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Association between an Incomplete Vaccination Schedule and Nosocomial Sepsis among Children with Cancer 不完整的疫苗接种计划与癌症儿童院内败血症的关系
Pub Date : 2013-02-22 DOI: 10.4236/WJV.2013.31002
J. Reyna-Figueroa, Diana PerezPeña-Rosas, Patricia Galindo-Delgado, A. E. Limón-Rojas, V. Madrid-Marina
Background: Patients with cancer constitute a special group where immunization programs are often interrupted to begin treatment with chemotherapy. Sepsis is one of the main complications in this group. Methods: A hospital-based case-control study matched by age was carried out among subjects ≤ 9 years of age with cancer diagnosis. Children with cancer without sepsis and children with surgical pathology were included as controls; children with sepsis were included as cases. A bivariate logistic regression was used to determine the factors associated to nosocomial sepsis, and odds ratios were calculated with 95% confidence intervals. The percentage of attributable risk was calculated for the variables included in the final model. Results: Nineteen children with cancer and sepsis and 83 controls were included. Twelve (44%) caseshad an incomplete vaccination schedule according to their age. The association force between incomplete schedule and sepsis was 10.1 (95% CI, 3 - 36; p Conclusions: Approximately, 20% to 65% of the cases of serious nosocomial infection can be associated to an incomplete vaccination schedule. Strategies should be implemented to improve the general pediatric population’s vaccination status before a serious disease, such as cancer or another chronic condition preventing the application of vaccines, develops.
背景:癌症患者是一个特殊的群体,他们的免疫计划经常中断,开始化疗。脓毒症是该组的主要并发症之一。方法:以医院为基础的病例对照研究,在年龄≤9岁的诊断为癌症的受试者中进行年龄匹配。无脓毒症的癌症患儿和有手术病理的患儿作为对照;脓毒症患儿作为病例。采用双变量logistic回归确定院内败血症相关因素,并以95%置信区间计算优势比。对最终模型中包含的变量计算归因风险的百分比。结果:纳入19例癌症合并脓毒症患儿和83例对照组。根据年龄,12例(44%)的疫苗接种计划不完整。时间表不全与脓毒症的相关性为10.1 (95% CI, 3 - 36;结论:大约20%至65%的严重医院感染病例可能与不完整的疫苗接种计划有关。应实施各项战略,在出现严重疾病(如癌症或其他妨碍疫苗应用的慢性疾病)之前,改善一般儿科人口的疫苗接种状况。
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引用次数: 4
Vaccines in Non-Small Cell Lung Cancer 非小细胞肺癌的疫苗研究
Pub Date : 2013-02-22 DOI: 10.4236/WJV.2013.31004
L. Corrales-Rodríguez, N. Blais, D. Soulières
Immunotherapy as an option of treatment in cancer has experienced an important development with the inclusion of vaccines. In lung cancer this type of treatment has emerged and vaccines can be classified in three groups: antigen-specific vaccines, tumor cell vaccines, and dendritic cell vaccines. Emepepimut (L-BLP25) and MAGE-A3 have been the vaccines most widely studied. Their promising results with benefit in survival and limited toxicity in preclinical and clinical trials have led to phase III trials with results eagerly awaited. Other vaccines have been investigated, but results were not favorable or are still pending. Hopefully, vaccines could be an additional instrument for the treatment of lung cancer in the adjuvant or metastatic setting as time will unveil the results of current and future trials.
