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成人麻疹。免疫接种的意外后果?

Measles in adults. An unforeseen consequence of immunization?

作者信息

Rand K H, Emmons R W, Merigan T C

出版信息

JAMA. 1976 Aug 30;236(9):1028-31. doi: 10.1001/jama.236.9.1028.

Abstract

An outbreak of measles occurred in California in the first half of 1975, especially in the San Francisco Bay area. Of four adult patients with complicated cases, two were receiving immunosuppressive chemotherapy, and both died from a giant-cell pneumonia. The clinical presentation in such cases may be atypical, and special viral isolation and immunofluorescent techniques may be diagnostically helpful. A significant (P less than .0005) trend toward the occurrence of measles in adolescents was observed in this epidemic, which may also occur in future epidemics elsewhere. With wide spread but incomplete immunization, it is possible for the nonimmunized to reach adulthood without acquiring natural infection. As a result, internists as well as pediatricians will have to consider the possibility of measles and be aware of its serious potential in the immunosuppressed patient.

摘要

1975年上半年,加利福尼亚州爆发了麻疹疫情,尤其是在旧金山湾区。在4例患有复杂病例的成年患者中,有2例正在接受免疫抑制化疗,且均死于巨细胞肺炎。此类病例的临床表现可能不典型,特殊的病毒分离和免疫荧光技术可能有助于诊断。在此次疫情中,观察到青少年中麻疹发病有显著(P小于0.0005)趋势,未来其他地方的疫情中也可能出现这种情况。由于免疫接种广泛但不完全,未接种疫苗的人有可能在未获得自然感染的情况下成年。因此,内科医生以及儿科医生都必须考虑麻疹的可能性,并意识到其在免疫抑制患者中的严重潜在风险。

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