Immunization Unit, Robert Koch Institute, Seestr. 10, 13353 Berlin, Germany.
National Reference Centre Measles, Mumps, Rubella, Robert Koch Institute, Seestr. 10, 13353 Berlin, Germany.
Vaccine. 2018 Dec 18;36(52):7916-7922. doi: 10.1016/j.vaccine.2018.10.070. Epub 2018 Nov 23.
Passive immunisation with immunoglobulins as post-exposure prophylaxis after contact with measles is recommended by the German Standing Committee on Vaccination (STIKO) particularly for unprotected individuals at high risk of complications for whom active immunization is contraindicated, such as infants <6 months of age, immunocompromised patients and pregnant women. The efficacy of passive immunisation in preventing measles depends on how soon after exposure it is administered, the concentration of measles antibodies in the immunoglobulin products and dosage. Since the global introduction of standard active immunisation against measles and the concomitant reduction in virus circulation, the levels of measles virus (MV)-specific IgG antibodies in the population have dropped. Thus, the concentration of MV-specific antibodies in immunoglobulin products derived from human plasma donors has declined as the proportion of vaccinated donors has increased. The MV-neutralizing capacity of immunoglobulin products is not routinely tested in Germany. No official data exist on the concentrations of MV-specific IgG antibodies in individual batches of immunoglobulins available in Germany and the required minimum level for MV-specific IgG is not stipulated. The STIKO re-evaluated available data and measurements of MV-neutralizing capacities of available immunoglobulin (IgG) products in Germany at the National Reference Centre Measles, Mumps, Rubella at the Robert Koch Institute. Based on the findings, STIKO modified its previous recommendations on the post-exposure use of immunoglobulins (2001), especially with respect to risk groups, application and dosage. STIKO now recommends a single intravenous administration of immunoglobulins (400 mg/kg body weight) as soon as possible, preferably within six days, after exposure to measles, specifically for infants aged <6 months, susceptible pregnant women and immunocompromised patients.
德国疫苗常设委员会（STIKO）推荐在接触麻疹后使用免疫球蛋白进行被动免疫，作为暴露后的预防措施，尤其适用于有并发症高风险但不宜主动免疫的未受保护人群，如<6 个月龄的婴儿、免疫功能低下的患者和孕妇。被动免疫预防麻疹的效果取决于接触后多久给予免疫球蛋白、免疫球蛋白产品中麻疹抗体的浓度和剂量。自从全球引入针对麻疹的标准主动免疫以及病毒传播的相应减少，人群中麻疹病毒（MV）特异性 IgG 抗体的水平已经下降。因此，随着接种供体比例的增加，从人血浆供体中获得的免疫球蛋白产品中 MV 特异性抗体的浓度已经下降。德国没有常规测试免疫球蛋白产品的 MV 中和能力。德国尚无关于个人批次免疫球蛋白中 MV 特异性 IgG 抗体浓度的官方数据，也没有规定 MV 特异性 IgG 的最低要求。STIKO 在罗伯特·科赫研究所国家麻疹、腮腺炎、风疹参考中心重新评估了现有的数据和可用于德国的 MV 中和能力的现有免疫球蛋白（IgG）产品的测量值。根据这些发现，STIKO 修改了其先前关于暴露后使用免疫球蛋白（2001 年）的建议，特别是针对风险群体、应用和剂量。STIKO 现在建议在接触麻疹后尽快（最好在 6 天内），单次静脉内给予免疫球蛋白（400mg/kg 体重），特别是<6 个月龄的婴儿、易感孕妇和免疫功能低下的患者。
