Samb B, Aaby P, Whittle H C, Seck A M, Rahman S, Bennett J, Markowitz L, Simondon F
Unité de Recherche sur les Maladies Infectieuses et Parasitaires, ORSTOM, Dakar, Senegal.
Pediatr Infect Dis J. 1995 Mar;14(3):203-9. doi: 10.1097/00006454-199503000-00007.
During a measles vaccine trial in a rural area of Senegal, antibody status was examined within 10 days of exposure for 228 previously vaccinated and 313 unvaccinated children more than 12 months old who were exposed to measles at home. Thirty-six percent of the children developed clinical measles, the clinical diagnosis being confirmed for 135 of the 137 children from whom 2 blood samples were collected. Vaccine efficacy was 90% (95% confidence interval, 83 to 94%). The hemagglutinin-inhibiting antibodies (HI) or plaque neutralizing antibodies (PN) assays were equally efficient in predicting susceptibility and protection against measles. Vaccinated children who had no detectable HI or PN antibodies at exposure had significant protection against measles compared with seronegative unvaccinated children (HI vaccine efficacy, 49% (95% confidence interval, 21 to 68%); PN vaccine efficacy, 43% (95% confidence interval, 12 to 62%)). The attack rate was high for children with a titer of 40 to 125 mIU) 67% (4 of 6) of those with a positive hemagglutinin-inhibiting antibody test and 36% (13 of 36) of those with a positive PN test developed measles. Attack rates among children with HI or PN titers above 125 mIU were 2% (6 of 295) and 3% (7 of 258), respectively. Because titers of < or = 120 mIU have been found to offer little protection in another study, this antibody level may be the best screening value for assessing susceptibility and protection against measles. However, it should be noted that many seronegative vaccinated children are protected against measles infection.
在塞内加尔一个农村地区进行的麻疹疫苗试验中，对228名先前接种过疫苗以及313名未接种疫苗、年龄超过12个月且在家中接触过麻疹的儿童，在接触后10天内检查了抗体状态。36%的儿童出现了临床麻疹，从137名采集了两份血样的儿童中，有135名儿童的临床诊断得到确认。疫苗效力为90%（95%置信区间为83%至94%）。血凝抑制抗体（HI）或蚀斑中和抗体（PN）检测在预测对麻疹的易感性和保护性方面同样有效。与血清阴性的未接种疫苗儿童相比，接触时未检测到HI或PN抗体的接种疫苗儿童对麻疹有显著的保护作用（HI疫苗效力为49%（95%置信区间为21%至68%）；PN疫苗效力为43%（95%置信区间为12%至62%））。滴度为40至125 mIU的儿童发病率很高（血凝抑制抗体检测呈阳性的儿童中有67%（6例中的4例）、PN检测呈阳性的儿童中有36%（36例中的13例）患了麻疹）。HI或PN滴度高于125 mIU的儿童发病率分别为2%（295例中的6例）和3%（258例中的7例）。由于在另一项研究中发现滴度≤120 mIU几乎没有保护作用，该抗体水平可能是评估对麻疹的易感性和保护性的最佳筛查值。然而，应当指出的是，许多血清阴性的接种疫苗儿童对麻疹感染具有抵抗力。
