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麻疹:向前迈进,防止倒退。

Measles: taking steps forward to prevent going backwards.

机构信息

Department of Pediatrics.

General Pediatrics.

出版信息

Curr Opin Pediatr. 2020 Jun;32(3):436-445. doi: 10.1097/MOP.0000000000000895.

Abstract

PURPOSE OF REVIEW

The measles vaccine, first introduced in 1963, directly led to a dramatic decrease in the incidence of the disease. Measles transitioned from being a common childhood disease, affecting approximately three to four million children annually, to being eradicated in the United States in 2000. What was once an astounding victory for modern medicine, however, has recently seen a dramatic reversal in fortune, with a resurgence of measles cases in the United States. Hence, it merits careful discussion.

RECENT FINDINGS

The United States has seen more measles cases in 2019 than in any prior year in the past 30 years. These outbreaks are because of many factors but a significant cause is the increase in vaccine refusal within sub-populations in America. This finding indicates that the current approach that healthcare workers take with families towards MMR vaccination could be more effective.

SUMMARY

This article aims to educate the reader about the measles virus and its clinical presentation, the MMR vaccine and its overwhelming success, and the concerning current national and international trends in measles outbreaks. Importantly, we focus on positions proposed by hesitant vaccinators and determine how medical providers can participate in productive conversation about vaccination to better gain trust and guide improved shared clinical decision-making.

摘要

综述目的:麻疹疫苗于 1963 年问世,它的出现直接导致了麻疹发病率的显著下降。在此之前,麻疹是一种常见的儿童疾病,每年影响约 300 至 400 万儿童,到 2000 年,美国已消灭麻疹。然而,这一曾令现代医学引以为豪的成就,最近却出现了戏剧性的逆转,美国的麻疹病例再次出现。因此,值得我们仔细讨论。

最新发现:2019 年,美国麻疹病例数超过过去 30 年来的任何一年。这些疫情爆发的原因有很多,但一个重要原因是美国部分人群中麻疹疫苗接种率的上升。这一发现表明,医疗工作者目前与家庭就 MMR 疫苗接种进行的接触可能会更加有效。

总结:本文旨在向读者介绍麻疹病毒及其临床表现、MMR 疫苗及其巨大成功,以及目前国际和国内麻疹疫情令人担忧的趋势。重要的是,我们关注犹豫不决的疫苗接种者的立场,并确定医疗服务提供者如何参与关于疫苗接种的建设性对话,以更好地获得信任并指导改进共同的临床决策。

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