随着疫苗的加入,免疫疗法作为癌症治疗的一种选择经历了重要的发展。在肺癌中已经出现了这种类型的治疗,疫苗可分为三组:抗原特异性疫苗、肿瘤细胞疫苗和树突状细胞疫苗。empepimut (L-BLP25)和MAGE-A3是研究最广泛的疫苗。它们在临床前和临床试验中有希望的结果,有利于生存和有限的毒性,已经导致了III期试验,结果迫切等待。其他疫苗也进行了研究,但结果并不乐观,或仍在等待结果。随着时间的推移,目前和未来的试验结果将会揭晓,疫苗有望成为辅助或转移性肺癌治疗的额外工具。
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引用次数: 1
High-Dose Intra-Dermal Hepatitis B Vaccine in a Liver Transplant Patient Who Failed Prior Intramuscular Vaccination: A Brief Case Report 先前肌肉注射疫苗失败的肝移植患者皮下注射高剂量乙型肝炎疫苗:一个简短的病例报告
Pub Date : 2013-02-22 DOI: 10.4236/WJV.2013.31003
S. Dhillon, K. Sampath, C. Moore, A. Dosanjh, D. Thiel
Hepatitis B virus (HBV) chronic infection represents a significant cause of morbidity and mortality worldwide. While traditional intramuscular (IM) HBV vaccination is an excellent method for robust and sustained seroconversion in healthy individuals, its efficacy in chronic liver disease is sub-optimal and scant data exists in the post-liver transplant state. Importantly, HBV complications are even more severe in these same immunocompromised populations. Intra-dermal (ID) vaccination has shown initial promise as a successful alternative to achieving HBV seroconversion in patients refractory to standard vaccination protocols. Herein is a case report of a 61 year-old female who underwent liver transplantation for chronic HBV infection and achieved HBsAg seroconversion with a robust HSsAb titer with ID vaccination after having failed both standard and double dose IM vaccination.
乙型肝炎病毒(HBV)慢性感染是世界范围内发病率和死亡率的重要原因。虽然传统的肌肉注射(IM) HBV疫苗接种是健康个体稳健和持续血清转化的一种极好的方法,但其在慢性肝病中的疗效并不理想,并且在肝移植后状态下存在缺乏数据。重要的是,在这些免疫功能低下的人群中,HBV并发症甚至更为严重。皮内(ID)疫苗接种已经显示出初步的希望,作为一种成功的替代方法,可以在对标准疫苗接种方案难治性的患者中实现HBV血清转化。本文报告一例61岁女性因慢性HBV感染接受肝移植,在接种标准剂量和双剂量IM疫苗失败后,接种ID疫苗后HBsAg血清转化为HSsAb滴度高。
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引用次数: 1
Montanide TM Gel01 ST Adjuvant Enhances PRRS Modified Live Vaccine Efficacy by Regulating Porcine Humoral and Cellular Immune Responses Montanide TM Gel01 ST佐剂通过调节猪体液和细胞免疫反应增强PRRS修饰活疫苗的效力
Pub Date : 2013-02-22 DOI: 10.4236/WJV.2013.31001
Xiangdong Li, A. Galliher-Beckley, J. Nietfeld, K. Faaberg, Jishu Shi
Porcine reproductive and respiratory syndrome (PRRS) is a devastating disease caused by the PRRS virus. The MontanideTM class of flexible polymeric adjuvants has recently been shown to enhance protective immunity against PRRSV infection in piglets when used in combination with PRRS modified live vaccines (MLV). In this study, we explored the efficacy and immunological mechanisms of protection of MontanideTM Gel01 ST (Gel01) adjuvanted modified live PRRSV vaccine in pigs challenged with two genetically distinct strains of PRRSV. Gel01-MLV reduced lymph node pathology scores in pigs challenged with VR-2332 (parental strain of MLV vaccine) but not that in pigs challenged with MN184A (heterologous strain), when compared to that in pigs vaccinated with un-adjuvanted MLV. Pigs vaccinated with Gel01-MLV had higher levels of PRRS-specific antibodies, as measured by IDEXX ELISA and virus neutralizing antibodies, after vaccination and VR-2332 challenge. In addition, pigs vaccinated with Gel01-MLV had decreased levels of IFN-γ, IL-10, and T-regulatory lymphocytes in the blood as compared to that in pigs vaccinated with MLV alone. Interestingly, we found that addition of Gel01 did not change the profile of other T lymphocyte populations after PRRSV challenge. These results demonstrate that the MLV adjuvanted with Gel01 provides enhanced protection against homologous PRRSV infection, possibly by regulating the production of PRRSV-specific antibodies and cytokines involved in the development of T-regulatory cells. Thus, Gel01 ST is a promising adjuvant that can be formulated with PRRSV MLV vaccines to reduce disease severity and tissue damage caused by PRRSV infection in pigs.
