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Front Public Health ; 9: 689458, 2021.
Article in English | MEDLINE | ID: covidwho-1775809


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.

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
PLoS One ; 17(1): e0261332, 2022.
Article in English | MEDLINE | ID: covidwho-1633231


Recent reports indicate that respiratory infectious diseases were suppressed during the novel coronavirus disease-2019 (COVID-19) pandemic. COVID-19 led to behavioral changes aimed to control droplet transmission or contact transmission. In this study, we examined the incidence of common infectious diseases in Japan during the COVID-19 pandemic. COVID-19 data were extracted from the national data based on the National Epidemiological Surveillance of Infectious Diseases (NESID). Common infectious diseases were selected from notifiable infectious diseases under the NESID. The epidemic activity of the diseases during 2015-2020 was evaluated based on the Infectious Disease Weekly Reports published by the National Institute of Infectious Diseases. Each disease was then categorized according to the route of transmission. Many Japanese people had adopted hygienic activities, such as wearing masks and hand washing, even before the COVID-19 pandemic. We examined the correlation between the time-series of disease counts of common infectious diseases and COVID-19 over time using cross-correlation analysis. The weekly number of cases of measles, rotavirus, and several infections transmitted by droplet spread, was negatively correlated with the weekly number of cases of COVID-19 for up to 20 weeks in the past. According to the difference-in-differences analysis, the activity of influenza and rubella was significantly lower starting from the second week in 2020 than that in 2015-2019. Only legionellosis was more frequent throughout the year than in 2015-2019. Lower activity was also observed in some contact transmitted, airborne-transmitted, and fecal-oral transmitted diseases. However, carbapenem-resistant Enterobacteriaceae, exanthema subitum, showed the same trend as that over the previous 5 years. In conclusion, our study shows that public health interventions for the COVID-19 pandemic may have effectively prevented the transmission of most droplet-transmitted diseases and those transmitted through other routes.

COVID-19/pathology , Communicable Diseases/epidemiology , COVID-19/epidemiology , COVID-19/virology , Communicable Diseases/diagnosis , Databases, Factual , Health Behavior , Humans , Incidence , Influenza, Human/epidemiology , Japan/epidemiology , Masks , Pandemics , Rubella/epidemiology , SARS-CoV-2/isolation & purification
Pak J Biol Sci ; 24(11): 1169-1174, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1542850


<b>Background and Objective:</b> In recent years, respiratory tract viral infections have caused many pandemics that impact the whole world. To investigate the seropositivity of <i>Toxoplasma gondii</i>, rubella, CMV, HSV-1 and group A <i>Streptococcus</i> in recovered COVID-19 patients and correlate these findings with vitamin D levels. <b>Materials and Methods:</b> A total of 417 COVID-19 patients with diarrhoea were enrolled in this study. Vitamin D and seroprevalence for <i>Toxoplasma gondii</i>, rubella, CMV, HSV-1 and group A <i>Streptococcus</i> were evaluated and correlated. <b>Results:</b> It was found that recent infection in COVID-19 patients with HSV-1, rubella, <i>Toxoplasma</i> and CMV, respectively. IgG was detected indicating the development of adaptive immunity with all microbes. <b>Conclusion:</b> Current study detected a correlation between vitamin D levels and HSV-1 and no correlation between this infection and vitamin D deficiency with the other microbes.

COVID-19 Serological Testing , COVID-19/diagnosis , Calcifediol/blood , Herpes Simplex/diagnosis , Herpesvirus 1, Human/immunology , Immunoglobulin G/blood , Vitamin D Deficiency/diagnosis , Adaptive Immunity , Adult , Biomarkers/blood , COVID-19/blood , COVID-19/epidemiology , COVID-19/immunology , Cytomegalovirus/immunology , Cytomegalovirus Infections/blood , Cytomegalovirus Infections/diagnosis , Cytomegalovirus Infections/epidemiology , Cytomegalovirus Infections/immunology , Female , Herpes Simplex/blood , Herpes Simplex/epidemiology , Herpes Simplex/immunology , Humans , Male , Middle Aged , Predictive Value of Tests , Prevalence , Rubella/blood , Rubella/diagnosis , Rubella/epidemiology , Rubella/immunology , Rubella virus/immunology , Saudi Arabia/epidemiology , Seroepidemiologic Studies , Streptococcal Infections/blood , Streptococcal Infections/diagnosis , Streptococcal Infections/epidemiology , Streptococcal Infections/immunology , Streptococcus/immunology , Toxoplasma/immunology , Toxoplasmosis/blood , Toxoplasmosis/diagnosis , Toxoplasmosis/epidemiology , Toxoplasmosis/immunology , Vitamin D Deficiency/blood , Vitamin D Deficiency/epidemiology
Expert Rev Vaccines ; 20(7): 811-826, 2021 07.
Article in English | MEDLINE | ID: covidwho-1258699


