Mumps resurgences in the United States: A historical perspective on unexpected elements
Mumps resurgences in the United States: A historical perspective on unexpected elements
复制标题
DOI：
10.1016/j.vaccine.2009.06.109
复制
发表时间：
2009-10-19
期刊：
影响因子：
5.5
通讯作者：
LeBaron, Charles W.
中科院分区：
文献类型：
--
作者：
Barskey, Albert E.;Glasser, John W.;LeBaron, Charles W.
2006年，美国经历了20年来最大的全国性腮腺炎流行，主要影响大学宿舍居民。爆发的意外因素包括非常突然的时间进程（75%的病例发生在90天内），地理集中性（85%的病例发生在中西部的八个农村州），特定年龄段的发病率高峰期迅速上升和下降（5-9奥尔兹至18-24奥尔兹，然后返回），和两剂疫苗的失败（63%的病例患者接受了两剂疫苗）。为了构建一个历史背景，以了解最近的疫情，我们回顾了美国腮腺炎监测数据，疫苗接种覆盖率估计，以及1917- 2008年期间的相关同行评议文献。2006年腮腺炎爆发的许多意外特征此前在美国已报告过多次，例如，1986-1987年流行性腮腺炎的重新流行具有非常突然的发病、农村地理集中性和先上升后下降的年龄变化。有证据表明，流行性腮腺炎反复暴发的模式是由于在地方病暴露风险较低的分散情况下易感人群的积累，当这些易感人群聚集在拥挤的生活条件下时，就会引发流行性腮腺炎。2006年的流行遵循了这一模式，有两个独特的变化：它之前是一个非常高的疫苗接种率和非常低的疾病发病率的时期，其特点是在儿童时期接种疫苗的成年人中的两剂失败率。过去80年的数据表明，预防未来的腮腺炎流行将取决于创新的措施，以发现和消除高度接种人群中易感人群的积累。爱思唯尔有限公司出版
In 2006 the United States experienced the largest nationwide mumps epidemic in 20 years, primarily affecting college dormitory residents. Unexpected elements of the outbreak included very abrupt time course (75% of cases occurred within 90 days), geographic focality (85% of cases occurred in eight rural Midwestern states), rapid upward and downward shift in peak age-specific attack rate (5-9-year olds to 18-24-year olds, then back), and two-dose vaccine failure (63% of case-patients had received two doses).To construct a historical context in which to understand the recent outbreak, we reviewed US mumps surveillance data, vaccination coverage estimates, and relevant peer-reviewed literature for the period 1917-2008.Many of the unexpected features of the 2006 mumps outbreak had been reported several times previously in the US, e.g., the 1986-1987 mumps resurgence had extremely abrupt onset, rural geographic focality, and an upward-then-downward age shift. Evidence suggested recurrent mumps outbreak patterns were attributable to accumulation of susceptibles in dispersed situations where the risk of endemic disease exposure was low and were triggered when this susceptible population was brought together in crowded living conditions. The 2006 epidemic followed this pattern, with two unique variations: it was preceded by a period of very high vaccination rates and very low disease incidence and was characterized by two-dose failure rates among adults vaccinated in childhood.Data from the past 80 years suggest that preventing future mumps epidemics will depend on innovative measures to detect and eliminate build-up of susceptibles among highly vaccinated populations. Published by Elsevier Ltd.