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3.
Washington, D.C.; PAHO; 2021-02-01.
en Inglés, Español | PAHO-IRIS | ID: phr-53240

RESUMEN

Several factors have contributed to the outbreaks of measles and diphtheria in the Region of the Americas, including lack of compliance of vaccination coverage. Moreover, the onset of the COVID-19 pandemic has decrease in the demand for vaccination services, followed by the impact on the vaccination coverages and the postponement of vaccination campaigns. The following is a summary of the epidemiological situation of measles and diphtheria in 2020, as of epidemiological week (EW) 53.


Diversos factores han contribuido a la ocurrencia de brotes de sarampión y difteria en la Región de las Américas, entre ellos el no alcanzar coberturas de vacunación útiles. Adicionalmente, el inicio de la pandemia por la COVID-19 ha disminuido la demanda de servicios de vacunación, con el consecuente impacto en las coberturas; además del aplazamiento de las campañas de vacunación. A continuación, se presenta un resumen de la situación epidemiológica de sarampión y difteria para el 2020 con datos hasta la semana epidemiológica (SE) 53.


Asunto(s)
Sarampión , Difteria , Urgencias Médicas , Infecciones por Coronavirus , Reglamento Sanitario Internacional , Infecciones por Coronavirus , Coronavirus , Américas , Región del Caribe , Sarampión , Difteria , Urgencias Médicas , Reglamento Sanitario Internacional , Infecciones por Coronavirus , Américas , Región del Caribe , Betacoronavirus
4.
BMC Med ; 19(1): 35, 2021 02 03.
Artículo en Inglés | MEDLINE | ID: mdl-33531015

RESUMEN

BACKGROUND: The COVID-19 pandemic has disrupted routine measles immunisation and supplementary immunisation activities (SIAs) in most countries including Kenya. We assessed the risk of measles outbreaks during the pandemic in Kenya as a case study for the African Region. METHODS: Combining measles serological data, local contact patterns, and vaccination coverage into a cohort model, we predicted the age-adjusted population immunity in Kenya and estimated the probability of outbreaks when contact-reducing COVID-19 interventions are lifted. We considered various scenarios for reduced measles vaccination coverage from April 2020. RESULTS: In February 2020, when a scheduled SIA was postponed, population immunity was close to the herd immunity threshold and the probability of a large outbreak was 34% (8-54). As the COVID-19 contact restrictions are nearly fully eased, from December 2020, the probability of a large measles outbreak will increase to 38% (19-54), 46% (30-59), and 54% (43-64) assuming a 15%, 50%, and 100% reduction in measles vaccination coverage. By December 2021, this risk increases further to 43% (25-56), 54% (43-63), and 67% (59-72) for the same coverage scenarios respectively. However, the increased risk of a measles outbreak following the lifting of all restrictions can be overcome by conducting a SIA with ≥ 95% coverage in under-fives. CONCLUSION: While contact restrictions sufficient for SAR-CoV-2 control temporarily reduce measles transmissibility and the risk of an outbreak from a measles immunity gap, this risk rises rapidly once these restrictions are lifted. Implementing delayed SIAs will be critical for prevention of measles outbreaks given the roll-back of contact restrictions in Kenya.


Asunto(s)
/epidemiología , Brotes de Enfermedades/prevención & control , Vacuna Antisarampión/provisión & distribución , Sarampión/prevención & control , Adolescente , Niño , Preescolar , Femenino , Humanos , Programas de Inmunización , Lactante , Recién Nacido , Kenia/epidemiología , Masculino , Sarampión/sangre , Sarampión/complicaciones , Cobertura de Vacunación
6.
Isr J Health Policy Res ; 10(1): 2, 2021 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-33451324

RESUMEN

Measles is a highly contagious disease. A 24 years old patient, recently exposed to measles (unvaccinated), presented in the emergency department with severe agitation, compatible with an acute psychotic episode, during the measles epidemic which spread in Israel in 2018-2019. Upon hospital admission, strict isolation was instructed, yet, without compliance, probably due to the patient's status. Measles diagnosis was promptly confirmed. As measles transmission was eminent, public health measures were employed through immediate implementation of the section 15 of the Public Health Ordinance, allowing for compulsory short-term isolation. The patient's condition improved within a few days and the measures were no longer necessary. This measles case occurred in the pre-Coronavirus disease 2019 (COVID-19) epidemic when use of a Public Health Ordinance was considered an extreme measure. This is in contrast to the current global use of Public Health laws to enforce strict quarantine and isolation on persons infected or potentially exposed to COVID-19. Nevertheless, minimizing infectious diseases transmission is a core function of public health law. Utilizing legal enforcement in circumstances of immediate public health hazard, such as nosocomial measles transmission, necessitates careful consideration. The integrative clinical and public health approach and prompt measures employed in this exceptional case, led to prevention of further infection spread.


