Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 70
Filter
1.
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
2.
Int J Environ Res Public Health ; 19(7)2022 Mar 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
3.
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
6.
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
7.
Eur J Clin Microbiol Infect Dis ; 41(3): 455-466, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1694520

ABSTRACT

We describe a measles outbreak among previously vaccinated healthcare workers (HCWs) and inpatients and the control measures implemented at a tertiary care hospital in 2019. Case-patients were laboratory-confirmed measles with throat swabs tested by quantitative polymerase chain reactions (PCR), during April-May 2019. Medical histories and documented immunization records were obtained. We compared attack rates (ARs) among HCWs by occupational subgroup and age and examined the outbreak-associated costs. The index case was not ascertained. Among 26 measles case-patients (22 HCWs, four inpatients) aged 18-28 years, 25 had previously received measles-mumps-rubella (MMR) vaccine (12/26, 46% (two doses); 13/26, 50% (one dose)), and 16 (62%) had positive results of measles IgG prior to measles diagnosis. ARs were higher among HCWs aged < 30 years (1.88%), especially in the subgroup under 25 years of age (2.22%). Control measures included work restrictions for seronegative HCWs (218/2320, 9.4%) in immunity verification, administration of the MMR vaccine (207 HCWs) or intravenous immunoglobulin (2 HCWs and 11 inpatients), enhanced health surveillance of HCWs, and mandatory assessment of patients with measles-like symptoms at the infectious diseases screening units. The hospital spent 90,417,132 Korean won (US $79,733) in response to the outbreak. Measles outbreaks can occur in healthcare settings despite high population immunity, highlighting the importance of stronger vaccination policies, particularly among young HCWs. Moreover, an effective outbreak response comprising immunization activities and enhanced surveillance of HCWs and patients to rapidly detect measles-like symptoms at a prodromal phase is essential to control nosocomial measles outbreaks.


Subject(s)
Cross Infection , Measles , Adolescent , Adult , Antibodies, Viral , Cross Infection/epidemiology , Cross Infection/prevention & control , Disease Outbreaks , Hospitals , Humans , Measles/epidemiology , Measles/prevention & control , Measles-Mumps-Rubella Vaccine , Republic of Korea/epidemiology , Vaccination , Young Adult
8.
Pan Afr Med J ; 40: 87, 2021.
Article in English | MEDLINE | ID: covidwho-1667708

ABSTRACT

During January 2018-June 2020, Aweil East confirmed five measles outbreaks. In March 2020, Aweil East reported twenty measles IgM+ cases. Before this outbreak, Aweil East had confirmed an outbreak in late November 2019. Even after conducting outbreak reactive vaccinations (ORV) in December 2019 and February 2020, measles spread was not interrupted. The nationally supported measles follow-up campaign (MFUC) conducted in late February 2020 was deferred in Aweil East because of the February ORV. We reviewed the measles data collected through passive and active surveillance. A matched case-control study was conducted to evaluate potential exposures. Face-to-face interviews with cases and controls using a semi-structured questionnaire were used to collect demographics, disease, and exposures related data. A total of 687 cases with eight deaths; attack and case fatality rate of 123/100,000 population and 1.16%, respectively. Among the cases, 51.8% were male, the median age was four years, and 59% of cases ≥9 months were unvaccinated. Eighty point six percent (80.6%) of cases reported after the February ORV were unvaccinated. The outbreak peaked in late March 2020. Unvaccinated persons had higher odds of getting measles (adjusted odds ratio (AOR)=8.569; 95% CI [1.41- 53.4], p=0.02). Non exposed persons had a lower odd of getting measles (AOR=0.114; 95% CI [0.02-0.61], p=0.011). During 2018-2019, the accumulated number of unvaccinated children (18,587) is more than a birth cohort of the county. Persistent low routine vaccination is the most critical driver of the measles outbreaks. Low-quality ORV and the intermediate population density are secondary drivers of the outbreaks.


Subject(s)
Measles , Case-Control Studies , Child , Child, Preschool , Disease Outbreaks , Humans , Male , Measles/epidemiology , Measles/prevention & control , South Sudan
9.
Med Anthropol Q ; 36(1): 119-138, 2022 03.
Article in English | MEDLINE | ID: covidwho-1626709

ABSTRACT

This article contributes to anthropological debates surrounding borderlands and biosecurity by tracing the multiple pursuits of protection that emerge between the state and minorities during infectious disease outbreaks. Drawing on an ethnographic study of child health in Jerusalem following epidemics of measles and COVID-19, the article demonstrates how responses to public health interventions are less about compliance or indiscipline than a competing pursuit of immunity to preserve religious lifeworlds. The voices of Orthodox Jews are situated alongside printed broadsides that circulated anonymous truth-claims in Jerusalem neighborhoods. These broadsides cast state intervention against historical narratives of deception and ethical failures. Borderland tensions, like a virus, mutate and influence responses to authority and biosecurity, and they reconfigure vernacular entanglements of religion, state, and health. The article encourages anthropologists to consider responses to public health interventions and non-vaccination beyond a COVID-19 silo, as part of situated relations between states and minority populations.


