Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 125
Filter
1.
Viruses ; 14(5)2022 05 17.
Article in English | MEDLINE | ID: covidwho-1875808

ABSTRACT

Despite the existence of an effective live-attenuated vaccine, measles can appear in vaccinated individuals. We investigated breakthrough measles cases identified during our surveillance activities within the measles/rubella surveillance network (MoRoNet) in Milan and surrounding areas (Northern Italy). Between 2017 and 2021, we confirmed measles virus (genotypes B3 or D8) infections in 653 patients and 51 of these (7.8%) were vaccinees. Among vaccinated individuals whose serum was available, a secondary failure was evidenced in 69.4% (25/36) of cases while 11 patients (30.6%) were non-responders. Non-responders were more frequently hospitalized and had significantly lower Ct values in both respiratory and urine samples. Median age and time since the last immunization were similar in the two groups. Importantly, we identified onward transmissions from vaccine failure cases. Vaccinees were involved in 20 outbreaks, in 10 of them they were able to transmit the virus, and in 8 of them, they were the index case. Comparing viral hemagglutinin sequences from vaccinated and non-vaccinated subjects did not show a specific mutation pattern. These results suggest that vaccination failure was likely due to the poor immune response of single individuals and highlights the importance of identifying breakthrough cases and characterizing their clinical and virologic profiles.


Subject(s)
Measles , Disease Outbreaks/prevention & control , Humans , Italy/epidemiology , Measles/epidemiology , Measles/prevention & control , Measles Vaccine , Measles virus/genetics , Vaccines, Attenuated
2.
Medicina (Kaunas) ; 58(5)2022 May 20.
Article in English | MEDLINE | ID: covidwho-1875702

ABSTRACT

Measles is an RNA virus infectious disease mainly seen in children. Despite the availability of an effective vaccine against measles, it remains a health issue in children. Although it is a self-limiting disease, it becomes severe in undernourished and immune-compromised individuals. Measles infection is associated with secondary infections by opportunistic bacteria due to the immunosuppressive effects of the measles virus. Recent reports highlight that measles infection erases the already existing immune memory of various pathogens. This review covers the incidence, pathogenesis, measles variants, clinical presentations, secondary infections, elimination of measles virus on a global scale, and especially the immune responses related to measles infection.


Subject(s)
Coinfection , Measles , Child , Humans , Incidence , Measles/epidemiology , Measles/prevention & control
3.
Vaccine ; 40(26): 3676-3683, 2022 Jun 09.
Article in English | MEDLINE | ID: covidwho-1852210

ABSTRACT

Vaccine-preventable diseases, such as measles, have been re-emerging in countries with moderate to high vaccine uptake. It is increasingly important to identify and close immunity gaps and increase coverage of routine childhood vaccinations, including two doses of the measles-mumps-rubella vaccine (MMR). Here, we present a simple cohort model relying on a Bayesian approach to evaluate the evolution of measles seroprevalence in Belgium using the three most recent cross-sectional serological survey data collections (2002, 2006 and 2013) and information regarding vaccine properties. We find measles seroprevalence profiles to be similar for the different regions in Belgium. These profiles exhibit a drop in seroprevalence in birth cohorts that were offered vaccination at suboptimal coverages in the first years after routine vaccination has been started up. This immunity gap is observed across all cross-sectional survey years, although it is more pronounced in survey year 2013. At present, the COVID-19 pandemic could negatively impact the immunization coverage worldwide, thereby increasing the need for additional immunization programs in groups of children that are impacted by this. Therefore, it is now even more important to identify existing immunity gaps and to sustain and reach vaccine-derived measles immunity goals.


Subject(s)
COVID-19 , Measles , Mumps , Rubella , Bayes Theorem , Belgium/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Child , Cross-Sectional Studies , Humans , Measles/epidemiology , Measles/prevention & control , Measles-Mumps-Rubella Vaccine , Mumps/prevention & control , Pandemics , Rubella/prevention & control , Seroepidemiologic Studies , Vaccination
4.
Pediatr Allergy Immunol ; 33 Suppl 27: 58-60, 2022 01.
Article in English | MEDLINE | ID: covidwho-1840508

ABSTRACT

Allergic individuals at risk for hypersensitivity reactions to measles vaccine marketed for a long time are well established. On the other hand, risk factors for hypersensitivity reactions to the new mRNA COVID-19 vaccines currently include a history of allergy, allergy to excipient of the vaccine, or hypersensitivity reactions to the first dose of COVID-19 vaccine. In the last two cases, the recipient should be assessed by an allergist before vaccination to share a decision on the choice of vaccination. Studies on skin testing accuracy and desensitization protocols to the COVID-19 vaccines and the efficacy of potential alternatives in patients with confirmed hypersensitivity reactions to the first COVID-19 vaccine are necessary to improve the safety of COVID-19 vaccines.