Asunto(s)
Infección Hospitalaria/prevención & control , Sarampión/prevención & control , Aislamiento de Pacientes/legislación & jurisprudencia , Salud Pública/legislación & jurisprudencia , Enfermedad Aguda , Servicio de Urgencia en Hospital , Hospitalización , Humanos , Israel/epidemiología , Masculino , Sarampión/complicaciones , Sarampión/epidemiología , Trastornos Psicóticos/etiología , Trastornos Psicóticos/terapia , Adulto Joven
7.
BMC Med ; 19(1): 2, 2021 01 05.
Artículo en Inglés | MEDLINE | ID: mdl-33397366

RESUMEN

BACKGROUND: Through a combination of strong routine immunization (RI), strategic supplemental immunization activities (SIA) and robust surveillance, numerous countries have been able to approach or achieve measles elimination. The fragility of these achievements has been shown, however, by the resurgence of measles since 2016. We describe trends in routine measles vaccine coverage at national and district level, SIA performance and demographic changes in the three regions with the highest measles burden. FINDINGS: WHO-UNICEF estimates of immunization coverage show that global coverage of the first dose of measles vaccine has stabilized at 85% from 2015 to 19. In 2000, 17 countries in the WHO African and Eastern Mediterranean regions had measles vaccine coverage below 50%, and although all increased coverage by 2019, at a median of 60%, it remained far below levels needed for elimination. Geospatial estimates show many low coverage districts across Africa and much of the Eastern Mediterranean and southeast Asian regions. A large proportion of children unvaccinated for MCV live in conflict-affected areas with remote rural areas and some urban areas also at risk. Countries with low RI coverage use SIAs frequently, yet the ideal timing and target age range for SIAs vary within countries, and the impact of SIAs has often been mitigated by delays or disruptions. SIAs have not been sufficient to achieve or sustain measles elimination in the countries with weakest routine systems. Demographic changes also affect measles transmission, and their variation between and within countries should be incorporated into strategic planning. CONCLUSIONS: Rebuilding services after the COVID-19 pandemic provides a need and an opportunity to increase community engagement in planning and monitoring services. A broader suite of interventions is needed beyond SIAs. Improved methods for tracking coverage at the individual and community level are needed together with enhanced surveillance. Decision-making needs to be decentralized to develop locally-driven, sustainable strategies for measles control and elimination.


Asunto(s)
Erradicación de la Enfermedad , Programas de Inmunización , Inmunización Secundaria , Sarampión , Regionalización/organización & administración , Cobertura de Vacunación/tendencias , África/epidemiología , Asia Sudoriental/epidemiología , /prevención & control , Niño , Erradicación de la Enfermedad/métodos , Erradicación de la Enfermedad/estadística & datos numéricos , Humanos , Programas de Inmunización/métodos , Programas de Inmunización/organización & administración , Inmunización Secundaria/métodos , Inmunización Secundaria/estadística & datos numéricos , Sarampión/epidemiología , Sarampión/prevención & control , Vacuna Antisarampión/uso terapéutico , Región Mediterránea/epidemiología
8.
Nat Commun ; 12(1): 132, 2021 01 08.
Artículo en Inglés | MEDLINE | ID: mdl-33420104

RESUMEN

The use of pesticides to reduce mosquito vector populations is a cornerstone of global malaria control efforts, but the biological impact of most pesticides on human populations, including pregnant women and infants, is not known. Some pesticides, including carbamates, have been shown to perturb the human immune system. We measure the systemic absorption and immunologic effects of bendiocarb, a commonly used carbamate pesticide, following household spraying in a cohort of pregnant Ugandan women and their infants. We find that bendiocarb is present at high levels in maternal, umbilical cord, and infant plasma of individuals exposed during pregnancy, indicating that it is systemically absorbed and trans-placentally transferred to the fetus. Moreover, bendiocarb exposure is associated with numerous changes in fetal immune cell homeostasis and function, including a dose-dependent decrease in regulatory CD4 T cells, increased cytokine production, and inhibition of antigen-driven proliferation. Additionally, prenatal bendiocarb exposure is associated with higher post-vaccination measles titers at one year of age, suggesting that its impact on functional immunity may persist for many months after birth. These data indicate that in utero bendiocarb exposure has multiple previously unrecognized biological effects on the fetal immune system.


Asunto(s)
Contaminantes Ambientales/efectos adversos , Feto/inmunología , Exposición Materna/efectos adversos , Sarampión/sangre , Plaguicidas/efectos adversos , Adulto , Anticuerpos Antivirales/sangre , Preescolar , Ensayos Clínicos Fase III como Asunto , Femenino , Sangre Fetal/química , Estudios de Seguimiento , Humanos , Sistema Inmunológico/efectos de los fármacos , Inmunogenicidad Vacunal , Inmunoglobulina G/sangre , Lactante , Recién Nacido , Malaria/prevención & control , Intercambio Materno-Fetal/inmunología , Sarampión/inmunología , Sarampión/prevención & control , Vacuna Antisarampión/administración & dosificación , Vacuna Antisarampión/inmunología , Control de Mosquitos/métodos , Plaguicidas/análisis , Fenilcarbamatos/efectos adversos , Fenilcarbamatos/análisis , Embarazo , Ensayos Clínicos Controlados Aleatorios como Asunto
12.
Nature ; 589(7842): 415-419, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33328634

RESUMEN

The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99% of both occurred in low- and middle-income countries (LMICs)1-4. Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19)5-8. Here we generated annual estimates of routine childhood MCV1 coverage at 5 × 5-km2 pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations; strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children.


