Núcleo de Medicina Tropical, Universidade de Brasília, Brasília, DF, Brasil.
Rev Soc Bras Med Trop. 2013 Mar-Apr;46(2):166-71. doi: 10.1590/0037-8682-0007-2012.
The yellow fever epidemic that occurred in 1972/73 in Central Brazil surprised the majority of the population unprotected. A clinical-epidemiological survey conducted at that time in the rural area of 19 municipalities found that the highest (13.8%) number of disease cases were present in the municipality of Luziânia, State of Goiás.
Thirty-eight years later, a new seroepidemiological survey was conducted with the aim of assessing the degree of immune protection of the rural population of Luziânia, following the continuous attempts of public health services to obtain vaccination coverage in the region. A total of 383 volunteers, aged between 5 and 89 years and with predominant rural labor activities (75.5%), were interviewed. The presence of antibodies against the yellow fever was also investigated in these individuals, by using plaque reduction neutralization test, and correlated to information regarding residency, occupation, epidemiological data and immunity against the yellow fever virus.
We found a high (97.6%) frequency of protective titers (>1:10) of neutralizing antibodies against the yellow fever virus; the frequency of titers of 1:640 or higher was 23.2%, indicating wide immune protection against the disease in the study population. The presence of protective immunity was correlated to increasing age.
This study reinforces the importance of surveys to address the immune state of a population at risk for yellow fever infection and to the surveillance of actions to control the disease in endemic areas.
1972/73 年在巴西中部发生的黄热病疫情令大多数未受保护的民众感到意外。当时在 19 个城市的农村地区进行的临床流行病学调查发现,疾病发病率最高(13.8%)的是戈亚斯州的卢济亚尼亚市。
38 年后,为了评估卢济亚尼亚农村人口的免疫保护程度,在公共卫生服务部门不断试图在该地区获得疫苗接种覆盖率的情况下,开展了一项新的血清流行病学调查。共对 383 名年龄在 5 至 89 岁之间、以农村劳动活动为主(75.5%)的志愿者进行了访谈。还通过蚀斑减少中和试验调查了这些个体中针对黄热病的抗体的存在情况,并将其与有关居住地点、职业、流行病学数据和对黄热病病毒的免疫力的信息相关联。
我们发现针对黄热病病毒的中和抗体保护性滴度(>1:10)的高频率(97.6%);滴度为 1:640 或更高的频率为 23.2%,表明研究人群对该病具有广泛的免疫保护。保护性免疫的存在与年龄的增长有关。
这项研究强调了调查的重要性,以确定易感染黄热病的人群的免疫状态,并监测控制流行地区疾病的行动。