猪繁殖与呼吸综合征(PRRS)是由PRRS病毒引起的一种毁灭性疾病。MontanideTM类柔性聚合佐剂最近被证明与PRRS修饰活疫苗(MLV)联合使用可增强仔猪对PRRSV感染的保护性免疫。在这项研究中,我们探讨了蒙塔尼特™Gel01 ST (Gel01)佐剂修饰PRRSV活疫苗对两种基因不同的PRRSV毒株攻毒的猪的保护效果和免疫学机制。Gel01-MLV降低了接种VR-2332 (MLV疫苗亲本株)的猪的淋巴结病理评分,但与接种未佐剂MLV的猪相比,接种MN184A(异源株)的猪的淋巴结病理评分没有降低。通过IDEXX ELISA和病毒中和抗体检测,接种Gel01-MLV的猪在接种疫苗和VR-2332攻毒后具有更高水平的prrs特异性抗体。此外,与单独接种MLV的猪相比,接种Gel01-MLV的猪血液中IFN-γ、IL-10和t调节淋巴细胞的水平降低。有趣的是,我们发现添加Gel01并没有改变PRRSV攻击后其他T淋巴细胞群的特征。这些结果表明,Gel01佐剂的MLV对同源PRRSV感染具有增强的保护作用,可能是通过调节PRRSV特异性抗体的产生和参与t调节细胞发育的细胞因子来实现的。因此,Gel01 ST是一种很有前景的佐剂,可以与PRRSV MLV疫苗配制,以降低猪PRRSV感染引起的疾病严重程度和组织损伤。
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引用次数: 11
IMT504: A New and Potent Adjuvant for Rabies Vaccines Permitting Significant Dose Sparing IMT504:一种新的有效的狂犬病疫苗佐剂,可显著节省剂量
Pub Date : 2012-11-28 DOI: 10.4236/WJV.2012.24025
A. Montaner, Analia De Nichilo, Jose Rodriguez, A. Hernando-Insúa, J. Fló, R. López, V. Sierra, C. Paolazzi, O. Larghi, D. Horn, J. Zorzópulos, F. Elías
Background: Rabies virus infection causes encephalitis, which is almost always fatal. Vaccination can be extremely effective at preventing disease but is prohibitively costly. Vaccine formulations allowing dose-sparing and fewer inoculations with faster antibody response would be extremely desirable. IMT504, an immunostimulatory non-CpG oligo-deoxynucleotide, is a highly potent vaccine adjuvant. Methods: Human and rat antibody measurements, and rat chal-lenge studies were performed. Results: In rats, highly effective immune responses with IMT504 were observed even after diluting vaccine up to 1/625. In highly lethal, live intracerebral rabies challenge studies, protection occurred even with extremely dilute vaccine plus IMT504. In humans, antibody titers developed faster and were significantly higher with IMT504-adjuvanted diluted vaccine vs non-adjuvanted vaccine (full strength or diluted). All five administered IMT504-adjuvanted diluted vaccine reached protective antibodies (≥0.5 IU/ml) after the second injection. After the third injection, individuals receiving IMT504-adjuvanted diluted vaccine reached levels approximately 10 times higher than controls (M ± SEM: 31.0 ± 10.9 vs 3.40 ± 0.99 IU/ml). Conclusions: These data suggest that IMT504 may allow fewer inoculations, highly significant dose-sparing of vaccine, rapid antibody production and protection from rabies. Extensive clinical studies are necessary to confirm if the use of IMT504 will permit significantly greater access to highly effective life-saving rabies vaccines.
背景:狂犬病毒感染引起脑炎,几乎总是致命的。疫苗接种在预防疾病方面非常有效,但费用过高。能够节省剂量和较少接种、抗体反应更快的疫苗配方将是非常可取的。IMT504是一种免疫刺激非cpg寡聚脱氧核苷酸,是一种高效的疫苗佐剂。方法:测定人和大鼠抗体,并进行大鼠激射试验。结果:在大鼠中,即使将疫苗稀释到1/625,也能观察到IMT504的高效免疫反应。在高致死率的脑内狂犬病活体攻击研究中,即使使用极稀释的疫苗加IMT504也能产生保护作用。在人体内,imt504佐剂稀释疫苗与非佐剂疫苗(全强度或稀释)相比,抗体滴度发展更快,且显著更高。5种经imt504佐剂稀释疫苗在第二次注射后均达到保护抗体(≥0.5 IU/ml)。在第三次注射后,接受imt504佐剂稀释疫苗的个体的水平比对照组高约10倍(M±SEM: 31.0±10.9 vs 3.40±0.99 IU/ml)。结论:这些数据表明,IMT504可以减少接种次数,高度显着的疫苗剂量节约,快速产生抗体和预防狂犬病。需要进行广泛的临床研究,以确认使用IMT504是否能够大大增加获得高效救生狂犬病疫苗的机会。
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引用次数: 8
Persistence of Pleural Effusions and Empyemas after Pneumococcal Conjugate Vaccine Implementation in Uruguay 乌拉圭肺炎球菌结合疫苗接种后胸腔积液和脓胸的持续存在
Pub Date : 2012-11-28 DOI: 10.4236/WJV.2012.24024
M. Estevan, L. Martínez, Edith Arreisengor, M. Hortal
In Uruguay a post pneumococcal conjugate vaccine implementation surveillance of hospitalized children with pneumonia showed an increase of complicated pneumonias, while uncomplicated pneumonias decreased. Out of 151 pleural effusions, 62 were empyemas requiring drainage, the rest of cases were treated with antibiotics with a favorable outcome. Patient’s vaccinated status varied. Pneumococcal etiology was poorly documented. The few identified sero-types were 1 and 3, a fact that urges PCV13 use for their control.
