台灣麻疹抗體盛行率，以民眾麻疹抗體檢驗調查為例

The Prevalence Rate of Measles Antibody in Taiwan: An Epidemiological Investigation in the Wake of a Measles Outbreak

10.3966/168232812019092903002

溫倩茹(Chien-Ru Wen)；吳振誠(Chen-Cheng Wu)；林佳怡(Chia-Yi Lin)；張百齡(Pai-Ling Chang)；鄭舒倖(Shu-Hsing Cheng)；徐永年(Yung-Nien Hsu)

麻疹 ； 群聚感染 ； 麻疹抗體 ； 麻疹德國麻疹篩腺炎三合一疫苗 ； measles ； measles antibody ； measles-mumps-rubella vaccine ； outbreak

台灣家庭醫學雜誌

29卷3期（2019 / 09 / 01）

124 - 131

繁體中文

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。

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.

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