Subject(s)
COVID-19 , Measles , Anthropology, Medical , Child , Disease Outbreaks/prevention & control , Humans , Measles/epidemiology , Measles/prevention & control , Public Health
11.
BMJ Glob Health ; 6(12)2021 12.
Article in English | MEDLINE | ID: covidwho-1591304

ABSTRACT

INTRODUCTION: Despite gains in global coverage of childhood vaccines, many children remain undervaccinated. Although mass vaccination campaigns are commonly conducted to reach these children their effectiveness is unclear. We evaluated the effectiveness of a mass vaccination campaign in reaching zero-dose children. METHODS: We conducted a prospective study in 10 health centre catchment areas in Southern province, Zambia in November 2020. About 2 months before a national mass measles and rubella vaccination campaign conducted by the Ministry of Health, we used aerial satellite maps to identify built structures. These structures were visited and diphtheria-tetanus-pertussis (DTP) and measles zero-dose children were identified (children who had not received any DTP or measles-containing vaccines, respectively). After the campaign, households where measles zero-dose children were previously identified were targeted for mop-up vaccination and to assess if these children were vaccinated during the campaign. A Bayesian geospatial model was used to identify factors associated with zero-dose status and measles zero-dose children being reached during the campaign. We also produced fine-scale zero-dose prevalence maps and identified optimal locations for additional vaccination sites. RESULTS: Before the vaccination campaign, 17.3% of children under 9 months were DTP zero-dose and 4.3% of children 9-60 months were measles zero-dose. Of the 461 measles zero-dose children identified before the vaccination campaign, 338 (73.3%) were vaccinated during the campaign and 118 (25.6%) were reached by a targeted mop-up activity. The presence of other children in the household, younger age, greater travel time to health facilities and living between health facility catchment areas were associated with zero-dose status. Mapping zero-dose prevalence revealed substantial heterogeneity within and between catchment areas. Several potential locations were identified for additional vaccination sites. CONCLUSION: Fine-scale variation in zero-dose prevalence and the impact of accessibility to healthcare facilities on vaccination coverage were identified. Geospatial modelling can aid targeted vaccination activities.


Subject(s)
Measles , Rubella , Bayes Theorem , Child , Humans , Immunization Programs , Measles/epidemiology , Measles/prevention & control , Prospective Studies , Rubella/prevention & control , Vaccination , Zambia/epidemiology
12.
Acta Paediatr ; 111(3): 595-601, 2022 03.
Article in English | MEDLINE | ID: covidwho-1555863

ABSTRACT

AIM: To examine and compare the medical burden of measles, influenza and COVID-19 outbreaks in the city of Bnei Brak, Israel. METHODS: The study was conducted during 2018-2021. The numbers of hospitalisations for these infections and their complications were recorded. Hospitalisation rates were determined by using the number of children residing in Bnei Brak and hospitalised with these infections during the study period as the numerators. The denominators were the estimated paediatric cases of measles, influenza and COVID-19 in Bnei Brak and were calculated under both pragmatic and conservative assumptions. RESULTS: A total of 247, 65 and 32 children were hospitalised with influenza, COVID-19 and measles respectively. Complication rates were higher following measles than after influenza and SARS-CoV-2 infections. Hospitalisation rates were 10% for measles, 0.6%-1.2% for influenza and 0.15% - 0.25% for COVID-19 infections. Relative risks (RR) with 95% confidence intervals (CI) for hospitalisation following measles compared with COVID-19 ranged from 42 (26.3-67.3) to 70.1 (43.8-112.1), while the relative risks for influenza hospitalisation ranged from 2.5 (1.83-3.41) to 8.2 (6.0-11.2), compared with COVID-19 infection. CONCLUSION: Hospitalisation rates and direct medical burdens of measles and influenza were significantly higher than those of COVID-19 infection in children.