在乌拉圭,对住院肺炎儿童接种肺炎球菌结合疫苗后实施的监测显示,复杂性肺炎增加,而非复杂性肺炎减少。151例胸腔积液中,62例为需要引流的脓胸,其余病例均应用抗生素治疗,结果良好。患者接种疫苗的情况各不相同。肺炎球菌的病因鲜有文献记载。少数确定的血清型是1型和3型,这一事实促使使用PCV13进行控制。
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引用次数: 1
Safety and Tolerability of a 13-Valent Pneumococcal Conjugated Vaccine Distributed in the Public Immunization Program of the Municipality of Campos dos Goytacazes, Rio de Janeiro, Brazil 巴西里约热内卢Campos dos Goytacazes市公共免疫规划中分配的13价肺炎球菌结合疫苗的安全性和耐受性
Pub Date : 2012-11-28 DOI: 10.4236/WJV.2012.24026
C. Kury, A. Wilken, R. Henriques, Renata de Carvalho Salles, Wilza Abreu de Brito, M. Kury, Rafael Pessanha de Sá, Felipe Pessanha de Sá
From september to december, 2010, we have assessed the frequency and occurrence of adverse events to Pneumo-coccal conjugated 13-valent vaccine (PCV-13) in the Public vaccination program of the municipality of Campos dos Goytacazes, State of Rio de Janeiro, the unique city in Brazil that has introduced this vaccine in it’s immunization schedule. This study analyzed 1001 toddlers who have received PCV-13 at 3, 5 and 7 months and a booster dose at 12 months. We observed a total of 514 local and systemic events in 303 subjects (30.2% of 1001 infants). The most reported systemic events were irritability (18.8%) and fever or = 38.5°C (8.8%), loss of appetite (8.4%). Erythema (11.2%) and local pain (9.4%) were the most reported local events. Other events reported were diarrhea (6.2%), increased sleep (5.1%), edema and induration (4.8%), decreased sleep (4.3%), vomiting (1.4%), eruption (1.2%) urticaria (0.8%), prurience (0.8%), lymphadenopathy (0.2%) and hypersensitivity reaction (0.2%). There wasn’t any reported case of convulsion or Hospital admission. When stratified by each dose, irritability (systemic) and erythema (local) were the most common events reported at the first and fourth dose, although fever < 38.5°C (systemic) and pain (local) were the most common at second and third doses. Results were close to those encountered in product monograph. In our study, PCV-13 was secure in pneumococcal disease prevention and well tolerated.
