流行性乙型脑炎减毒活疫苗大面积接种后安全性和流行病学效果的5年观察

目的 考核乙脑减毒活疫苗大面积接种后的安全性和降低乙脑发病率,在乙脑高发区安徽省蒙城和涡阳县进行为期５年（１９９２￣１９９６年）的人群观察。方法 观察对象１￣６岁儿童。１岁初免１针,２岁加强１针。结果 通过５年连续观察共接种乙脑活疫苗３３５９４１人。 表明：①疫苗对小龄儿童接种后近期和５年内均未出现不良反应,表明疫苗是安全的。②当地乙脑平均总发病率有显著性下降,从接种观察前１９８７￣１９９１年的１     

规范化甲肝减毒活疫苗（LA—1株）大规模免疫的3年保护效果

目的 探讨国产规范化甲肝减毒活疫苗（ＬＡ－１株）大规模免疫后的长期保护效果。方法 将广西７个县（市）１．５～１０岁儿童２１２９８５人随机分成疫苗接种组（１００７３５人）和对照组（１１２２５０人）。疫苗组接种１针国产甲肝减毒活疫苗（ＬＡ－１株,滴度１０＾６．７５ＴＣＩＤ５０）。免后１个月开始对两组观察肝炎发病情况。结果 随访３年,对照组发现甲型肝炎病人７１例,发病率６３．２５／１０万;疫苗组发现２例     

接种SA-14-14-2株流行性乙型脑炎减毒活疫苗的安全性观察

为在我省推广使用ＳＡ－１４－１４－２株流行性乙型脑炎（乙脑）减毒活疫苗提供科学根据，我们于１９９８年５月在江苏省新沂市和邳州市进行试点，对新沂市２５４名１～１５岁健康儿童接种了ＳＡ－１４－１４－２株乙脑减毒活疫苗，对邳州市２１６名６月龄～１．５岁健康儿童接种乙脑灭活疫苗。经观察，接种减毒活疫苗后无疑似乙脑症状，未发现严重的副反应，安全可靠。减毒活疫苗只需接种１次，易于推广和应用．     

规范化甲肝减毒活疫苗（LA—1株）大规模免疫近期效果观察

为研究国产规范化甲肝减毒活疫苗（ＬＡ－１株）大规模免疫的安个性、免疫原性和保护效果,对广西８个县（市）１．５～１０岁儿童１７１６３４人随机分成疫苗接种组（９７２７８人）和对照组（７４３５６人）。疫苗组接种１针国产甲肝减毒活疫苗（ＬＡ－１株）,滴度１０６．７５ＴＣＩＤ５０）。结果甲肝疫苗接种者均无局部和全身不良反应。免前阴性的疫苗组儿童于免后３、６、１２个月定人采血,用Ａｂｂｏｔ公司的ＩＭｘｍＥＩＡ试剂检测甲肝抗体阳性率分别为７３．９％（８８／１１９）、８３．２％（７９／９５）和８１．７％（４９／６０）,ＧＭＴ分别为１２２．７、８０．７和８３．６ｍＩＵ／ｍｌ。随访９～１３个月,对照组发现１８例临床甲型肝炎病例,发病率２４．２／１０万,疫苗组无一病例发生,保护率１００％,保护率９５％可信限下限为８６．２％。     

河北省1990~1992年急性弛缓性麻痹发病情况调查

笔者报告了１９９３年９月对河北省１９９０～１９９２年０～１４岁儿童住院的急性弛缓性麻痹（ＡｃｕｔｅＦＬａｃｃｉｄＰａｒａｌｙｓｉｓ，ＡＦＰ）进行调查的情况。结果表明，３年平均ＡＦＰ、非脊髓灰质炎急性弛缓性麻痹（Ｎｏｎ－ｐｏｌｉｏＡＦＰ）调查发病率分别为１．４９８／１０万、０．９８８／１０万；０～４岁儿童３年平均发病率二者分别为２．９１７／１０万和１．５９１／１０万。格林巴利综合征（ＧＢＳ）占全部ＡＦＰ病例的５４．０６％。     

无为县1984──1993年乙脑调查分析

无为县１９８４──１９９３年乙脑调查分析无为县卫生防疫站（２３８３００）汪开平１发病情况：１９８４～１９９３年发生乙脑６１０例，平均年发病率４．８０／１０万，病死率５．３％。最高年发病率为１９８５年为１６．２４／１０万，最低１９８９年为０．９４／１０...     

