Field Epidemiology Training Program (FETP), National Institute of Infectious Diseases, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Japan.
Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Japan.
Vaccine. 2020 Oct 27;38(46):7278-7283. doi: 10.1016/j.vaccine.2020.09.045. Epub 2020 Oct 2.
On 12 February 2015, a local health department (LHD) in Shizuoka prefecture identified two reported rubella cases in its jurisdiction as employees of the same company. As other employees at the company resided both inside and outside of the health department's jurisdiction, it began collaborating with two additional LHDs and the National Institute of Infectious Diseases to investigate and respond to the outbreak, which subsequently identified cases in two additional companies. We obtained epidemiological, clinical, and outbreak response information from the national epidemiological surveillance of infectious disease system's database, the local health departments, and the associated companies. One specimen for genetic sequencing was collected from each of the three companies. The outbreak included a total of twenty-five cases, with seventeen confirmed and eight probable cases from three companies. Among them, 24 (96%) were male, 22 (88%) were employees of one company (Company X), and none had rubella vaccination history. The median age was 45 years (interquartile range: 40-51). Epidemiological information did not reveal the source of infection nor transmission route. All rubella viruses sequenced from the three specimens were classified into genotype 1E. The nucleotide sequences in the 739 bp-window region were completely identical in two specimens, with only one nucleotide difference in the third specimen. According to phylogenetic analysis, these strains were closely related to the Southeast and East Asian lineage. This rubella outbreak at three companies, ranging in size from small- to medium-size, in Japan occurred among unvaccinated employees aged at least 30 years, most of whom were male. Virologic analyses suggest all cases were infected with the same viral strain imported from Southeast Asia. Similar to these companies, most employees at small- and medium-size businesses in Japan are males with no vaccination history for rubella, which poses a serious risk for associated cases of congenital rubella syndrome (CRS).
2015 年 2 月 12 日，静冈县地方卫生局（LHD）在其管辖范围内发现两例报告的风疹病例，均为同一家公司的员工。由于公司的其他员工居住在卫生部门管辖范围内外，因此它开始与另外两个 LHD 和国家传染病研究所合作，对该疫情进行调查和应对，随后又在另外两家公司发现了病例。我们从国家传染病监测系统数据库、地方卫生局和相关公司获得了流行病学、临床和疫情应对信息。从三家公司中的每一家都采集了一份用于基因测序的标本。该疫情共涉及 25 例病例，其中三家公司的确诊病例 17 例，可能病例 8 例。其中，24 例（96%）为男性，22 例（88%）为一家公司（公司 X）的员工，且均无风疹疫苗接种史。中位年龄为 45 岁（四分位间距：40-51）。流行病学信息未揭示感染源和传播途径。从三个标本中测序的所有风疹病毒均被归类为基因型 1E。两个标本中 739bp 窗口区域的核苷酸序列完全相同，第三个标本中仅有一个核苷酸差异。根据系统发育分析，这些毒株与东南亚和东亚谱系密切相关。日本三家规模不一的公司爆发了此次风疹疫情，受感染者均为未接种疫苗、年龄至少 30 岁的员工，其中大多数为男性。病毒学分析表明，所有病例均感染了从东南亚输入的同一病毒株。与这些公司类似，日本大多数中小企业的员工均为男性，没有风疹疫苗接种史，这对相关先天性风疹综合征（CRS）病例构成严重威胁。
