RESUMO
Although few measles cases were reported in France during 2006 and 2007, suggesting the country might have been close to eliminating the disease, a dramatic outbreak of >20,000 cases occurred during 2008-2011. Adolescents and young adults accounted for more than half of cases; median patient age increased from 12 to 16 years during the outbreak. The highest incidence rate was observed in children <1 year of age, reaching 135 cases/100,000 infants during the last epidemic wave. Almost 5,000 patients were hospitalized, including 1,023 for severe pneumonia and 27 for encephalitis/myelitis; 10 patients died. More than 80% of the cases during this period occurred in unvaccinated persons, reflecting heterogeneous vaccination coverage, where pockets of susceptible persons still remain. Although vaccine coverage among children improved, convincing susceptible young adults to get vaccinated remains a critical issue if the target to eliminate the disease by 2015 is to be met.
Assuntos
Surtos de Doenças/prevenção & controle , Vacinação em Massa , Sarampo/prevenção & controle , Adolescente , Adulto , Criança , Pré-Escolar , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/virologia , Feminino , França/epidemiologia , Genótipo , Humanos , Lactente , Masculino , Sarampo/epidemiologia , Sarampo/virologia , Vacina contra Sarampo , Morbillivirus/genética , Morbillivirus/imunologia , Adulto JovemRESUMO
From January 2008 to May 2012, over 22,000 cases of measles were reported in France. The highest incidence rate was observed in children below one year of age. Over 50% of cases were reported in young adults. Almost 5,000 patients were hospitalised including 1,023 with severe pneumonia, 27 with encephalitis and/or myelitis : 10 died. This situation is linked to insufficient and heterogeneous vaccination coverage with pockets of susceptible people allowing virus circulation. Although the vaccine coverage in children has now improved for both doses, the issue of convincing young susceptible adults to catch up for measles vaccination remains critical, if the elimination target is to be met, and in order to protect the most vulnerable population unable to benefit from this vaccination (children below 1 year, immunodeficient people, pregnant women).
Assuntos
Sarampo/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Diarreia/etiologia , Encefalite Viral/etiologia , França/epidemiologia , Guiana Francesa/epidemiologia , Mapeamento Geográfico , Guadalupe/epidemiologia , Humanos , Incidência , Lactente , Recém-Nascido , Martinica/epidemiologia , Sarampo/complicações , Sarampo/prevenção & controle , Vacina contra Sarampo , Otite Média/etiologia , Pneumonia Viral/etiologia , Reunião/epidemiologia , Panencefalite Esclerosante Subaguda/etiologia , Vacinação/estatística & dados numéricos , Adulto JovemRESUMO
The three French territories in the Pacific (New Caledonia [NC], French Polynesia [FP] and Wallis and Futuna [WF]) have been affected by an outbreak of influenza A(H1N1)2009 during the austral winter of 2009. This wave of influenza-like illness was characterized by a short duration (approximately 8 weeks) and high attack rates: 16-18% in NC and FP, 28% in Wallis and 38% in Futuna. The number of infected patients requiring hospitalization in critical care services and the number of deaths were, respectively, 21 and 10 in NC and 13 and 7 in FP (none in WF). Diabetes, cardiac and pulmonary diseases, obesity in adults, neuromuscular diseases in children, and Oceanic origin were frequently observed among severe cases and deaths. A significant proportion of the population remains susceptible to A(H1N1)2009, making the occurrence of a second wave likely. A state of preparedness and control efforts must be implemented, based on preventive measures (immunization), as well as combined clinical and virological surveillance and health organization.