Subject(s)
COVID-19 , Hypersensitivity , Measles , Vaccines , COVID-19 Vaccines , Child , Humans , Hypersensitivity/etiology , Measles/prevention & control , SARS-CoV-2 , Vaccination/adverse effects
5.
Travel Med Infect Dis ; 48: 102348, 2022.
Article in English | MEDLINE | ID: covidwho-1819613

ABSTRACT

The coronavirus disease 2019 (COVID-19) has promoted stringent public health measures such as hand hygiene, face mask wearing, and physical distancing to contain the spread of the viral infection. In this retrospective study, the secondary outcomes of those public health measures on containing other respiratory infections among the Thai population were investigated. Hospitalization data spanning from 2016 to 2021 of six respiratory infectious diseases, namely influenza, measles, pertussis, pneumonia, scarlet fever, and tuberculosis (TB), were examined. First, the expected respiratory infectious cases where no public health measures are in place are estimated using the seasonal autoregressive integrated moving average (SARIMA) model. Then the expected number of cases and the observed cases were compared. The results showed a significant drop in the incidence of respiratory infectious diseases by an average of 61%. The reduction in hospitalization is significant for influenza, measles, pertussis, pneumonia, and scarlet fever (p < 0.05), while insignificant for TB (p = 0.54). The notable decrease in the incidence of cases is ascribed to the implementation of public health measures that minimized the opportunity for spread of disease. This decline in cases following relaxation of pandemic countermeasure is contingent on its scope and nature, and it is proof that selective physical distancing, hand hygiene, and use of face masks in public places is a viable route for mitigating respiratory morbidities.


Subject(s)
COVID-19 , Communicable Diseases , Influenza, Human , Measles , Scarlet Fever , Whooping Cough , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Diseases/epidemiology , Humans , Influenza, Human/epidemiology , Measles/epidemiology , Measles/prevention & control , Pandemics/prevention & control , Public Health , Retrospective Studies , SARS-CoV-2 , Scarlet Fever/epidemiology , Thailand/epidemiology , Whooping Cough/epidemiology
6.
BMC Genomics ; 23(1): 305, 2022 Apr 14.
Article in English | MEDLINE | ID: covidwho-1808339

ABSTRACT

BACKGROUND: Measles caused by measles virus (MeV) is a highly contagious viral disease which has also been associated with complications including pneumonia, myocarditis, encephalitis, and subacute sclerosing panencephalitis. The current study isolated 33 strains belonging to 2 groups, outbreak and sporadic strains, in 13 cities of Shandong province, China from 2013 to 2019. Comparison of genetic characterization among 15 outbreak strains and 18 sporadic strains was performed by analyzing nucleotide sequences of the C-terminal region of N protein gene (N-450). RESULTS: All 33 stains belonged to genotype H1. The outbreak strains and sporadic strains distributed crossly in phylogenetic tree. Sequences alignment revealed some interesting G to A transversion which changed the amino acids on genomic sites 1317, 1422, and 1543. The nucleotide and amino acid similarities among outbreak isolates were 98-100% (0-10 nucleotide variations) and 97.7-100%, respectively; They were 97.3-100% and 96.6-100%, respectively for sporadic isolates. Evolutionary genetics analysis revealed that the mean evolution rates of outbreak and sporadic isolates were 1.26 N 10- 3 and 1.48 N 10- 3 substitutions per site per year separately, which were similar with corresponding data before 2012. Local transmission analysis suggested that there were three transmission chains in this study, two of them originated from Japan. Outbreak cases and sporadic cases emerged alternatively and were reciprocal causation on the transmission chains. CONCLUSIONS: Our study investigated the phylogeny and evolutional genetics of MeV during a 7-year surveillance, and compared epidemic and genetic characteristics of outbreak strains and sporadic strains. These results underscore the importance of evolutionary study alongside with sporadic cases in discovering and tracing possible outbreaks, especially in the stage of measles elimination.


