Tokuda Koichi, Ikarashi Masami, Yamamoto Kumi Ueno, Taya Keiko Tanaka, Nakashima Kazutoshi, Nakanishi Yoshiko, Shima Fumiko, Teranishi Arata, Taniguchi Kiyosu, Okabe Nobuhiko
Field Epidemiology Training Program, National Institute of Infectious Diseases.
Kansenshogaku Zasshi. 2010 Nov;84(6):714-20. doi: 10.11150/kansenshogakuzasshi.84.714.
Epidemiological investigation of a March 2007 detected measles outbreak of 28 cases in a 792-student high school in Tokyo. Students with a vaccination history had significantly milder symptoms than those without, and no cases occurred among students having two of measles vaccine in two doses of measles vaccine in their childhood. Vaccine efficacy (VE) calculated in our investigation was 93.9% (95% CI:87-97), and no significant difference was observed in vaccine type or manufacturer product. Students and parents were extremely difficult to persuade to cooperate in control measures such as emergency vaccination and home isolation through notification letters even during outbreaks. Schools should thus develop measles outbreak preparedness and response plans and identify potentially susceptible students in advance through documented proof of case histories and MCV vaccination. Outbreaks should promote early detection of patients and emergency vaccination targetting potentially susceptible students backed through close cooperation with medical facilities, education institutions, and the public health sector, together with school closures as appropriate.
2007年3月,东京一所拥有792名学生的高中发生了一起28例麻疹疫情的流行病学调查。有疫苗接种史的学生症状明显比没有接种史的学生轻,童年时期接种过两剂麻疹疫苗的学生中没有出现病例。我们调查中计算的疫苗效力(VE)为93.9%(95%CI:87-97),在疫苗类型或制造商产品方面未观察到显著差异。即使在疫情期间,通过通知书说服学生和家长配合紧急接种和居家隔离等控制措施也极其困难。因此,学校应制定麻疹疫情防范和应对计划,并通过病例历史记录和麻疹-风疹联合疫苗(MCV)接种的书面证明提前识别潜在易感学生。疫情应促进患者的早期发现,并通过与医疗机构、教育机构和公共卫生部门密切合作,针对潜在易感学生进行紧急接种,同时酌情关闭学校。