台灣麻疹抗體盛行率，以民眾麻疹抗體檢驗調查為例
 
溫倩茹¹　吳振誠²　林佳怡³　張百齡³　鄭舒倖^2,4　徐永年¹

 
目的：台灣在2018年發生一波麻疹群聚的流行疫情。起因為一位3月1日至4日於泰國旅遊時感染麻疹返台的30多歲男子，隨後又前往日本沖繩旅遊時，因肢體出疹由當地醫院收治，在19日被確診為麻疹。此波疫情引起台灣共13人發生麻疹。本研究探討2018年麻疹流行期間，北區某區域教學醫院抽血檢驗麻疹抗體民眾的麻疹抗體盛行率。
方法：自2018年4月1日至5月30日期間，共有984位民眾至本院門診抽血檢驗麻疹抗體。民眾的血清檢體經化學冷光免疫分析儀偵測麻疹抗體，檢驗結果>16.5 AU/mL判讀為陽性。以年齡及台灣麻疹疫苗接種政策分層，用SPSS18.0進行線性迴歸分析。
結果：經過篩選共808個結果可供分析。總共有598 (74%)人的血清麻疹抗體呈現陽性，71.7%的男性受檢者為陽性、75.3%的女性受檢者為陽性，以出生年代分層分析，1978-1987年出生之男性與女性各有74.0%及74.6%抗體陽性；1988-1997年出生之男性與女性各有58.8%及66.5%抗體陽性，1998-2007年男性與女性各有71.4%及65.0%抗體陽性。1977年（含）以前出生者高達97.9%有抗體陽性反應，而1978年（含）以後出生者僅有68.7%有抗體陽性反應(p<0.005)，而且抗體幾何平均數(geometirc mean)呈現下降趨勢。
結論：本研究建議1978年後出生的成年人，特別是1988-1997年出生世代，應注意麻疹抗體漸漸消失的狀況，重新追加疫苗接種。
（台灣家醫誌2019; 29: 124-131）DOI: 10.3966/168232812019092903002
 
關鍵詞：麻疹、群聚感染、麻疹抗體、麻疹德國麻疹篩腺炎三合一疫苗
 

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¹衛生福利部桃園醫院家庭醫學科、²教研部、³檢驗科、⁴感染科
受理日期：108年3月31日　　修改日期：108年7月20日　　同意刊登：108年8月15日
通訊作者：徐永年　　通訊地址：桃園市桃園區中山路1492號　衛生福利部家庭醫學科

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The Prevalence Rate of Measles Antibody in Taiwan:
An Epidemiological Investigation in the Wake of a Measles Outbreak
 
Chien-Ru Wen¹, Chen-Cheng Wu², Chia-Yi Lin³, Pai-Ling Chang³, Shu-Hsing Cheng^2,4 and Yung-Nien Hsu¹
 

Purpose: In Taiwan, there was a measles outbreak in 2018. A 30-year-old male visiting Thailand during March 1 to 4 came back to Taiwan and then flied to Okinawa for sightseeing. He developed fever and associated symptoms and was subsequently hospitalized as a confirmed case of measles. In response to the outbreak that involved 13 victims, the study was conducted to examine the prevalence of measles antibodies in Taiwan.
Methods: Between April 1 to May 30, 2018, 984 subjects who visited the out-patient clinics of Taoyuan General Hospital and requested measles antibody detection were enrolled. Chemiluminescence immunoassay was performed. A measles antibody titer higher than 16.5 AU/mL indicated a positive result. Stratification was based on age and Taiwan measles vaccination policy, and SPSS used for linear regression analysis.
Results: A total of 808 enrolled subjects were eligible for analysis. 71.7% of the male subjects and 75.3% of the female ones were tested positive, adding up to a total of 598 positive cases. With the tests results stratified by gender and birth year, the percentages of male and female subjects tested positive for measles antibodies were respectively 74.0% and 74.6% for those born between 1978-1987, 58.8% and 66.5% for those born between 1988-1977, and 71.4% and 65.0% for those born between 1998-2007. Subjects born in and before 1977 reported a high rate of measles antibodies (97.9%). On the other hand, subjects born in and after 1978 showed a lower rate (68.7%, p<0.005). Moreover, the geometric mean titer appeared to drop gradually with age.
Conclusion: Taiwanese people born in and after 1978, especially those born between 1988-1997, should monitor the gradual decline of measles antibodies in them so as to receive revaccination.
(Taiwan J Fam Med 2019; 29: 124-131) DOI: 10.3966/168232812019092903002
 
Key words:measles, measles antibody, measles-mumps-rubella vaccine, outbreak

 

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¹Departments of Family Medicine, ²Education and Research, ³Laboratory Medicine, ⁴Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.
Received: March 21, 2019; Revised: July 20, 2019; Accepted: August 15, 2019.