广东省52例急性弛缓性麻痹病例检出脊髓灰质炎疫苗株病毒分析

广东省１９９４～１９９６年１５岁以下儿童非脊髓灰质炎（脊灰）急性弛缓性麻痹（ＡＦＰ）病例报告发病率，分别为０９２／１０万、１７４／１０万和１３６／１０万。对７４３例粪便标本进行病毒分离，５２例检出脊灰疫苗株病毒，分布在３０个县（市、区），其中Ⅱ型占４６２％（２４／５２）；２８例有残留麻痹，最小年龄３个月，最大６岁。７６９％（４０／５２）病例有免疫史，首次服苗并于服苗后６～４０天出现肢体麻痹者１０例，占１９２％（１０／５２），占服苗总人次数１６７／１００万（５２／３１１３１７３７）。本文分析有５例可诊断为脊灰疫苗相关病例。对检出疫苗株病毒的ＡＦＰ病例进行了流行病学分析。     

武汉市前列腺癌的流行病学研究

本文在武汉市１９９０～１９９２年前列腺癌的发病及死亡报告的基础上进行了１∶１配比的病例对照研究，结果显示武汉市前列腺癌的发病率和死亡率分别为１．３７／１０万和０．７５／１０万，世界人口年平均标化发病率和死亡率分别为１．１０／１０万和０．６６／１０万。泌尿系统病史（ＯＲ＝５．４２，９５％可信区间＝１．５６～１８．８３）、子女数超过３个（ＯＲ＝２．４３，９５％可信区间＝１．１７～５．０２）、每周性交超过３次（ＯＲ＝３．３８，９５％可信区间＝１．５１～７．５８）、滥用药物（ＯＲ＝４．１１，９５％可信区间＝１．６５～１０．２５）、体质指数高（ＯＲ＝２．５８，９５％可信区间＝１．３０～５．１１）等是前列腺癌的危险因素，而体力劳动（ＯＲ＝０．３５，９５％可信区间＝０．１７～０．７１）、初次遗精年龄晚于１８岁（ＯＲ＝０．２０，９５％可信区间＝０．０８～０．５２）等是其保护性因素。     

某高校教职工1982～1992年死亡状况分析

采用回顾性调查法分析教职工病伤死亡情况。结果：１９８２年１月１日～１９９２年１２月３１日，１１年间教职工累计人年数为６１５５２人，死亡人１６９人，死亡率为２７４．５６／１０万，男女死亡率分别为４０６．４０／１０万和１６５．９４／１０万，男性明显高于女性；前５位死因顺位是：恶性肿瘤（死亡率为６８．２３／１０万）、呼吸系疾病（死亡率为５５．２４／１０万）、心血管疾病（死亡率为４３．８７／１０万）、脑血管疾病（死亡率为３５．７４／１０万）、损伤和中毒（死亡率为２２．７５／１０万）。教职工平均死亡年龄为６３．２５岁，工人最高（６５．４９岁），干部次之（６３．３２岁）．教师最低（６０．３１岁）。     

肾综合征出血热(I型)疫苗免疫后3年效果观察

目的：考核人群接种ＨＦＲＳ（Ｉ型）灭活疫苗后３年内防病效果。方法：比较受试期间接种组和对照组ＨＦＲＳ发病情况。结果：第１年接种组种后２月内即１１～１２月间未发生ＨＦＲＳ病人，对照组发病５例，发病率９２．８５／１０万，疫苗保护率１００％；第２年全年接种组发病２例，发病率４１．０６／１０万，对照组发５例，发病率９２．８５／１０万，疫苗保护率５５．７８％；种后第３年接种组未发生ＨＦＲＳ病人，对照组发生２例，发病率３７．１４／１０万，疫苗保护率１００％。本研究为Ｉ型ＨＦＲＳ疫苗在姬鼠型疫区的推广使用提供了科学依据     

流行性乙型脑炎减毒活疫苗效果的病例对照研究

为了解流行性乙型脑炎 (乙脑 )减毒活疫苗在乙脑流行时的保护效果 ,对 2 0 0 0年发生乙脑流行的重庆市万州区 1～ 6岁临床诊断病例 4 7例 ,按照 1∶2配对进行乙脑减毒活疫苗免疫接种史调查。结果显示 :乙脑病例和对照中 ,有免疫接种史的分别占 2 13% (1/47)和 35 11% (33/94 )。乙脑减毒活疫苗对 1～ 6岁儿童的保护率为95 98% ,95 %可信限为 72 0 3%～ 99 4 2 % ,即最低的保护率为 72 0 3%。接种乙脑减毒活疫苗可提高人群免疫力 ,在乙脑流行时有较好的保护效果。     

