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2015年中国既往接种过疫苗的成年医护人员中发生麻疹疫情。

Measles Outbreak among Previously Immunized Adult Healthcare Workers, China, 2015.

作者信息

Zhang Zhengyi, Zhao Yuan, Yang Lili, Lu Changhong, Meng Ying, Guan Xiaoli, An Hongjin, Zhang Meizhong, Guo Wenqin, Shang Bo, Yu Jing

机构信息

Department of General Medicine, Lanzhou University Second Hospital, Gansu 730030, China.

Department of Public Health, Lanzhou University Second Hospital, Gansu 730030, China.

出版信息

Can J Infect Dis Med Microbiol. 2016;2016:1742530. doi: 10.1155/2016/1742530. Epub 2016 Apr 20.

Abstract

Measles is caused by measles virus belonging to genus Morbillivirus of the family Paramyxoviridae. Vaccination has played a critical role in controlling measles infection worldwide. However, in the recent years, outbreaks of measles infection still occur in many developing countries. Here, we report an outbreak of measles among healthcare workers and among the 60 measles infected patients 50 were healthcare workers including doctors, nurses, staff, and medics. Fifty-one patients (85%) tested positive for IgM antibodies against the measles virus and 50 patients (83.3%) tested positive for measles virus RNA. Surprisingly, 73.3% of the infected individuals had been previously immunized against measles. Since there is no infection division in our hospital, the fever clinics are located in the Emergency Division. In addition, the fever and rash were not recognized as measles symptoms at the beginning of the outbreak. These factors result in delay in isolation and early confirmation of the suspected patients and eventually a measles outbreak in the hospital. Our report highlights the importance of following a two-dose measles vaccine program in people including the healthcare workers. In addition, vigilant attention should be paid to medical staff with clinical fever and rash symptoms to avoid a possible nosocomial transmission of measles infection.

摘要

麻疹是由属于副粘病毒科麻疹病毒属的麻疹病毒引起的。疫苗接种在全球控制麻疹感染方面发挥了关键作用。然而,近年来,许多发展中国家仍有麻疹感染疫情爆发。在此,我们报告一起医护人员中发生的麻疹疫情,在60例麻疹感染患者中,有50例是医护人员,包括医生、护士、工作人员和医务人员。51例患者(85%)麻疹病毒IgM抗体检测呈阳性,50例患者(83.3%)麻疹病毒RNA检测呈阳性。令人惊讶的是,73.3%的感染个体此前已接种过麻疹疫苗。由于我们医院没有感染科,发热门诊设在急诊科。此外,在疫情爆发初期,发热和皮疹并未被识别为麻疹症状。这些因素导致疑似患者的隔离和早期确诊延迟,最终导致医院内麻疹爆发。我们的报告强调了对包括医护人员在内的人群实施两剂次麻疹疫苗接种计划的重要性。此外,应密切关注出现临床发热和皮疹症状的医务人员,以避免麻疹感染可能的医院内传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/824c/4904577/fc2da6dd20d2/CJIDMM2016-1742530.001.jpg

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