Resurgence of mumps in Korea.
Resurgence of mumps in Korea.
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DOI：
10.3947/ic.2015.47.1.1
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发表时间：
2015-03
影响因子：
4.2
通讯作者：
Park SH
中科院分区：
文献类型：
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作者：
Park SH
预防流行性腮腺炎的常规疫苗接种已显著降低了发病率。然而，自2007年以来，腮腺炎的发病率持续上升。2013年，韩国发生大规模腮腺炎疫情，这一疫情至今仍是一个持续存在的问题。这一流行病主要发生在学校环境中，影响到接种疫苗的青少年，主要是男生。最近流行性腮腺炎的复苏是由多种因素引起的：当前流行性腮腺炎疫苗的次优效果，Rubini株疫苗的使用，由于流行性腮腺炎发病率显著降低而在缺乏自然加强的情况下免疫力减弱，疫苗和流行性腮腺炎病毒株之间的基因型不匹配，以及促进强烈暴露的环境条件。控制流行性腮腺炎暴发具有挑战性，因为接种疫苗者中诊断测试的敏感性较低，并且由于流行性腮腺炎病毒的固有性质，控制措施效率较低。尽管疫苗在爆发情况下的效果欠佳，但保持高疫苗覆盖率是预防流行性腮腺炎爆发的重要策略，因为与疫苗前时代相比，常规使用流行性腮腺炎疫苗已大幅降低流行性腮腺炎及其并发症的发病率。为了控制目前的流行性腮腺炎疫情并防止进一步爆发，我们需要更好地了解接种疫苗人群中流行性腮腺炎的动态以及韩国不断变化的流行病学。应协同努力，系统监测韩国人口的免疫状况，提高诊断效率。此外，今后还需要开发更有效的腮腺炎疫苗。
Routine vaccination against mumps has markedly reduced its incidence. However, the incidence of mumps continuously has increased since 2007. In 2013, a large mumps epidemic occurred in Korea, and this epidemic is still an ongoing problem. This epidemic occurred primarily in school settings and affected vaccinated adolescents, predominantly male students. The recent resurgence of mumps is caused by multiple factors: suboptimal effectiveness of the current mumps vaccines, use of the Rubini strain vaccine, waning immunity in the absence of natural boosting due to the marked reduction in the mumps incidence, genotype mismatch between the vaccine and circulating mumps virus strains, and environmental conditions that foster intense exposures. Containment of mumps outbreaks is challenging because the sensitivity of diagnostic tests is low among vaccinees and control measures are less efficient because of the inherent nature of the mumps virus. Despite the suboptimal vaccine effectiveness in outbreak settings, maintaining the high vaccine coverage is an important strategy to prevent mumps outbreaks, given that the routine use of mumps vaccines has substantially reduced the incidence of mumps and its complications as compared with that in the pre-vaccine era. In order to control the current mumps epidemic and prevent further outbreaks, we need to better understand the dynamics of mumps among vaccinated populations and the changing epidemiology in Korea. Concerted efforts should be made to systematically monitor the immunization status of the Korean population and to improve diagnosis efficiency. Furthermore, more effective mumps vaccines need to be developed in the future.