Abstract

The measles situation is still unstable — there are imported cases, the formation of nosocomial foci with the involvement of medical personnel, patients and visitors of medical institutions. Objective of the study : to assess the level of seroprevalence of primary health care workers in St. Petersburg during the period of epidemic trouble with measles. Materials and methods: An open retrospective randomized uncontrolled study of the intensity of specific immunity to measles in 980 employees aged 18 to 78 years, examined in July-September 2018, was carried out. The level of anti-measles IgG antibodies was determined by the method of enzyme-linked immunosorbent assay (810 people) and passive hemagglutination reactions (170 people). The results are presented with the indication of the shares (%) and the calculation of the 95% confidence interval according to Clopper — Pearson. Differences between groups were assessed using Pearson's chi-square test (%2). Differences in the groups were considered statistically significant when the criterion level was p < 0.05. Results: It was found that 8.2% of personnel are not protected against measles infection. At the same time, the number of seronegative persons among doctors (8.1 %), nurses (7.7%) and non-medical workers (9.6%) differed statistically. Age-related differences in the immune layer were revealed — the greatest susceptibility was observed in persons under 30 years of age (1 8.3%). Anti-measles antibodies in those who had been ill persisted for a long time and at a high level. At the same time, the intensity of post-vaccination immunity decreased over time, and 20 years after immunization, the number of seronegative individuals increased significantly. Only 64.1 % of those surveyed had two vaccinations, more than a third were immunized once. Nevertheless, the proportion of people unprotected from measles exceeded the criterion of epidemic well-being with the same frequency in both groups (9.2% and 1 0.4%, respectively). The results of a serological study showed that the presence of a record of two vaccinations in the certificate in 9.2% of cases does not guarantee protection in case of contact with a patient with measles. Only a serological examination is evidence of specific immunity to measles infection.

Highlights

  • The measles situation is still unstable — there are imported cases, the formation of nosocomial foci with the involvement of medical personnel, patients and visitors of medical institutions

  • The level of anti-measles IgG antibodies was determined by the method of enzyme-linked immunosorbent assay (810 people) and passive hemagglutination reactions (170 people)

  • The results are presented with the indication of the shares (%) and the calculation of the 95% confidence interval according to Clopper — Pearson

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Summary

Материалы и методы исследования

Проведено открытое ретроспективное рандомизированное неконтролируемое исследование напряженности специфического иммунитета к кори у 980 сотрудников учреждений здравоохранения Санкт-Петербурга, обследованных в июле-сентябре 2018 г. (31,5%) сотрудники СПб ГБУЗ «Городская поликлиника No56», 82 чел. (8,4%) — СПб ГБУЗ «Городская поликлиника No 24», 456 чел. (46,5%) — СПб ГБУЗ «Детская городская поликлиника No68» г. (13,6%) — СПб ГБУЗ «Городская поликлиники No27». Напряженность специфического иммунитета изучали в зависимости от способа его формирования (постинфекционный или поствакцинальный); сроков после перенесенной кори или вакцинации против кори; количества полученных прививок против кори и интервала между вакцинациями. (82,7%) определялся методом иммуноферментного анализа (ИФА) с использованием тест-системы «ВектоКорь IgG» (ЗАО «Вектор-Бест», РФ). В 170 случаях (17,3%) напряженность специфического иммунитета к кори определялась при помощи ре-. Положительными считались результаты с титром специфических антител 1:10 и выше. Различия между группами оценивали с помощью критерия хи-квадрат Пирсона (χ2). Статистический анализ выполнен с использованием пакета прикладных программ Exeel 2013 и аналитической системы Statistica. Различия в группах считались статистически значимыми при уровне критерия p < 0,05

Результаты и их обсуждение
Категория обследованных Category of examined
Количество прививок Number of vaccinations
Findings
Интервал между прививками Interval between vaccinations
Full Text
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