Subject(s)
Measles , Amino Acids/genetics , China/epidemiology , Disease Outbreaks , Genotype , Humans , Measles/epidemiology , Measles virus/genetics , Molecular Epidemiology , Nucleotides , Phylogeny
7.
Pan Afr Med J ; 41: 104, 2022.
Article in English | MEDLINE | ID: covidwho-1789672

ABSTRACT

Introduction: the COVID-19 outbreak was declared a public health emergency of international concern by the WHO on the 30th January 2020. The occurrence of measles outbreaks in the context of COVID-19, both highly infectious respiratory illnesses, impacts additional challenges to the health system in a state with an ongoing humanitarian crisis. This article documents the implementation of an outbreak response immunization (ORI) during the COVID-19 pandemic and the implementation of global guidelines for mass vaccination. Methods: a retrospective review of the response to measles outbreak implemented in Borno state across six local government areas (LGAs) in 2019 was conducted. This review assessed the utilization of the World Health Organization (WHO) decision making framework, measles and COVID-19 epidemiological reports and the measle's vaccination response data. Results: an outbreak response immunization was implemented in six LGAs in Borno State, with a validated post campaign coverage of 96.3% (95% CI: 93.0 - 98.1). In total, 181,634 children aged 9 months-9 years were vaccinated with 27,961 (15.4%) receiving the measles vaccine for the first time. Prior to the interventions, 20 COVID-19 cases were reported in the six LGAs while only seven suspected cases were reported with only two cases confirmed in one of the six LGAs four weeks after the ORI. Conclusion: the WHO decision-making framework for implementing mass vaccinations in the context of the COVID-19 Pandemic was utilized for the outbreak response immunization in Borno State, Nigeria with 181,634 children aged 9 Months-9 years vaccinated with the measles vaccine. The use of the WHO decision-making framework to assess risk benefits of initiating mass vaccination campaigns remains a very important practical tool. These types of responses in Nigeria and other low and middle income countries (LMICs), with hitherto suboptimal immunization coverage and weak health systems and other settings, affected by humanitarian emergencies is essential in the achievement of the regional measle's elimination targets.


Subject(s)
COVID-19 , Measles , COVID-19/prevention & control , Child , Disease Outbreaks/prevention & control , Humans , Immunization , Immunization Programs , Infant , Mass Vaccination , Measles/epidemiology , Measles/prevention & control , Measles Vaccine , Nigeria/epidemiology , Pandemics , Vaccination
8.
Sci Rep ; 12(1): 6202, 2022 04 13.
Article in English | MEDLINE | ID: covidwho-1788315

ABSTRACT

Contagious respiratory diseases, such as COVID-19, depend on sufficiently prolonged exposures for the successful transmission of the underlying pathogen. It is important that organizations evaluate the efficacy of non-pharmaceutical interventions aimed at mitigating viral transmission among their personnel. We have developed a operational risk assessment simulation framework that couples a spatial agent-based model of movement with an agent-based SIR model to assess the relative risks of different intervention strategies. By applying our model on MIT's Stata center, we assess the impacts of three possible dimensions of intervention: one-way vs unrestricted movement, population size allowed onsite, and frequency of leaving designated work location for breaks. We find that there is no significant impact made by one-way movement restrictions over unrestricted movement. Instead, we find that reducing the frequency at which individuals leave their workstations combined with lowering the number of individuals admitted below the current recommendations lowers the likelihood of highly connected individuals within the contact networks that emerge, which in turn lowers the overall risk of infection. We discover three classes of possible interventions based on their epidemiological effects. By assuming a direct relationship between data on secondary attack rates and transmissibility in the agent-based SIR model, we compare relative infection risk of four respiratory illnesses, MERS, SARS, COVID-19, and Measles, within the simulated area, and recommend appropriate intervention guidelines.


