SATURDAY NIGHT FEVER - A COMMON-SOURCE OUTBREAK OF RUBELLA AMONG ADULTS IN HAWAII
SATURDAY NIGHT FEVER - A COMMON-SOURCE OUTBREAK OF RUBELLA AMONG ADULTS IN HAWAII
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DOI：
10.1093/oxfordjournals.aje.a113223
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发表时间：
1981-01-01
影响因子：
5
通讯作者：
WIEBENGA, NH
中科院分区：
文献类型：
--
作者：
MARKS, JS;SERDULA, MK;WIEBENGA, NH
1977年夏天，在夏威夷的成年人中发生了风疹流行。发病率最高的是20-24岁的妇女（226/100 000），几乎完全没有年轻的学童。病例对照调查表明，特定迪斯科舞厅是流行高峰期发病人员的常见接触场所（χ 2 = 12.9，P < 0.001）。迪斯科舞厅的一名钢琴演奏者/歌手是病毒传播的明显来源。与这位音乐家有关的大量病例表明，空气传播是在他唱歌时发生的，而不是通过直接的人与人之间的接触。在流行期间，在公共诊所为6 523名妇女接种了风疹疫苗。尽管进行了妊娠筛查和避孕措施使用，但仍有23名妇女（3.5/1000）在3个月内妊娠。接种疫苗后。据报道，12名在怀孕期间感染自然风疹的妇女中有11名选择终止妊娠;第12名婴儿外观正常。所有成人风疹血凝抑制抗体检测的敏感率为36.9%，与早期在夏威夷调查中发现的相似。这一流行病的发生证实了风疹流行病学在年龄分布方面的变化，并支持了这样一种观点，即幼儿接种疫苗可能不足以保护成年妇女免受风疹的影响，特别是在成年人比例较高的地区。
During the summer of 1977, an epidemic of rubella occurred among adults in Hawaii. The highest attack rate was in women 20-24 yr old (226/100,000), with almost total sparing of young schoolchildren. A case-control investigation implicated a specific discotheque as a common place of exposure for persons with onset of disease during the epidemic peak (.chi.2 = 12.9, P < 0.001). A piano player/singer at the discotheque was the apparent source of the virus transmission. The large number of cases linked to this musician suggests that airborne transmission occurred while he was singing rather than by direct person-to-person contact. Rubella vaccine was given to 6523 women in public clinics held during the epidemic. Despite screening for pregnancy and birth control usage, 23 women (3.5/1000) became pregnant within 3 mo. after receiving the vaccine. Eleven of 12 women who reportedly contracted natural rubella while pregnant elected to terminate their pregnancies; the 12th had a normal appearing infant. The susceptibility rate for all adults tested for rubella hemagglutination inhibition antibody was 36.9%, a rate similar to that found in earlier surveys in Hawaii. The occurrence of this epidemic confirms the changing epidemiology of rubella with respect to age distribution and supports the view that vaccination of young children may not be sufficient to protect adult women from exposure to rubella, especially in areas where a high proportion of adults remain susceptible.