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医学生报告病例后水痘和乙型肝炎感染的血清学监测以及既往水痘病史与免疫状态之间的关系。

Serosurveillance of varicella and hepatitis B infection after reported cases in medical students and the relationship between past varicella disease history and immunity status.

作者信息

Suwanpakdee Detchvijitr, Laohapand Chalida, Moolasart Visal, Lomtong Prasong, Krairojananan Nat, Srisawat Phutsapong, Watanaveeradej Veerachai

机构信息

Department of Pediatrics, Phramongkutklao Hospital, Bangkok, Thailand.

出版信息

J Med Assoc Thai. 2012 May;95 Suppl 5:S80-5.

Abstract

OBJECTIVE

To identify seroprevalence of varicella and the relationship with their histories of experiences of varicella diseases and to provide appropriate immunization against varicella, mumps, measles, rubella and hepatitis B to medical students.

MATERIAL AND METHOD

All of the medical students were eligible for participation after informed consents. Immunization history against varicella, mumps, measles, rubella (MMR) and hepatitis B were obtained from a questionnaire. A blood sample was obtained from each student for IgG antibody against VZV by ELISA. Medical students with an uncertain history or no documentation of hepatitis B vaccination were tested for HBsAg and anti-HBcIgG by ELISA.

RESULTS

There were 383 medical students enrolled. The mean age at enrollment was 21.6 years (median 21.4 years; range 18-25.8 years). Of 383 medical students, 372 (97.2%) had documents of receiving MMR immunizations. The blood samples were obtained from 374 of 383 (97.6%) medical students to identify the immunity against varicella zoster virus (VZV) and the seroprevalence rate was 92%. Using VZVIgG antibody detection as a standard test, history of experience of varicella disease provided positive predictive value of 99.3% (148/149). Of 383 medical students, 277 (72.3%) were tested for hepatitis B markers and 243 (87.7%) students showed negative results. The prevalence of HBsAg carriers was 0.01% (4/383).

CONCLUSION

Suboptimal immunities against vaccine preventable diseases could be demonstrated in the medical students including varicella and hepatitis B. New recommendations of immunizations against varicella, MMR and hepatitis B viruses for a particular group of the population were provided.

摘要

目的

确定水痘的血清流行率及其与水痘病史的关系,并为医学生提供针对水痘、腮腺炎、麻疹、风疹和乙型肝炎的适当免疫接种。

材料与方法

所有医学生在获得知情同意后均有资格参与。通过问卷调查获取水痘、腮腺炎、麻疹、风疹(MMR)和乙型肝炎的免疫接种史。从每位学生采集血液样本,采用酶联免疫吸附测定法(ELISA)检测抗水痘带状疱疹病毒(VZV)的IgG抗体。对病史不确定或无乙肝疫苗接种记录的医学生,采用ELISA检测HBsAg和抗-HBcIgG。

结果

共纳入383名医学生。入学时的平均年龄为21.6岁(中位数21.4岁;范围18 - 25.8岁)。383名医学生中,372名(97.2%)有MMR免疫接种记录。从383名中的374名(97.6%)医学生采集了血液样本,以确定对水痘带状疱疹病毒(VZV)的免疫力,血清流行率为92%。以VZV IgG抗体检测作为标准检测方法,水痘病史的阳性预测值为99.3%(148/149)。383名医学生中,277名(72.3%)接受了乙肝标志物检测,243名(87.7%)学生结果为阴性。HBsAg携带者的患病率为0.01%(4/383)。

结论

医学生中对疫苗可预防疾病的免疫力欠佳,包括水痘和乙型肝炎。针对特定人群提供了关于水痘、MMR和乙型肝炎病毒免疫接种的新建议。

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