Matter H C, Cloetta J, Zimmermann H
Division of Epidemiology and Infectious Diseases, Federal Office of Public Health, Berne, Switzerland.
J Epidemiol Community Health. 1995 Aug;49 Suppl 1(Suppl 1):4-8. doi: 10.1136/jech.49.suppl_1.4.
Since 1986, the national sentinel network in Switzerland (Sentinella) has collected reports of measles, mumps, and rubella cases in order to evaluate the impact of the Swiss MMR vaccination campaign (started in 1987) on disease frequency.
Passive surveillance of clinical measles, mumps, and rubella cases through a voluntary physician based sentinel network in Switzerland.
Each year between June 1986 and May 1994, 150 to 200 general practitioners, specialists in internal medicine, and paediatricians in private practice covering the whole country have reported weekly numbers of consultations.
Every patient who fulfilled the case definition and consulted a physician participating in the Sentinella network was reported.
Since 1986, the annual number of reported measles cases per physician has fallen--from 1.3 (95% confidence interval (CI) 1.11, 1.50) in 1986-87 to 0.4 (95% CI 0.30, 0.50) in 1993-94. A decreasing trend, although less pronounced, was also observed for rubella. An initial decrease in mumps cases was reported--from 1.8 (95% CI 1.57, 2.03) annually reported cases per physician in 1986-87 to 0.7 (95% CI 0.55, 0.83) in 1989-90. This was followed, however, by a net and sustained increase. In 1993-94, the mean annual number of reported mumps cases per practitioner reached 4.7 (95% CI 4.34, 5.01) which was the highest level since surveillance had started. Over the whole eight year period, reported mumps cases, in terms of the percentage of consultations, were four times more frequent in the French speaking part of Switzerland than in the rest of the country. The proportion of mumps cases in people reported to have been vaccinated also increased--from 10% in 1986-87 to 60% in 1993-94.
Reductions in cases of measles and rubella but an appreciable increase in mumps cases have been observed in the past three years in Switzerland. This findings, combined with increasing vaccination coverage and the fact that 60% of mumps cases are reported in vaccinated people, suggests that the overall efficacy of the mumps vaccines used in Switzerland is probably below 80%. Under these conditions the goal of eliminating mumps will probably not be reached. Further studies are needed to evaluate the efficacy of the different mumps vaccines used.
自1986年以来，瑞士全国哨点监测网络（Sentinella）收集麻疹、腮腺炎和风疹病例报告，以评估瑞士MMR疫苗接种计划（始于1987年）对疾病发病率的影响。
通过瑞士一个基于自愿参与的医生的哨点网络对临床麻疹、腮腺炎和风疹病例进行被动监测。
在1986年6月至1994年5月期间，每年有150至200名覆盖全国的全科医生、内科专科医生和私人执业儿科医生每周报告会诊人数。
每一位符合病例定义并咨询参与Sentinella网络医生的患者均被报告。
自1986年以来，每位医生报告的麻疹病例年数有所下降——从1986 - 1987年的1.3例（95%置信区间（CI）1.11，1.50）降至1993 - 1994年的0.4例（95% CI 0.30，0.50）。风疹病例也观察到下降趋势，尽管不太明显。腮腺炎病例最初有所下降——从1986 - 1987年每位医生每年报告1.8例（95% CI 1.57，2.03）降至1989 - 1990年的0.7例（95% CI 0.55，0.83）。然而，随后出现了净增长且持续上升。在1993 - 1994年，每位从业者报告的腮腺炎病例年平均数达到4.7例（95% CI 4.34，5.01），这是监测开始以来的最高水平。在整个八年期间，就会诊百分比而言，瑞士法语区报告的腮腺炎病例比该国其他地区多四倍。报告中已接种疫苗人群中腮腺炎病例的比例也有所增加——从1986 - 1987年的10%增至1993 - 1994年的60%。
过去三年在瑞士观察到麻疹和风疹病例减少，但腮腺炎病例明显增加。这一发现，再加上疫苗接种覆盖率的提高以及60%的腮腺炎病例报告来自已接种疫苗人群，表明瑞士使用的腮腺炎疫苗总体效力可能低于80%。在这种情况下，消除腮腺炎的目标可能无法实现。需要进一步研究来评估所使用的不同腮腺炎疫苗的效力。
