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发达国家和发展中国家的麻疹疫情持续不断。

Ongoing Measles in the Developed and Developing World.

机构信息

Pediatric Infectious Diseases, David Geffen School of Medicine at UCLA, Mattel Children's Hospital UCLA, Los Angeles, CA.

出版信息

J Pediatric Infect Dis Soc. 2024 Apr 24;13(4):233-236. doi: 10.1093/jpids/piae018.

Abstract

Measles is a vaccine-preventable illness. Nevertheless, in recent years, measles is still endemic and epidemic in both the developed world and the developing world. The public perception of measles in the past was that it was not a big deal. However, measles is associated with a number of complications which can be places in three categories which are: acute(diarrhea, otitis media, pneumonia, encephalitis, seizures, and death) and delayed-subacute sclerosing panencephalitis (SSPE) and post-measles immune amnesia. Contrary to the beliefs of the anti-vaccine lobby, measles is bad. In acute measles, the death rate is 1-3 per 1000 and the risk of encephalitis is 1 per 1000. Relatively recent investigations indicate that SSPE is considerably more common than previously believed. The worldwide contribution of post-measles immune amnesia to morbidity and mortality is likely to be huge. In exposure situations, two doses of measles vaccine will prevent 99% of cases. Presently in the United States, the first dose is given at 12 through 15 months of age. The second dose is most often administered at 4 through 6 years of age. In my opinion, the second dose of measles vaccine should be given 4-6 weeks after the first dose rather than at 4-6 years of age. Children who don't have antibody to measles should not travel to risk areas.

摘要

麻疹是一种可以通过疫苗预防的疾病。然而,近年来,麻疹在发达国家和发展中国家仍然呈地方性和流行性。过去,公众对麻疹的看法是,它没什么大不了的。然而,麻疹与许多并发症有关,可以分为三类:急性(腹泻、中耳炎、肺炎、脑炎、癫痫发作和死亡)、亚急性硬化性全脑炎(SSPE)和麻疹后免疫性遗忘症。与反疫苗游说团体的观点相反,麻疹是很严重的。在急性麻疹中,死亡率为每 1000 人中有 1-3 人,脑炎的风险为每 1000 人中有 1 人。最近的调查表明,SSPE 的发病率比以前认为的要高得多。麻疹后免疫性遗忘症对发病率和死亡率的全球贡献可能是巨大的。在接触情况下,两剂麻疹疫苗将预防 99%的病例。目前在美国,第一剂在 12 至 15 个月大时接种,第二剂通常在 4 至 6 岁时接种。在我看来,第二剂麻疹疫苗应在第一剂后 4-6 周而不是在 4-6 岁时接种。没有麻疹抗体的儿童不应前往疫区旅行。

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