養護施設で集団発症した成人麻疹の5例 Five Cases of Adult Measles from an Outbreak Occurring in a Foster Care Facility

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養護施設で集団発生した成人麻疹の5例を経験した.いずれの症例も精神発達遅延などの基礎疾患があり,20年間以上も獨協医科大学近くの同じ養護施設に入所していた.5症例はほぼ同時期に発症し,いずれも入院加療にて良好な経過が得られた.当施設では平成11年に入所者全員(61名)の麻疹,風疹,ムンプスおよび水痘・帯状疱疹ウイルスの各抗体価を予め測定していたため,早期に発症を予測でき診断の助けになった.当施設の入所者は全員成人であるが,各ウイルス抗体価の保有率は麻疹86.9%,風疹45.9%,ムンプス67.2%および水痘・帯状疱疹93.4%で,麻疹と風疹は一般成人に比較し低い傾向であった.その原因として,ワクチン未接種者が多いことや,養護施設では一般社会と隔離した環境にあり,感染機会が少ないことが考えられた.また,限られた環境で集団生活しているため,集団発生の危険があり注意を要する.今回の経験から他の同様の施設においても,各ウイルス抗体価のスクリーニングが必要と思われた.

We report five patients with adult measles from an outbreak occurring at a foster care facility. All had delayed mental development and had been residents of a foster care facility located near Dokkyo University School of Medicine for more than 20 years. The five patients developed measles essentially simultaneously and had a favorable clinical course during inpatient treatment. Titers of antibody against measles, rubella, mumps, and varicella zoster had been measured in all the residents of this facility in 1999 (61 patients) and were helpful in the early prediction of the outbreak and establishing the diagnosis. Although all the residents of this facility are adults, the viral seroprevalence was 86.9% for measles, 45.9% for rubella, 67.2% for mumps, and 93.4% for varicella zoster. The seroprevalences for measles and rubella were lower than those in the general adult population ; this may be due to a higher number of unvaccinated individuals and a lower likelihood of infections at a residential facility in an environment located away from the general society. Attention is required because of the increased risk of outbreaks among those living in a group setting in a closed environment. Based on our experience, we believe that viral titer screening may be useful at other similar facilities.

収録刊行物

  • 日本皮膚科学会雑誌

    日本皮膚科学会雑誌 112(3), 255-260, 2002-03-20

    Japanese Dermatological Association

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各種コード

  • NII論文ID(NAID)
    10008584562
  • NII書誌ID(NCID)
    AN00196602
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    0021499X
  • NDL 記事登録ID
    025120700
  • NDL 請求記号
    Z19-202
  • データ提供元
    CJP書誌  NDL  J-STAGE 
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