2010年9月至12月,我们评估了里约热内卢州坎波斯多斯戈伊塔卡泽斯市公共疫苗接种计划中肺炎球菌结合13价疫苗(PCV-13)不良事件的频率和发生情况,这是巴西唯一一个将该疫苗纳入其免疫计划的城市。这项研究分析了1001名在3个月、5个月和7个月时接受过PCV-13疫苗接种的幼儿,并在12个月时接受了加强剂量的疫苗接种。我们在303名受试者(1001名婴儿的30.2%)中观察到总共514例局部和全身事件。报告最多的系统事件是烦躁(18.8%)和发热(38.5°C)(8.8%),食欲不振(8.4%)。红斑(11.2%)和局部疼痛(9.4%)是报告最多的局部事件。其他报告的事件有腹泻(6.2%)、睡眠增加(5.1%)、水肿和硬结(4.8%)、睡眠减少(4.3%)、呕吐(1.4%)、皮疹(1.2%)、荨麻疹(0.8%)、搔痒(0.8%)、淋巴结病(0.2%)和超敏反应(0.2%)。没有任何惊厥或住院的报告。当按每个剂量分层时,在第一次和第四次剂量时报告的最常见事件是烦躁(全身)和红斑(局部),尽管在第二次和第三次剂量时最常见的是发烧< 38.5°C(全身)和疼痛(局部)。所得结果与产品专论接近。在我们的研究中,PCV-13在预防肺炎球菌疾病方面是安全的,并且耐受性良好。
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引用次数: 0
Therapeutic MUC1-Based Cancer Vaccine Expressed in Flagella-Efficacy in an Aggressive Model of Breast Cancer 基于鞭毛表达muc1的治疗性肿瘤疫苗在侵袭性乳腺癌模型中的疗效
Pub Date : 2012-08-03 DOI: 10.4236/WJV.2012.23015
Nathalie Machluf, R. Arnon
MUC1, a tumor-associated antigen overexpressed in many carcinomas, represents a candidate of choice for cancer immunotherapy. Flagella-based MUC1 vaccines were tested in therapeutic setting in two aggressive breast cancer models, comprising the implantation of the 4T1-MUC1 cell line in either Balb/c, or Human MUC1 transgenic mice in which spontaneous metastases occurs. Recombinant flagella carrying only 7 amino acid of MUC1 elicited therapeutic activity, affecting both the growth of established growing tumors and the number of metastases. Higher therapeutic activity was achieved with an additional recombinant flagella designed with the SYFPEITHI algorithm. The vaccines triggered a Th1 response against MUC1 with no evident autoimmune response towards healthy MUC1-expressing tissues. Recombinant flagella carrying a 25-residue fragment of MUC1, induced the most effective response, as evidenced by a significant reduction of both the size and growth rate of the tumor as well as by the lower number of metastases, and expanding life span of vaccinated mice.
MUC1是一种在许多肿瘤中过表达的肿瘤相关抗原,代表了癌症免疫治疗的候选选择。在两种侵袭性乳腺癌模型中,基于鞭毛的MUC1疫苗在治疗环境中进行了测试,包括将4T1-MUC1细胞系植入Balb/c或人类MUC1转基因小鼠中,这些小鼠会发生自发转移。仅携带MUC1 7个氨基酸的重组鞭毛可激发治疗活性,既影响已建立的生长肿瘤的生长,也影响转移瘤的数量。用SYFPEITHI算法设计的另一个重组鞭毛获得了更高的治疗活性。这些疫苗触发了针对MUC1的Th1应答,而对表达MUC1的健康组织没有明显的自身免疫应答。携带MUC1 25残基片段的重组鞭毛诱导了最有效的反应,这证明了肿瘤的大小和生长速度显著降低,转移数量减少,并延长了接种小鼠的寿命。
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引用次数: 8
Purification of Dengue Virus Particles by One-Step Ceramic Hydroxyapatite Chromatography 陶瓷羟基磷灰石一步色谱法纯化登革病毒颗粒
Pub Date : 2012-08-03 DOI: 10.4236/WJV.2012.23020
Y. Kurosawa, M. Saito, Shintaro Kobayashi, T. Okuyama
Dengue virus type 2 ThNH7/93 retained infectious activity after purification by ceramic hydroxyapatite chromatogra-phy. Dengue virus type 2 culture fluid was loaded onto the ceramic hydroxyapatite column and eluted with a linear gradient of sodium phosphate buffer. Culture fluid and protein contaminants derived from host cells were eluted initially, followed by elutions of dsDNA, and then dengue virus type 2. The recoveries of dengue virus type 2 were 64 ± 14% (n = 11) in the hemagglutination (HA) test and 60% (n = 2) determined by focus assay for viral infectivity. This protocol was highly reproducible, simple, rapid, and appears applicable to other virus species such as influenza virus, Japanese encephalitis virus and adenovirus.