Subject(s)
COVID-19 , Influenza, Human , Measles , Child , Disease Outbreaks , Hospitalization , Humans , Influenza, Human/epidemiology , Measles/epidemiology , SARS-CoV-2 , Seasons
13.
BMC Med ; 19(1): 281, 2021 11 17.
Article in English | MEDLINE | ID: covidwho-1523309

ABSTRACT

BACKGROUND: Model-based estimates of measles burden and the impact of measles-containing vaccine (MCV) are crucial for global health priority setting. Recently, evidence from systematic reviews and database analyses have improved our understanding of key determinants of MCV impact. We explore how representations of these determinants affect model-based estimation of vaccination impact in ten countries with the highest measles burden. METHODS: Using Dynamic Measles Immunisation Calculation Engine (DynaMICE), we modelled the effect of evidence updates for five determinants of MCV impact: case-fatality risk, contact patterns, age-dependent vaccine efficacy, the delivery of supplementary immunisation activities (SIAs) to zero-dose children, and the basic reproduction number. We assessed the incremental vaccination impact of the first (MCV1) and second (MCV2) doses of routine immunisation and SIAs, using metrics of total vaccine-averted cases, deaths, and disability-adjusted life years (DALYs) over 2000-2050. We also conducted a scenario capturing the effect of COVID-19 related disruptions on measles burden and vaccination impact. RESULTS: Incorporated with the updated data sources, DynaMICE projected 253 million measles cases, 3.8 million deaths and 233 million DALYs incurred over 2000-2050 in the ten high-burden countries when MCV1, MCV2, and SIA doses were implemented. Compared to no vaccination, MCV1 contributed to 66% reduction in cumulative measles cases, while MCV2 and SIAs reduced this further to 90%. Among the updated determinants, shifting from fixed to linearly-varying vaccine efficacy by age and from static to time-varying case-fatality risks had the biggest effect on MCV impact. While varying the basic reproduction number showed a limited effect, updates on the other four determinants together resulted in an overall reduction of vaccination impact by 0.58%, 26.2%, and 26.7% for cases, deaths, and DALYs averted, respectively. COVID-19 related disruptions to measles vaccination are not likely to change the influence of these determinants on MCV impact, but may lead to a 3% increase in cases over 2000-2050. CONCLUSIONS: Incorporating updated evidence particularly on vaccine efficacy and case-fatality risk reduces estimates of vaccination impact moderately, but its overall impact remains considerable. High MCV coverage through both routine immunisation and SIAs remains essential for achieving and maintaining low incidence in high measles burden settings.


Subject(s)
COVID-19 , Measles , Child , Humans , Immunization Programs , Infant , Measles/epidemiology , Measles/prevention & control , SARS-CoV-2 , Vaccination
14.
MMWR Morb Mortal Wkly Rep ; 70(45): 1563-1569, 2021 Nov 12.
Article in English | MEDLINE | ID: covidwho-1513269

ABSTRACT

In 2012, the World Health Assembly endorsed the Global Vaccine Action Plan,* with the objective of eliminating measles† in five of the six World Health Organization (WHO) regions by 2020 (1). The Immunization Agenda 2021-2030 (IA2030)§ uses measles incidence as an indicator of the strength of immunization systems. The Measles-Rubella Strategic Framework 2021-2030¶ and the Measles Outbreaks Strategic Response Plan 2021-2023** are aligned with the IA2030 and highlight robust measles surveillance systems to document immunity gaps, identify root causes of undervaccination, and develop locally tailored solutions to ensure administration of 2 doses of measles-containing vaccine (MCV) to all children. This report describes progress toward World Health Assembly milestones and measles elimination objectives during 2000-2020 and updates a previous report (2). During 2000-2010, estimated MCV first dose (MCV1) coverage increased globally from 72% to 84%, peaked at 86% in 2019, but declined to 84% in 2020 during the COVID-19 pandemic. All countries conducted measles surveillance, although fewer than one third achieved the sensitivity indicator target of ≥2 discarded†† cases per 100,000 population in 2020. Annual reported measles incidence decreased 88% during 2000-2016, from 145 to 18 cases per 1 million population, rebounded to 120 in 2019, before falling to 22 in 2020. During 2000-2020, the annual number of estimated measles deaths decreased 94%, from 1,072,800 to 60,700, averting an estimated 31.7 million measles deaths. To achieve regional measles elimination targets, enhanced efforts are needed to reach all children with 2 MCV doses, implement robust surveillance, and identify and close immunity gaps.


