麻疹和风疹腮腺炎（新）ppt课件.pptVIP

加08年 有关CRS的流行病学资料大部分来自美国和英国，美国1964年发生了CRS大流行，64-65年则发生了CRS大流行，有1250万风疹病例，和20000多例CRS婴儿，发病率10/1000。 国内研究：妊娠早期血清IgM阳性率0.46 %，由此推算，我国每年应该有2万例以上CRS 按照扩大免疫规划培训教材编写要求，“重点疾病的预防控制 ”部分的编写要求，分为4部分 麻疹、风疹、腮腺炎免疫预防实行2剂次麻疹－风疹－腮腺炎联合疫苗（麻风腮疫苗）免疫程序。最终全国实现麻风腮疫苗2剂次免疫程序。 考虑到目前麻风腮疫苗供应不足，采用过渡期免疫方案，即：8月龄接种麻疹-风疹联合疫苗；18～24月龄接种麻风腮疫苗，麻风腮疫苗供应不足的部分，使用麻疹-腮腺炎联合疫苗替代。 根据我国麻疹流行现状和2012年消除麻疹目标要求，使用麻疹疫苗开展强化免疫和应急免疫。 按照扩大免疫规划培训教材编写要求，“重点疾病的预防控制 ”部分的编写要求，分为4部分 1. Less than one confirmed measles case reported per million population per year (excluding imported cases) - not applicable in countries with less than one million population; 2. Excellent surveillance with comprehensive reporting and investigation of all fever and rash cases and chains of transmission, as demonstrated by: (a) at least one suspected measles case reported per 100 000 population per year in at least 80% of districts (or equivalent, as used for AFP surveillance); (b) serum samples adequate for detecting measles IgM collected in at least 80% of suspected measles cases (excluding from the denominator cases that are epidemiologically linked to a laboratory-confirmed case); and (c) viral isolate obtained from every confirmed chain of transmission (for genotyping to help identify source of virus); and 3. Maintaining 95% immunity to measles in each cohort in every district, as demonstrated by: (a) at least 95% coverage with two doses of measles-containing vaccine; and (b) importations lead only to small outbreaks ( 100 cases, three months duration). Globally 4 regions have measles elimination goals- the target dates range from 2000 – 2012; The Western Pacific Region is the most recent region to accept the challenge to eliminate measles - by 2012. 按照扩大免疫规划培训教材编写要求，“重点疾病的预防控制 ”部分的编写要求，分为4部分 麻疹是一种传染性极强的病毒性传染病，人类对麻疹普遍易感，在实施麻疹减毒活疫苗接种之前，几乎每个人都患过麻疹，所以民间有句“孩子出过疹和痘，才算解了阎王扣”的说法，这里痘指天花，疹就是指麻疹。 潜伏期：10-14天。可有轻度体温上升 前驱期：3－4天低-中度发热上呼吸道炎和结膜炎，麻疹粘膜斑（Koplik斑)，偶见皮肤荨麻疹，隐约斑疹或猩红热样皮疹，在出现典型皮疹时消失。 出疹期：体温骤升，皮疹初为稀疏不规则的玫瑰色斑丘疹，直径2-4毫米，疹间皮肤正常。其后逐