登革病毒2型ThNH7/93经陶瓷羟基磷灰石层析纯化后仍保持感染活性。将登革病毒2型培养液装在陶瓷羟基磷灰石柱上,用线性梯度的磷酸钠缓冲液洗脱。首先洗脱来自宿主细胞的培养液和蛋白质污染物,然后洗脱dsDNA,然后洗脱2型登革热病毒。血凝(HA)法检测登革病毒2型的回收率为64±14% (n = 11),焦点法检测登革病毒2型的回收率为60% (n = 2)。该方案重复性高,简单,快速,似乎适用于其他病毒种类,如流感病毒,乙型脑炎病毒和腺病毒。
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引用次数: 14
Epidemic Outbreaks in Plovdiv Region (Bulgaria) of Vaccine-Preventable Diseases: Measles, Mumps, Hepatitis A 保加利亚普罗夫迪夫地区疫苗可预防疾病的流行:麻疹、腮腺炎、甲型肝炎
Pub Date : 2012-08-03 DOI: 10.4236/WJV.2012.23023
N. Vatev, M. Stoycheva, A. Petrov, Rayna Velcheva
Aim: To analyze the reasons for epidemic outbreaks of measles, mumps and viral hepatitis A and to propose measures to prevent them in future. Materials and methods: Тhe incidence of measles, mumps and hepatitis A in Plovdiv region was studied for the period 2006-2010. An analysis of the age structure of the patients was made, while taking into account the time for routine immunization performed against measles and mumps (first and second dose). Results: In 2006-2009 single cases of measles were found occasionally, but in 2010 they were 2787 (incidence 395/100,000). Most of them (51%) were for ages 13 months-12years, 27%-0-13 months and 11%-13 to 18 years. The incidence of mumps for 2006-2010 varied widely, and has increased significantly in 2007 (130/100,000) and 2008 (169/100,000). The majority of patients (over 34%) during the epidemics were aged 13 months-12years, and over 26% of them-13-19 years. For the period 2006-2010 the incidence of hepatitis A ranged from 2.98/100, 000 (2009) to 426/100,000 (2006). Over 50% of the cases involved children aged up to 9 years. For the three diseases over 80% of patients were individuals of Roma origin. Conclusions: 1. Epidemic spread of measles in 2010 was mainly due to shortcomings in the routine immunization carried as a prevention of the disease. 2. There are two reasons for the outbreak of mumps: А) Failure to administer the second vaccine dose at 12 years in Bulgaria until 2001. B) Shortcomings in routinely performed immunization. 3. The extremely high incidence of hepatitis A in 2006 (and in the rest of the years) is due to the lack of routine immunization. 4. Essential for the outbreaks in all three diseases are the poor hygienic living conditions, the low social status and the lack of health promotion of the population at risk 5. To prevent future outbreaks of the diseases hereby in question, we suggest it is appropriate: А) To introduce compulsory immunization against hepatitis A; B) To carry out periodic catch-up vaccination campaigns against measles and mumps.
目的:分析麻疹、腮腺炎和病毒性甲型肝炎流行的原因,提出预防措施。材料和方法:Тhe对2006-2010年普罗夫迪夫地区麻疹、腮腺炎和甲型肝炎的发病率进行了研究。考虑到麻疹和腮腺炎常规免疫接种(第一剂和第二剂)的时间,对患者的年龄结构进行了分析。结果:2006-2009年偶见麻疹单发病例,2010年为2787例(发病率395/10万)。其中13个月-12岁儿童占51%,0-13个月儿童占27%,13 - 18岁儿童占11%。2006-2010年流行性腮腺炎发病率差异很大,2007年(130/10万)和2008年(169/10万)显著增加。在流行期间,大多数患者(34%以上)年龄在13个月至12岁之间,其中26%以上年龄在13至19岁之间。2006-2010年期间,甲型肝炎的发病率从2.98/10万(2009年)到426/10万(2006年)不等。超过50%的病例涉及9岁以下的儿童。对于这三种疾病,80%以上的患者是罗姆人。结论:1。2010年麻疹的流行传播主要是由于作为疾病预防的常规免疫接种存在缺陷。2. 腮腺炎的爆发有两个原因:А)直到2001年,保加利亚未能在12岁时接种第二剂疫苗。B)常规免疫的缺陷。3.2006年(以及其余年份)甲型肝炎的极高发病率是由于缺乏常规免疫。4. 造成这三种疾病暴发的根本原因是生活卫生条件差、社会地位低以及缺乏对高危人群的健康促进。为防止上述疾病在未来爆发,我们建议:А)实行甲型肝炎强制免疫;B)定期开展麻疹和腮腺炎疫苗接种运动。
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引用次数: 3
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