Xu Q, Xiong P, Fang X Q, Liu X D, Wang C Y, Song L Z, Xu A Q
Division of Expanded Immunization Program, Shandong Province Center for Disease Control and Prevention, Ji'nan 250014, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2018 Mar 6;52(3):265-270. doi: 10.3760/cma.j.issn.0253-9624.2018.03.009.
To evaluate the effectiveness of mumps prevention and control after implementation of two doses mumps-containing combined vaccine (MuCV) policy by analyzing epidemiological characteristics of mumps and mumps antibody levels in general population. We obtained data on cases of mumps reported during 2004-2015 from National Notifiable Diseases Reporting System (NNDRS). Descriptive analysis methods were used to describe the epidemiological characteristics of mumps during 2004-2015. MuCV immunization information from 2005 to 2015 was obtained from the immunization information management system in Shandong Province. Antibody data of mumps in healthy people were from a cross-sectional survey according to the principle of stratified random sampling from 0 to 60 years old healthy people in 2015. Commercial ELISA kits were used to detect and quantify human IgG antibodies against mumps virus in sera, and the results were analyzed statistically. The average incidence of mumps from 2004 to 2015 was 11.43/100 000 in Shandong. The incidence of mumps in the central region (14.64/100 000) was higher than that in the eastern and western regions (11.14/100 000, 11.33/100 000). The incidence of mumps was still high in 2009-2013 (stage of one-dose MuCV free, 16.07/100 000) with the highest incidence of 25.33/100 000 and 24.45/100 000 occurred in 2012 and 2013 and the cases were mainly 6 to 9 years old group (172.67/100 000). Since the second dose MuCV was introduced into NIP for 6 years old children in May 2013 in Shandong, the incidence of mump decreased significantly in 2014-2015 (7.81/100 000), especially in children of 6-8 years old who were vaccinated with two doses of MuCV (2009-2013 was 114.02/100 000; 2014-2015 was 45.66/100 000) and lower than 3-5 years old vaccinated one doses of MuCV. A total of 1 785 serum samples were collected from the healthy population, the average seroprevalence was 80.62% and Geometric Mean Concentration (GMC) was 38.11 IU/ml (95: 37.03-39.19 IU/ml) . There was no significant difference about seroprevalence in different regions, while the GMC in middle region was significantly higher compared to east and west region. The prevalence and GMC in children aged 19 months-2 years and 3-5 years old who received one dose of MuCV were significantly higher than those of <19 months old children. The GMC (46.88 IU/ml, 95 39.43-55.74 IU/ml) in children aged 6-9 years old who received the two doses MuCV was significantly higher than that of aged 3-5 years old children (31.71 IU/ml, 95 27.23-36.93 IU/ml). The incidence of mumps in Shandong was still at a high level in spite of coverage one doses MuCV to children. Compared with the period of the 1 dose MuCV immunization strategy, the incidence the groups coverage two doses MuCV was significantly reduced and lower the groups coverage one dose MuCV, but the prevalence and GMC were higher than that of the groups coverage one dose MuCV.
通过分析流行性腮腺炎(以下简称“腮腺炎”)的流行病学特征及人群中腮腺炎抗体水平,评估在实施含腮腺炎联合疫苗(MuCV)两剂次接种策略后腮腺炎的防控效果。我们从国家法定传染病报告系统(NNDRS)获取了2004 - 2015年期间报告的腮腺炎病例数据,采用描述性分析方法描述2004 - 2015年腮腺炎的流行病学特征。2005 - 2015年的MuCV免疫信息来自山东省免疫信息管理系统。2015年按照分层随机抽样原则,从0至60岁健康人群中进行横断面调查获取健康人群的腮腺炎抗体数据,使用商用ELISA试剂盒检测并定量血清中抗腮腺炎病毒的人IgG抗体,并对结果进行统计学分析。2004 - 2015年山东省腮腺炎平均发病率为11.43/10万。中部地区腮腺炎发病率(14.64/10万)高于东部和西部地区(11.14/10万、11.33/10万)。2009 - 2013年(单剂次MuCV免费接种阶段)腮腺炎发病率仍较高(16.07/10万),2012年和2013年发病率最高,分别为25.33/10万和24.45/10万,病例主要集中在6至9岁组(172.67/10万)。自2013年5月山东省将MuCV第二剂次纳入国家免疫规划(NIP)用于6岁儿童后,2014 - 2015年腮腺炎发病率显著下降(7.81/10万),尤其是接种两剂次MuCV的6 - 8岁儿童(2009 - 2013年为114.02/10万;2014 - 2015年为45.66/10万),且低于接种一剂次MuCV的3 - 5岁儿童。共采集1785份健康人群血清样本,平均血清阳性率为80.62%,几何平均浓度(GMC)为38.11 IU/ml(95%可信区间:37.03 - 39.19 IU/ml)。不同地区血清阳性率无显著差异,但中部地区GMC显著高于东部和西部地区。接种一剂次MuCV的19个月至2岁及3 - 5岁儿童的血清阳性率和GMC显著高于<19个月龄儿童。接种两剂次MuCV的6 - 9岁儿童的GMC(46.88 IU/ml,95%可信区间:39.43 - 55.74 IU/ml)显著高于3 - 5岁儿童(31.71 IU/ml,95%可信区间:27.23 - 36.93 IU/ml)。尽管对儿童实施了一剂次MuCV接种,但山东省腮腺炎发病率仍处于较高水平。与单剂次MuCV免疫策略时期相比,接种两剂次MuCV组的发病率显著降低且低于接种一剂次MuCV组,但血清阳性率和GMC高于接种一剂次MuCV组。