Subject(s)
Disease Eradication , Global Health/statistics & numerical data , Measles/prevention & control , Child , Humans , Immunization Programs , Incidence , Infant , Measles/epidemiology , Measles Vaccine/administration & dosage , World Health Organization
15.
J Med Virol ; 94(2): 521-530, 2022 02.
Article in English | MEDLINE | ID: covidwho-1508796

ABSTRACT

Measles is one of the most infectious diseases of humans. It is caused by the measles virus (MeV) and can lead to serious illness, lifelong complications, and even death. Whole-genome sequencing (WGS) is now available to study molecular epidemiology and identify MeV transmission pathways. In the present study, WGS of 23 MeV strains of genotype H1, collected in Mainland China between 2006 and 2018, were generated and compared to 31 WGSs from the public domain to analyze genomic characteristics, evolutionary rates and date of emergence of H1 genotype. The noncoding region between M and F protein genes (M/F NCR) was the most variable region throughout the genome. Although the nucleotide substitution rate of H1 WGS was around 0.75 × 10-3 substitution per site per year, the M/F NCR had an evolutionary rate three times higher, with 2.44 × 10-3 substitution per site per year. Phylogenetic analysis identified three distinct genetic groups. The Time of the Most Recent Common Ancestor (TMRCA) of H1 genotype was estimated at approximately 1988, while the first genetic group appeared around 1995 followed by two other genetic groups in 1999-2002. Bayesian skyline plot showed that the genetic diversity of the H1 genotype remained stable even though the number of MeV cases decreased 50 times between 2014 (52 628) and 2020 (993). The current coronavirus disease 2019 (COVID-19) pandemic might have some effect on the measles epidemic and further studies will be necessary to assess the genetic diversity of the H1 genotype in a post-COVID area.


Subject(s)
Evolution, Molecular , Genome, Viral/genetics , Measles virus/genetics , China/epidemiology , Genes, Viral/genetics , Genetic Variation , Genomics , Genotype , Humans , Measles/epidemiology , Measles/virology , Measles virus/classification , Phylogeny , RNA, Viral/genetics
16.
J Med Internet Res ; 23(11): e30150, 2021 11 08.
Article in English | MEDLINE | ID: covidwho-1507021

ABSTRACT

BACKGROUND: Despite the existence of an effective vaccine, measles still threatens the health and lives of many Europeans. Notably, during the COVID-19 pandemic, measles vaccine uptake declined; as a result, after the pandemic, European countries will have to increase vaccination rates to restore the extent of vaccination coverage among the population. Because information obtained from social media are one of the main causes of vaccine hesitancy, knowledge of the nature of information pertaining to measles that is shared on social media may help create educational campaigns. OBJECTIVE: In this study, we aim to define the characteristics of European news about measles shared on social media platforms (ie, Facebook, Twitter, and Pinterest) from 2017 to 2019. METHODS: We downloaded and translated (into English) 10,305 articles on measles published in European Union countries. Using latent Dirichlet allocation, we identified main topics and estimated the sentiments expressed in these articles. Furthermore, we used linear regression to determine factors related to the number of times a given article was shared on social media. RESULTS: We found that, in most European social media posts, measles is only discussed in the context of local European events. Articles containing educational information and describing world outbreaks appeared less frequently. The most common emotions identified from the study's news data set were fear and trust. Yet, it was found that readers were more likely to share information on educational topics and the situation in Germany, Ukraine, Italy, and Samoa. A high amount of anger, joy, and sadness expressed within the text was also associated with a higher number of shares. CONCLUSIONS: We identified which features of news articles were related to increased social media shares. We found that social media users prefer sharing educational news to sharing informational news. Appropriate emotional content can also increase the willingness of social media users to share an article. Effective media content that promotes measles vaccinations should contain educational or scientific information, as well as specific emotions (such as anger, joy, or sadness). Articles with this type of content may offer the best chance of disseminating vital messages to a broad social media audience.


Subject(s)
COVID-19 , Measles , Social Media , Humans , Measles/epidemiology , Measles/prevention & control , Pandemics , SARS-CoV-2
17.
Clin Microbiol Rev ; 34(3)2021 06 16.
Article in English | MEDLINE | ID: covidwho-1501522

ABSTRACT

Public health laboratories (PHLs) continue to face internal and external challenges to their abilities to provide successful, timely responses to public health crises and emerging threats. These laboratories are mandated to maintain the health of their communities by identifying, diagnosing, and warning constituents of potential and real health emergencies. Due to the changing characteristics of public health threats and their cross-jurisdictional nature, laboratories are facing increased pressure to ensure that they respond in a consistent and coordinated manner. Here, the Association of Public Health Laboratories (APHL) Emerging Leader Program Cohort 11 members have compiled stories from subject matter experts (SMEs) at PHLs with direct involvement in crises to determine the characteristics of a successful response. Experts examined a diverse selection of emerging threats from across PHLs, including infectious diseases, opioids, natural disasters, and government shutdowns. While no public health crisis will be identical to another, overarching themes were consistent across subjects. Experiences from SMEs that could improve future responses to emerging threats are highlighted.