Subject(s)
COVID-19 , Measles , COVID-19/epidemiology , COVID-19/prevention & control , Computer Simulation , Disease Outbreaks/prevention & control , Humans , Incidence
9.
PLoS One ; 17(4): e0266495, 2022.
Article in English | MEDLINE | ID: covidwho-1785197

ABSTRACT

BACKGROUND: Vitamin A Supplementation (VAS) is a cost-effective intervention to decrease mortality associated with measles and diarrheal diseases among children aged 6-59 months in low-income countries. Recently, experts have suggested that other interventions like large-scale food fortification and increasing the coverage of measles vaccination might provide greater impact than VAS. In this study, we conducted a cost-effectiveness analysis of a VAS scale-up in three sub-Saharan African countries. METHODS: We developed an individual-based microsimulation using the Vivarium simulation framework to estimate the cost and effect of scaling up VAS from 2019 to 2023 in Nigeria, Kenya, and Burkina Faso, three countries with different levels of baseline coverage. We calibrated the model with disease and risk factor estimates from the Global Burden of Disease 2019 (GBD 2019). We obtained baseline coverage, intervention effects, and costs from a systematic review. After the model was validated against GBD inputs, we modeled an alternative scenario where we scaled-up VAS coverage from 2019 to a level that halved the exposure to lack of VAS in 2023. Based on the simulation outputs for DALYs averted and intervention cost, we determined estimates for the incremental cost-effectiveness ratio (ICER) in USD/DALY. FINDINGS: Our estimates for ICER are as follows: $860/DALY [95% UI; 320, 3530] in Nigeria, $550/DALY [240, 2230] in Kenya, and $220/DALY [80, 2470] in Burkina Faso. Examining the data for DALYs averted for the three countries over the time span, we found that the scale-up led to 21 [5, 56] DALYs averted per 100,000 person-years in Nigeria, 21 [5, 47] DALYs averted per 100,000 person-years in Kenya, and 14 [0, 37] DALYs averted per 100,000 person-years in Burkina Faso. CONCLUSIONS: VAS may no longer be as cost-effective in low-income regions as it has been previously. Updated estimates in GBD 2019 for the effect of Vitamin A Deficiency on causes of death are an additional driver of this lower estimate of cost-effectiveness.


Subject(s)
Global Burden of Disease , Measles , Child , Cost-Benefit Analysis , Dietary Supplements , Humans , Kenya , Vitamin A/therapeutic use
10.
Indian J Public Health ; 66(1): 71-73, 2022.
Article in English | MEDLINE | ID: covidwho-1776447

ABSTRACT

India, as a member of the World Health Organization South-East Asia Region, had committed to measles elimination by 2020. Efforts to increase immunization coverage, special immunization activities, and case-based surveillance have been implemented rigorously over the last 7 years, but India has not been able to eliminate measles. Multiple factors led to this namely inadequate vaccination coverage and COVID pandemic and others. The pandemic added its contribution in disruption of vaccine delivery services under Intensified Mission Indradhanush preventing the achievement of the elimination target, in stipulated time. India may need to think beyond strengthening the routine immunization activities and increasing the geographical coverage under Intensified Mission Indradhanush. Promising the future in the measles vaccine delivery system in the form of Measles-Micro-Array-Patches is seen on the horizon may prove to be a game-changer for targeting measles elimination, in the current decade.


Subject(s)
COVID-19 , Measles , Humans , Immunization Programs , India/epidemiology , Measles/epidemiology , Measles/prevention & control , Measles Vaccine , Population Surveillance , Vaccination
11.
Viruses ; 14(4)2022 03 31.
Article in English | MEDLINE | ID: covidwho-1776352

ABSTRACT

Subacute sclerosing panencephalitis (SSPE) is a late complication of measles virus infection that occurs in previously healthy children. This disease has no specific cure and is associated with a high degree of disability and mortality. In recent years, there has been an increase in its incidence in relation to a reduction in vaccination adherence, accentuated by the COVID-19 pandemic. In this article, we take stock of the current evidence on SSPE and report our personal clinical experience. We emphasise that, to date, the only effective protection strategy against this disease is vaccination against the measles virus.


