Chiu H H, Lee C Y, Chih T W, Lee P I, Chang L Y, Lin Y J, Hsu C M, Huang L M
Department of Pediatrics, National Taiwan University Hospital, Taipei City, Republic of China.
J Med Virol. 1997 Jan;51(1):32-5.
The incidence of measles declined rapidly in Taiwan after the introduction of the measles vaccine into the routine immunization schedule in 1978. However, an epidemic still occurred every 3-5 years until recently. A nationwide measles-mumps-rubella (MMR) revaccination program for school and preschool children has been in place since 1992 to control the indigenous transmission of measles. In order to understand the current immune status after this recent nationwide revaccination program, we determined the presence of measles IgG antibodies by enzyme-linked immunosorbent assay (ELISA) in 1,281 blood samples from healthy persons aged from 2 months to above 30 years collected between 1993 and 1995, and also in another batch of 90 sera samples from children aged 2 years collected before 1992. The results showed that 1) the measles antibody seropositive rate (36.4%) was lowest in children aged 5-7 months and rose to an unexpectedly high level of 85.8% at the age of 12-14 months, 2) the seropositive rate rose further to between 85.9% and 95.1% after 2 years of age and remained high in adults and pregnant women, and 3) the seropositive rate of the 2-year-old children collected before 1992 was 61.4%, which was significantly lower than the rate of the same age group collected after the nationwide MMR revaccination program. We conclude that the national revaccination program has promoted effectively measles immunity in Taiwan. This immunity explains the rarity of reported measles cases since the last epidemic in 1989. This revaccination program should continue and be extended to all preschool children and young adults so that indigenous measles can be eliminated by the year 2000.
1978年麻疹疫苗被纳入常规免疫计划后，台湾地区麻疹发病率迅速下降。然而，直到最近，仍每3至5年发生一次疫情。自1992年起，台湾实施了一项针对中小学及学龄前儿童的全国性麻疹-腮腺炎-风疹（MMR）再接种计划，以控制麻疹的本土传播。为了解近期全国性再接种计划实施后的当前免疫状况，我们采用酶联免疫吸附测定（ELISA）法，检测了1993年至1995年间采集的1281份年龄从2个月至30岁以上健康人群的血样中的麻疹IgG抗体，同时还检测了1992年前采集的另一组90份2岁儿童血清样本中的抗体。结果显示：1）麻疹抗体血清阳性率在5至7个月龄儿童中最低，为36.4%，在12至14个月龄时升至85.8%这一意外的高水平；2）2岁以后血清阳性率进一步升至85.9%至95.1%之间，并在成年人及孕妇中保持较高水平；3）1992年前采集的2岁儿童血清阳性率为61.4%，显著低于全国MMR再接种计划实施后采集的同年龄组儿童的阳性率。我们得出结论，全国性再接种计划有效地提升了台湾地区的麻疹免疫力。这种免疫力解释了自1989年上次疫情以来报告的麻疹病例为何稀少。该再接种计划应继续实施并扩大至所有学龄前儿童及年轻成年人，以便到2000年消除本土麻疹。
