫，从而无法阻止病毒的持续传播和反复爆发。建议采取一项迅速克服这一问题的新策略。目前美国风疹疫苗接种计划所针对的似乎不存在先天性风疹综合征问题。然而，据估计每年仍有200万儿童受到感染，这可能会再次产生一种更易引发先天性风疹综合征的风疹病毒，因此建议对现行计划进行调整。每年6000万至7000万例严重到足以使患者卧床的流感病例中，约80%至90%并非由流感病毒引起。除了在流行年份直接归因于甲型流感病毒的数千例额外死亡外，近年来肺炎、心脏病、慢性支气管肺部疾病及其他以往“高危”疾病的死亡率持续下降，在流行年份的12个月期间也未上升。建议对现行流感疫苗接种政策进行重新评估。文中还讨论了乙肝疫苗和水痘-带状疱疹疫苗的前景。