Subject(s)
COVID-19 , Measles , Subacute Sclerosing Panencephalitis , COVID-19/prevention & control , Child , Humans , Measles/epidemiology , Measles/prevention & control , Measles virus , Pandemics , Subacute Sclerosing Panencephalitis/epidemiology , Subacute Sclerosing Panencephalitis/etiology , Subacute Sclerosing Panencephalitis/prevention & control , Vaccination/adverse effects
12.
Int J Environ Res Public Health ; 19(7)2022 03 31.
Article in English | MEDLINE | ID: covidwho-1776196

ABSTRACT

Due to the current burden of COVID-19 on public health institutions, increased migration and seasonal touristic traveling, there is an increased risk of epidemic outbreaks of measles, mumps and rubella (MMR). The aim of the present study was to analyze the epidemiological data on MMR immunization coverage and the number of measles cases in 2001-2019 in Croatia and a number of European countries. Results revealed a decreasing trend in vaccination in 2001-2019 throughout Europe. However, Croatia and Hungary still have the highest primary and revaccination coverage, compared to other analyzed countries. The highest number of measles cases was in 2017 in Romania. There was no significant correlation between the percentage of primary vaccination and the number of measles cases (r = -0.0528, p = 0.672), but there was a significant negative correlation between the percentage of revaccination and the number of measles cases (r = -0.445, p < 0.0001). In conclusion, the results of the present study emphasize the necessity to perform a full protocol of vaccination to reach appropriate protection from potential epidemic outbreaks. Furthermore, in the light of present migrations, documenting the migrants' flow and facilitating vaccination as needed is of utmost importance to prevent future epidemics.


Subject(s)
COVID-19 , Measles , Mumps , Rubella , Croatia/epidemiology , Disease Outbreaks , Europe , Humans , Measles/epidemiology , Measles/prevention & control , Mumps/epidemiology , Vaccination
13.
Front Public Health ; 9: 689458, 2021.
Article in English | MEDLINE | ID: covidwho-1775809

ABSTRACT

OBJECTIVE: This analysis examines governorate-level disease incidence as well as the relationship between incidence and the number of persons of concern for three vaccine-preventable diseases-measles, mumps, and rubella-between 2001 and 2016. METHODS: Using Iraqi Ministry of Health and United Nations High Commissioner for Refugees (UNHCR) data, we performed descriptive analyses of disease incidence and conducted a pooled statistical analysis with a linear mixed effects regression model to examine the role of vaccine coverage and migration of persons of concern on subnational disease incidence. RESULTS: We found large variability in governorate-level incidence, particularly for measles (on the order of 100x). We identified decreases in incident measles cases per 100,000 persons for each additional percent vaccinated (0.82, 95% CI: [0.64, 1.00], p-value < 0.001) and for every additional 10,000 persons of concern when incorporating displacement into our model (0.26, 95% CI: [0.22, 0.30], p-value < 0.001). These relationships were insignificant for mumps and rubella. CONCLUSIONS: National level summary statistics do not adequately capture the high geospatial disparity in disease incidence between 2001 and 2016. This variability is complicated by MMR vaccine coverage and the migration of "persons of concern" (refugees) during conflict. We found that even when vaccine coverage was constant, measles incidence was higher in locations with more displaced persons, suggesting conflict fueled the epidemic in ways that vaccine coverage could not control.


Subject(s)
Measles , Mumps , Rubella , Humans , Iraq/epidemiology , Measles/epidemiology , Measles/prevention & control , Measles-Mumps-Rubella Vaccine , Mumps/epidemiology , Mumps/prevention & control , Rubella/epidemiology , Rubella/prevention & control , Vaccination
14.
Expert Rev Vaccines ; 21(6): 853-859, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1772530

ABSTRACT

OBJECTIVES: Our aim was to estimate vaccination and susceptibility rates against vaccine-preventable diseases among healthcare personnel (HCP) in eight hospitals. METHODS: Cross-sectional survey. RESULTS: A total of 1284 HCP participated (physicians: 31.3%, nursing personnel: 36.6%, paramedical personnel: 11.1%, administrative personnel: 13.2%, supportive personnel: 7.3%). Vaccination rates were 32.9% against measles and mumps, 38.1% against rubella, 5.7% against varicella, 9.2% against hepatitis A, 65.8% against hepatitis B, 31.8% against tetanus-diphtheria, 7.1% against pertussis, 60.2% against influenza, and 80.1% against COVID-19. Susceptibility rates were as follows: 27.8% for measles, 39.6% for mumps, 33.4% for rubella, 22.2% for varicella, 86.3% for hepatitis A, 34.2% for hepatitis B, 68.2% for tetanus-diphtheria, and 92.9% for pertussis. Older HCP had higher susceptibility rates against mumps, rubella, varicella, hepatitis A, hepatitis B, tetanus-diphtheria, and pertussis (p-values <0.001 for all). Mandatory vaccinations were supported by 81.85% of HCP. CONCLUSIONS: Although most HCPs supported mandatory vaccinations, significant vaccination gaps, and susceptibility rates were recorded. The proportion of susceptible HCP to measles, mumps, rubella, and varicella has increased in the past decade, mostly because of reduction in acquired cases of natural illness. Vaccination programs for HCP should be developed. A national registry to follow HCP's vaccination rates is urgently needed.