A novel amino acid site closely associated with the neurovirulence of live,attenuated Japanese encephalitis vaccine (SA14-14-2 strain)

Japanese encephalitis (JE) poses a serious threat to the world’s public health yet without a cure, the only way to prevent Japanese encephalitis virus (JEV) infection is vaccination. Live attenuated vaccine (SA14-14-2 strain) is the most widely used JE vaccine, and clinical data have confirmed its safety and effectiveness. Eight sitesassociated with virulence in the Envelope (E) protein are often the focus of quality control of JE vaccine. However, sequences retrieved from NCBI, as well as our previous results showed that the wild strain SA14 may harbor two different amino acids at amino acid residue 244 of the E glycoprotein (E244), and it may be related to virulence. In this study, we introduced a single mutation at nt1708 (G → A) in the full-length cDNA clone of SA14-14-2, replacing a Gly with Glu at amino acid residue 244 of the E glycoprotein, and successfully constructed the mutant virus (JEV E244). JEV E244 exhibited a similar plaque morphology and growth characteristics to JEV SA14-14-2 in cell culture. However, it had lethal neurovirulence in mice and could enter the brain following intraperitoneal inoculation. Moreover, the virulence of JEV E244 in the context of vaccine in mice is significantly different from that of the JEV E244 alone. These results suggested that E244 site should be included in the assessment of the genetic stability of the attenuated JE vaccine. The detection of minor mutations in vaccine population and influence on the safety of vaccine is discussed.     

Primary and booster immune responses to SA14-14-2 Japanese encephalitis vaccine in Korean infants.

Attenuated SA14-14-2 Japanese encephalitis (JE) vaccine has been administered safely and effectively to more than 100 million children in China since 1988 and recently, licensure of the vaccine in Korea has been sought. In the first clinical evaluation of the vaccine outside of China, we monitored side effects in 84 children and evaluated antibody responses to a single dose given as primary JE vaccination in 68 children, 1-3 years old (mean age 27 months). No significant adverse events were noted. Neutralizing antibodies (geometric mean titer [GMT] of 188) were produced in 96% of the 68 subjects. In 10 other children who previously had been immunized with two or three doses of inactivated JE vaccine, the booster administration of SA14-14-2 vaccine produced an anamnestic response in all, with a GMT of 3378. In a comparison group of 25 children previously immunized with two doses of inactivated vaccine, neutralizing antibody titers were detected in 16 (64%). Viral specific IgM was detected in nine primary vaccinees (13%) but in others, IgM may have declined to undetectable levels in the four week postimmunization sample. Live attenuated SA14-14-2 JE vaccine is a promising alternative to the only commercially available JE vaccine for national childhood immunization programs in Asia.     

广西1960-2010年乙脑流行趋势及特征分析

目的分析广西壮族自治区1960-2010年流行性乙型脑炎(乙脑)流行趋势和特征,掌握其流行规律,为制定防控对策提供科学依据。方法收集广西壮族自治区1960-2010年乙脑的疫情资料,对该地区乙脑的流行趋势和特征进行统计学描述。结果广西1960-2010年共发生乙脑65 384例,死亡11 875例,年均发病率为3.38/10万,年均死亡率为0.61/10万,病死率为18.2%;发病主要集中在20世纪60和70年代,年均发病率分别为8.59/10万和9.24/10万,此后发病呈明显下降趋势;广西14个市均有病例发生,主要以贵港、防城港、北海、来宾、和玉林市发病较多,发病率分别为5.40/10万、4.12/10万、4.02/10万、3.88/10万和3.81/10万,分别占全省总病例数的14.3%、1.9%3、.4%、5.7%和12.5%;乙脑发病呈明显季节性,主要集中于5～9月份,占总发病例数的95.8%;患者以0～14岁散居儿童为主,男性发病多于女性。结论广西壮族自治区乙脑发病呈明显下降趋势;病例高度散发,发病有明显季节性;患者主要为低年龄散居儿童。     

