文档介绍：The New England Journal of Medicine
Review Article
Advances in Immunology EFFICACY OF SOME CHILDHOOD
INES
Records kept by the Centers for Disease Control
I AN R. MACKAY, ., AND FRED S. ROSEN, ., and Prevention (CDC) since 1912 reveal the num-
Editors ber of reported cases of an infectious disease before
and after a ine became The decrease
is remarkable: 100 percent in the case of indigenous
INES AND INATION poliomyelitis (the last case in the Americas was in
Peru in 1992); over 99 percent in the case of diph-
GORDON ADA, . theria, measles, mumps, and rubella; and over 97 per-
cent in the case of whooping cough (caused by Borde-
tella pertussis). All these agents undergo little antigenic
variation (or drift) or none at all, showing that un-
ORE than 70 bacteria, viruses, parasites,
der virtually ideal conditions, ination can be ex-
and fungi are serious human
traordinarily
ines are available against some of these
M Within one year after the introduction in 1999 of
agents and are being developed against almost all
a Neisseria meningitidis serogroup C conjugate vac-
the other bacteria and viruses and about half of the
cine in the United Kingdom, the incidence of men-
parasites. Table 1 lists infections for which there are
ingitis was reduced by 92 percent among young
now licensed ines and those for which a candi-
children and by 95 percent among A Sal-
date ine has undergone a phase 3 clinical trial, 2
monella typhi Vi conjugate ine (Vi-rEPA) reduced
indicating that a ine will probably be licensed
the incidence of typhoid fever among two-to-four-
within 5 to 10 years.
year-old children by more than 90 Both
Traditionally, attenuated ines were made by
findings confirm the remarkable effectiveness of con-
repeated passaging of the infectious agent in tissue
jugate ines.
culture or animal hosts until its virulence was greatly
The experie