Gay N, Ramsay M, Cohen B, Hesketh L, Morgan-Capner P, Brown D, Miller E
Immunisation Division, PHLS Communicable Disease Surveillance Centre, London.
Commun Dis Rep CDR Rev. 1997 Feb 7;7(2):R17-21.
The incidence of measles in England and Wales has fallen since the national vaccination campaign in November 1994, in which 92% of children aged 5 to 16 years were vaccinated. A total of 148 confirmed cases with onsets in the 18 months from January 1995 to June 1996 have been ascertained. Notified cases did not provide a reliable measure of incidence: 11,343 suspected cases were notified in the same period, 6426 (57%) of whom were tested for salivary antibody. Only 90 (1.4%) of cases tested were confirmed. Many confirmed cases occurred in small clusters; 12 imported cases were identified. The pattern of small, local clusters is what would be expected from the introduction of imported cases into a population with herd immunity. Serological surveillance showed that the campaign produced a significant fall in the proportion of 5 to 16 year old children with low levels of measles antibody: the proportion with levels < 50 mIU/ml fell from 8.4% to 2.1%; the proportion with levels < 100 mIU/ml fell from 15.7% to 6.6%. About 15% of 2 to 4 year old children had antibody levels < 100 mIU/ml before and after the campaign. The addition of a routine second dose of measles vaccine (as measles, mumps, and rubella vaccine) to the vaccination schedule will provide another opportunity to immunise these children before they start school. The two dose vaccination programme should maintain the herd immunity of the population and the elimination of endemic measles transmission.
自1994年11月在英格兰和威尔士开展全国性疫苗接种运动以来，麻疹发病率有所下降，在该运动中，92%的5至16岁儿童接种了疫苗。已查明在1995年1月至1996年6月的18个月内共有148例确诊病例发病。报告病例并不能可靠地衡量发病率：同期报告了11343例疑似病例，其中6426例（57%）进行了唾液抗体检测。检测的病例中只有90例（1.4%）得到确诊。许多确诊病例呈小范围聚集性发生；确认了12例输入性病例。小规模的局部聚集模式是将输入性病例引入具有群体免疫的人群中所预期的。血清学监测表明，该运动使麻疹抗体水平较低的5至16岁儿童比例大幅下降：抗体水平<50 mIU/ml的比例从8.4%降至2.1%；抗体水平<100 mIU/ml的比例从15.7%降至6.6%。在运动前后，约15%的2至4岁儿童抗体水平<100 mIU/ml。在疫苗接种计划中增加一剂常规的第二剂麻疹疫苗（作为麻疹、腮腺炎和风疹疫苗）将为这些儿童在入学前提供另一次免疫机会。两剂疫苗接种计划应能维持人群的群体免疫并消除地方性麻疹传播。