Subject(s)
COVID-19 , Chickenpox , Diphtheria , Hepatitis A , Hepatitis B , Measles , Mumps , Rubella , Tetanus , Whooping Cough , Attitude , Cross-Sectional Studies , Delivery of Health Care , Greece/epidemiology , Humans , Measles/epidemiology , Measles/prevention & control , Mumps/epidemiology , Mumps/prevention & control , Tertiary Care Centers , Vaccination , Vaccination Coverage
15.
Int J Clin Pract ; 2022: 7918604, 2022.
Article in English | MEDLINE | ID: covidwho-1765200

ABSTRACT

Background: The healthcare system in Jordan faced substantial burden during the 2020 COVID-19 pandemic including disruption of routine childhood vaccination services. Aims: We sought, for the first time, to describe the impact of the 2020 pandemic on vaccination coverage of Jordanian children in Jordan and to identify the key contributing factors. Methods: Nationwide vaccination rates were retrieved from the electronic records at the Ministry of Health (2018-2020) enrolling crude births of 220,057 Jordanian children during 2020. Records of doses administered were compared for each month of 2020 with the baseline of 2018-2019. A cross-sectional survey (March-August 2021) was also conducted enrolling a convenient sample of adults aged ≥18 who were Jordanian caregivers for vaccine-eligible children (0-23 months) between 1 January 2020 and the date of the interview. The survey aimed to address caregivers' adherence to routine vaccination during 2020-2021 and to describe the determinants of the current and future adherence to vaccination where multiple logistic regression model was utilized. Results: The electronic records revealed a significant decline in vaccination coverage during 2020. The greatest decline was observed during the lockdown period from 21 March 2020 to 21 April 2020 (32.4%-46.8%) followed by the decline observed by the entry of the first wave during September-October 2020 (18.4%-22.8%). A drop of 14-16% was observed for the vaccines recommended under the age of 12 months and of 6-7% for those recommended in 1-2-year-old children. The yearly coverage rates for measles-1 (at 9 months), 2 (at 12 months as part of measles-mumps-rubella (MMR) vaccine), and 3 (at 18 months as part of MMR) were 76%, 90%, and 87%, respectively, and for hexavalent-1, 2, and 3 were 78%, 78%, and 77%, respectively. The results of the survey revealed that the main reason for vaccination delay for at least 1 month from the recommended administration time was the lockdown, followed by child illness and smart lockdowns (regional lockdown/health center closure). Vaccination delay was less likely to be observed in children aged ≥12 months (P value < 0.001; OR: 0.18; CI: 0.11-0.29) or children with chronic diseases (P value < 0.05; OR: 0.5; CI: 0.33-0.88). Conclusion: The current study demonstrates a decline in vaccination coverage of Jordanian children during the 2020 COVID-19 pandemic. It is important to formulate future strategies to promote catch-up vaccination and to avoid future backsliding of vaccination rates during further waves of the COVID-19 pandemic or other pandemics. These include improving health services, allaying caregivers' concerns about contracting COVID-19, and arranging vaccination campaigns outside health centers.