Subject(s)
COVID-19 Testing/methods , COVID-19/diagnosis , Hemorrhagic Fever, Ebola/diagnosis , Measles/diagnosis , Opioid-Related Disorders/diagnosis , Public Health/methods , COVID-19/epidemiology , Clinical Laboratory Techniques , Hemorrhagic Fever, Ebola/epidemiology , Humans , Laboratories , Measles/epidemiology , Opioid-Related Disorders/epidemiology
19.
PLoS One ; 16(10): e0258961, 2021.
Article in English | MEDLINE | ID: covidwho-1484862

ABSTRACT

INTRODUCTION: In 2011, member states of the World Health Organization (WHO) Africa Regional Office (AFRO) resolved to eliminate Measles by 2020. Our study aims to assess The Gambia's progress towards the set AFRO measles elimination target and highlight surveillance and immunisation gaps to better inform future measles prevention strategies. MATERIAL AND METHODS: A retrospective review of measles surveillance data for the period 2011-2019, was extracted from The Gambia case-based measles surveillance database. WHO-UNICEF national coverage estimates were used for estimating national level MCV coverage. Measles post campaign coverage survey coverage estimates were used to estimate national measles campaign coverage. RESULTS: One hundred and twenty-five of the 863 reported suspected cases were laboratory confirmed as measles cases. More than half (53.6%) of the confirmed cases have unknown vaccination status, 24% of cases were vaccinated, 52.8% of cases occurred among males, and 72.8% cases were among urban residents. The incidence of measles cases per million population was lowest (0) in 2011-2012 and highest in 2015 and 2016 (31 and 23 respectively). The indicator for surveillance sensitivity was met in all years except in 2016 and 2019. Children aged 5-9 years (Incidence Rate Ratio-IRR = 0.6) and residents of Central River region (IRR = 0.21) had lower measles risk whilst unvaccinated (Adjusted IRR = 5.95) and those with unknown vaccination status (IRR 2.21) had higher measles risk. Vaccine effectiveness was 89.5%. CONCLUSION: The Gambia's quest to attain measles elimination status by 2020 has registered significant success but it is unlikely that all target indicators will be met. Vaccination has been very effective in preventing cases. There is variation in measles risk by health region, and it will be important to take it into account when designing prevention and control strategies. The quality of case investigations should be improved to enhance the quality of surveillance for decision making.


Subject(s)
Immunization Programs , Measles Vaccine/therapeutic use , Measles/epidemiology , Vaccination Coverage , Adolescent , Adult , Child , Child, Preschool , Disease Eradication , Female , Gambia/epidemiology , Humans , Incidence , Infant , Infant, Newborn , Male , Measles/prevention & control , Population Surveillance , Retrospective Studies
20.
Viruses ; 13(10)2021 10 02.
Article in English | MEDLINE | ID: covidwho-1465472

ABSTRACT

The MMR vaccination program was introduced in Spain in 1981. Consistently high vaccination coverage has led to Spain being declared free of endemic measles transmission since 2014. A few imported and import-related cases were reported during the post-elimination phase (2014 to 2020), with very low incidence: three cases per million of inhabitants a year, 70% in adults. In the post-elimination phase an increasing proportion of measles appeared in two-dose vaccinated individuals (up to 14%), posing a challenge to surveillance and laboratory investigations. Severity and clinical presentation were milder among the vaccinated. The IgM response varied and the viral load decreased, making the virus more difficult to detect. A valid set of samples (serum, urine and throat swab) is strongly recommended for accurate case classification. One third of measles in fully vaccinated people was contracted in healthcare settings, mainly in doctors and nurses, consistent with the important role of high intensity exposure in measles breakthrough cases. Surveillance protocols and laboratory algorithms should be adapted in advanced elimination settings. Reinforcing the immunity of people working in high exposure environments, such as healthcare settings, and implementing additional infection control measures, such as masking and social distancing, are becoming crucial for the global aim of measles eradication.


Subject(s)
Measles/diagnosis , Measles/epidemiology , Adolescent , Child , Child, Preschool , Disease Outbreaks/prevention & control , Epidemiological Monitoring , Female , Humans , Infant , Infant, Newborn , Male , Measles/prevention & control , Measles Vaccine/immunology , Measles Vaccine/pharmacology , Measles virus/pathogenicity , Morbillivirus/pathogenicity , Spain/epidemiology , Vaccination/trends , Vaccination Coverage/statistics & numerical data , Vaccination Coverage/trends , Young Adult
SELECTION OF CITATIONS
SEARCH DETAIL