1990-2011年广西浦北县流行性乙型脑炎流行特征

目的分析浦北县22年流行性乙型脑炎（简称乙脑）流行特征,为当地乙脑防治提供科学依据。方法收集整理该县1990--2011年报告的乙脑病例资料进行统计和分析,乙脑病例早期诊断采用酶链免疫吸附试验（ELISA）法检测血清IgM。结果1990--2011年该县共报告乙脑病例136例,死亡24例,留有后遗症患者5例。在过去的22年中有5年无病例报告,有病例报告的17年中人群年均发病率为1．02／10万,人群年均死亡率为0．18／10万;但1999和2002年人群年发病率分别到达10．09／10万和2．31／10万,人群年死亡率分别为2．42／10万和0．51／10万。0—6岁幼儿病例占总病例数的89．71％。全县16个镇除1个镇无病例报告外均有病例报告。结论该县属于广西乙脑流行非常不稳定的县份之一,每年应加强并提高乙脑疫苗应接种人群的接种率,继续保持乙脑病例的减少。     

Effectiveness of a single dose of Japanese encephalitis vaccine among adults,Assam, India, 2012–2018

BackgroundJapanese encephalitis virus (JEV) remains the major etiology of encephalitis throughout Asia. In India, the state of Assam alone contributes more than one-third of the national burden of JE. Between 2011 and 2014, a single dose of JE vaccine SA 14-14-2 (LAJEV) was administered among adults aged 15–65 years residing in Sivasagar and Dibrugarh districts of Assam, India. We monitored the trend of JE incidence between 2009 and 2018 using JE surveillance data, estimated the long-term effectiveness of the single dose of LAJEV and estimated the coverage of JE vaccine in two districts.MethodsWe compared the JE vaccination status of laboratory-confirmed hospitalized JE patients (case) and age, sex and locality matched healthy individuals (controls) to estimate the effectiveness of single dose of JE vaccine. We used surveillance data for 2009–2018 to calculate the incidence of JE among adults. We conducted a community-based survey to estimate the coverage of JE vaccine in the two districts.ResultsA total of 452 laboratory-confirmed JE case-patients and 904 matched healthy controls were enrolled in the study between 2012 and 2018. The effectiveness of a single dose of JE vaccine over the 7-year period was 77.0 (95% CI: 67.0–83.0). Vaccine effectiveness decreased from 91% (95% CI: 73.0–97.0) in first year of vaccination to 71% (95% CI: 21.0–90.0) at six years post-vaccination. The incidence of adults JE cases declined from 10.5 per 100,000 in the pre-vaccination period to 5.7 per 100,000 in the years following vaccination. The coverage of vaccine among adults in two districts was 40.1% (36.8–43.5).ConclusionsA single dose of JE vaccine offered adequate protection for at least six years. Conducting mass vaccination campaigns periodically would further reduce the incidence of JE in endemic districts in Assam.     

A cost–effectiveness analysis of Japanese encephalitis vaccine in Cambodia

This study aimed to evaluate the cost and effectiveness of introducing a live, attenuated vaccine (SA 14-14-2) against Japanese encephalitis (JE) into the immunization program. The study demonstrated that SA 14-14-2 immunization is cost–effective in controlling JE in Cambodia compared to no vaccination. Averting one disability-adjusted life year, from a societal perspective, through the introduction of SA 14-14-2 through routine immunization, or a combination of routine immunization plus a campaign targeting children 1–5 or 1–10 years of age, costs US$22, US$34 and US$53, respectively. Sensitivity analyses confirmed that there was a high probability of SA 14-14-2 immunization being cost–effective under conditions of uncertainty.     

福建省2005-2009年流行性乙型脑炎流行病学分析

目的了解福建省2005-2009年流行性乙型脑炎（乙脑）流行病学特征,为制定福建省乙脑监测及控制策略提供依据。方法对2005-2009年福建省乙脑疫情报告资料进行回顾性分析。结果福建省2005-2009年共报告174例乙脑病例,年均发病率0.0980/10万。历年发病率均低于全国同期水平。174例病例发生在除厦门市外的8个地市、57个县。7月份为发病高峰,占总病例的64.94%,其次为6月和8月。83.33%的病例集中在15岁以下儿童,在131例有调查资料的病例中,50.38%无免疫史。结论福建省自2004年将乙脑疫苗纳入儿童计划免疫后,乙脑发病率处于低发水平,控制效果较为显著。在乙脑高发地区必须进一步制定强有力的措施提高乙脑疫苗接种的及时率和全程接种率。