Subject(s)
COVID-19 , Measles , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Child, Preschool , Communicable Disease Control , Cross-Sectional Studies , Humans , Infant , Jordan/epidemiology , Measles-Mumps-Rubella Vaccine , Pandemics , Vaccination , Vaccination Coverage
16.
18.
Lancet ; 399(10325): 678-690, 2022 02 12.
Article in English | MEDLINE | ID: covidwho-1721141

ABSTRACT

Measles is a highly contagious, potentially fatal, but vaccine-preventable disease caused by measles virus. Symptoms include fever, maculopapular rash, and at least one of cough, coryza, or conjunctivitis, although vaccinated individuals can have milder or even no symptoms. Laboratory diagnosis relies largely on the detection of specific IgM antibodies in serum, dried blood spots, or oral fluid, or the detection of viral RNA in throat or nasopharyngeal swabs, urine, or oral fluid. Complications can affect many organs and often include otitis media, laryngotracheobronchitis, pneumonia, stomatitis, and diarrhoea. Neurological complications are uncommon but serious, and can occur during or soon after the acute disease (eg, acute disseminated encephalomyelitis) or months or even years later (eg, measles inclusion body encephalitis and subacute sclerosing panencephalitis). Patient management mainly involves supportive therapy, such as vitamin A supplementation, monitoring for and treatment of secondary bacterial infections with antibiotics, and rehydration in the case of severe diarrhoea. There is no specific antiviral therapy for the treatment of measles, and disease control largely depends on prevention. However, despite the availability of a safe and effective vaccine, measles is still endemic in many countries and causes considerable morbidity and mortality, especially among children in resource-poor settings. The low case numbers reported in 2020, after a worldwide resurgence of measles between 2017 and 2019, have to be interpreted cautiously, owing to the effect of the COVID-19 pandemic on disease surveillance. Disrupted vaccination activities during the pandemic increase the potential for another resurgence of measles in the near future, and effective, timely catch-up vaccination campaigns, strong commitment and leadership, and sufficient resources will be required to mitigate this threat.


Subject(s)
COVID-19/epidemiology , Endemic Diseases/prevention & control , Mass Vaccination/organization & administration , Measles Vaccine/administration & dosage , Measles/prevention & control , COVID-19/prevention & control , Communicable Disease Control/organization & administration , Communicable Disease Control/standards , Endemic Diseases/statistics & numerical data , Humans , Mass Vaccination/standards , Mass Vaccination/statistics & numerical data , Measles/epidemiology , Measles/immunology , Measles/virology , Measles virus/immunology , Measles virus/pathogenicity , Pandemics/prevention & control
20.
BMC Public Health ; 22(1): 221, 2022 02 03.
Article in English | MEDLINE | ID: covidwho-1707500

ABSTRACT

BACKGROUND: Following the 2015 earthquake, a measles-rubella (MR) supplementary immunization activity (SIA), in four phases, was implemented in Nepal in 2015-2016. A post-campaign coverage survey (PCCS) was then conducted in 2017 to assess SIA performance and explore factors that were associated with vaccine uptake. METHODS: A household survey using stratified multi-stage probability sampling was conducted to assess coverage for a MR dose in the 2015-2016 SIA in Nepal. Logistic regression was then used to identify factors related to vaccine uptake. RESULTS: Eleven thousand two hundred fifty-three households, with 4870 eligible children provided information on vaccination during the 2015-2016 MR SIA. Overall coverage of measles-rubella vaccine was 84.7% (95% CI: 82.0-87.0), but varied between 77.5% (95% CI: 72.0, 82.2) in phase-3, of 21 districts vaccinated in Feb-Mar 2016, to 97.7% (CI: 95.4, 98.9) in phase-4, of the last seven mountainous districts vaccinated in Mar-Apr 2016. Coverage in rural areas was higher at 85.6% (CI: 81.9, 88.8) than in urban areas at 79.0% (CI: 75.5, 82.1). Of the 4223 children whose caregivers knew about the SIA, 96.5% received the MR dose and of the 647 children whose caregivers had not heard about the campaign, only 1.8% received the MR dose. CONCLUSIONS: The coverage in the 2015-2016 MR SIA in Nepal varied by geographical region with rural areas achieving higher coverage than urban areas. The single most important predictor of vaccination was the caregiver being informed in advance about the vaccination campaign. Enhanced efforts on social mobilization for vaccination have been used in Nepal since this survey, notably for the most recent 2020 MR campaign.


Subject(s)
Measles , Rubella , Child , Humans , Immunization Programs , Infant , Measles/epidemiology , Measles/prevention & control , Measles Vaccine , Nepal/epidemiology , Rubella/prevention & control , Rubella Vaccine , Vaccination
SELECTION OF CITATIONS
SEARCH DETAIL