INTRODUCTION: Measles, mumps, and rubella incidence decreased drastically following vaccination programs' implementation. However, measles and mumps' resurgence was recently reported, outbreaks still occur, and challenges remain to control these diseases. AREAS COVERED: This qualitative narrative review provides an objective appraisal of the literature regarding current challenges in controlling measles, mumps, rubella infections, and interventions to address them. EXPERT OPINION: While vaccines against measles, mumps, and rubella (including trivalent vaccines) are widely used and effective, challenges to control these diseases are mainly related to insufficient immunization coverage and changing vaccination needs owing to new global environment (e.g. traveling, migration, population density). By understanding disease transmission peculiarities by setting, initiatives are needed to optimize vaccination policies and increase vaccination coverage, which was further negatively impacted by COVID-19 pandemic. Also, awareness of the potential severity of infections and the role of vaccines should increase. Reminder systems, vaccination of disadvantaged, high-risk and difficult-to-reach populations, accessibility of vaccination, healthcare infrastructure, and vaccination services management should improve. Outbreak preparedness should be strengthened, including implementation of high-quality surveillance systems to monitor epidemiology. While the main focus should be on these public health initiatives to increase vaccination coverage, slightly more benefits could come from evolution of current vaccines.

PLAIN LANGUAGE SUMMARYWhat is the context?Measles, mumps, and rubella are highly contagious diseases associated with significant medical and societal burden. Effective vaccines against these diseases are available, and the implementation of vaccination programs drastically reduced disease incidence globally. However, reports of measles and mumps outbreaks in the last few years highlight remaining challenges to eliminate these diseases.What does the review highlight?We conducted a literature review to identify challenges associated with controlling measles, mumps, and rubella infections, and interventions needed to address them. We identified 11 challenges mainly related to low immunization coverage and vaccine characteristics. Societal challenges could be addressed by increasing awareness of disease severity and vaccines impact, targeting high-risk, unvaccinated, and under-vaccinated populations, improving vaccination access, setting up clear outbreak preparedness plans, and implementing country-specific vaccination policies. System weaknesses could be addressed through improving vaccination services and health infrastructure, implementing high-quality surveillance, patient invite, and reminder systems, ensuring vaccine implementation and long-term supply. Interventions related to vaccine characteristic challenges could include adaptation of vaccination schedules (shorter interval between doses, administration of a third dose) and development of vaccines against emerging strains.What is the take-home message?Policymakers should support the following strategies to increase vaccination coverage and reach elimination of measles, mumps, and rubella: strengthening health systems and vaccination access; raising awareness of disease severity and vaccination impact; limiting disease propagation owing to global changing environment and population dynamics (traveling, migration); improving surveillance systems to rapidly address the immunity gaps against disease resurgence.

Measles-Mumps-Rubella Vaccine/administration & dosage , Measles/prevention & control , Mumps/prevention & control , Rubella/prevention & control , Vaccination Coverage/methods , Vaccination/methods , Disease Outbreaks/prevention & control , Humans , Measles/epidemiology , Measles/psychology , Mumps/epidemiology , Mumps/psychology , Rubella/epidemiology , Rubella/psychology , Vaccination/psychology , Vaccination Refusal/psychology
Int J Environ Res Public Health ; 18(1)2020 12 22.
Article in English | MEDLINE | ID: covidwho-1011508


The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted essential health services. Simultaneously, it has created opportunities for citizens to raise awareness of personal hygiene, mask wearing, and other preventive measures. This brief report aims to clarify the epidemiological trends of measles and rubella in Japan and to explore future challenges for controlling these diseases during and after the COVID-19 pandemic. Although Japan eliminated measles in 2015, the number of measles patients has gradually increased since then, and reached 744 in 2019. In the 2010s, Japan experienced two large rubella epidemics, and the majority of the patients were reported in Tokyo and other metropolitan areas. While the transmission of measles and rubella seems to be suppressed during the COVID-19 pandemic, closing the gap in routine childhood vaccination will be challenging in any country. Moreover, supplementary immunization campaigns for adults have also been disrupted, and they must be invigorated. While the pandemic has a devastating effect on a global scale, it should be utilized as a good opportunity to regain faith in vaccines, implement an evidence-based vaccination policy, and strengthen international cooperation.

COVID-19 , Immunization Programs , Measles , Pandemics , Rubella , Adult , Child , Humans , Japan/epidemiology , Measles/epidemiology , Measles/prevention & control , Rubella/epidemiology , Rubella/prevention & control , Vaccination