Asunto(s)
Países Desarrollados/estadística & datos numéricos , Mapeo Geográfico , Sarampión/epidemiología , Sarampión/prevención & control , Vacunación/estadística & datos numéricos , Niño , Preescolar , Disparidades en Atención de Salud/estadística & datos numéricos , Humanos , Internacionalidad , Sarampión/inmunología , Salud Rural/estadística & datos numéricos , Incertidumbre , Salud Urbana/estadística & datos numéricos , Negativa a la Vacunación/estadística & datos numéricos
14.
Artículo en Inglés | MEDLINE | ID: mdl-33333819

RESUMEN

On 21 January 2019, public health authorities of two neighboring Austrian provinces reported an increase in measles cases. We investigated this occurrence to identify clusters of epidemiologically linked cases and the associated vaccination status in order to generate hypotheses on those factors explaining the size of the measles clusters. Probable cases were residents of the provinces of Styria or Salzburg with clinical presentation of measles after 1 January 2019 who were linked to a confirmed case using RNA virus detection. We collected data on age, rash onset, certificate-based vaccination status and reasons for being unvaccinated. Contact history was used to identify chains of transmission. By 11 March, we identified 47 cases, with 40 (85.1%) in unvaccinated patients. A cluster of 35 cases with a median age of seven years (IQR: 1-11) occurred between 9 January and 20 February in the province of Styria due to one transmission chain with four case generations. Of 31 vaccine-eligible cases, 25 (80.6%) were unvaccinated, of which 13 refused vaccination. Between 10 January and 1 March, we identified 12 cases as part of five unlinked clusters in the province of Salzburg. Each of these five clusters consisted of two generations: the primary case and the successive cases (median age: 22 years, IQR: 11-35). Eleven of 12 cases occurred in unvaccinated patients, with none of the 11 having a vaccination-refusing attitude. An extended measles cluster in a vaccination-refusing community, compared to five short-lived clusters concurrently occurring in the neighboring province, illustrates how vaccine refusal may hamper control of transmission.


Asunto(s)
Brotes de Enfermedades , Sarampión , Adolescente , Adulto , Austria/epidemiología , Niño , Humanos , Sarampión/epidemiología , Sarampión/prevención & control , Salud Pública , Vacunación , Adulto Joven
17.
Washington, D.C.; PAHO; 2020-12-28.
en Inglés | PAHO-IRIS | ID: phr-53167

RESUMEN

Vaccines save between 2 million and 3 million lives each year and protect the entire population from more than a dozen life-threatening diseases. Thanks to vaccination, smallpox was eradicated in 1980, and we are on track to eradicate polio. However, despite great strides in the control of measles, one of the most contagious diseases known, the last few years have unfortunately seen an increase in cases. This is why high vaccination coverage—95% or more—is needed, posing a major technical and communication challenge for health workers. Studies show that telling people about the quality, safety, effectiveness and availability of vaccines is not enough to influence behavior change related to immunization, and in general, doesn´t increase coverage. For this reason, it´s necessary to understand the reasons why people choose not to get vaccinated or not get their children vaccinated, in order to begin a two-way respectful dialogue using the best, most effective messages. Given this context, the main objective of these guidelines is to provide tools for staff working in the field of immunization to support effective communication between health personnel and the general population, with the aim of strengthening, maintaining or recovering trust in vaccines and the immunization programs in the Region of the Americas.


Asunto(s)
Vacunas , Vacunación , Inmunización , Familia , Cuidadores , Infecciones por Coronavirus , Coronavirus , Infecciones por Coronavirus , Vacuna Tetravalente Recombinante contra el Virus del Papiloma Humano Tipos 6, 11 , 16, 18 , Papiloma , Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Sarampión , Vacunas contra la Influenza , Vacuna Antisarampión , Virus de la Influenza A , Virus de la Influenza B , Influenzavirus C , Vacuna contra el Sarampión-Parotiditis-Rubéola
18.
Artículo en Inglés | MEDLINE | ID: mdl-33374998

RESUMEN

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.


Asunto(s)
Programas de Inmunización , Sarampión , Pandemias , Rubéola (Sarampión Alemán) , Adulto , Niño , Humanos , Japón/epidemiología , Sarampión/epidemiología , Sarampión/prevención & control , Rubéola (Sarampión Alemán)/epidemiología , Rubéola (Sarampión Alemán)/prevención & control , Vacunación
19.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-47966

RESUMEN

Em 2019, o sarampo aumentou em todo o mundo, atingindo o maior número de casos notificados em 23 anos. Destacados em uma publicação da Organização Mundial da Saúde (OMS) e dos Centros para Controle e Prevenção de Doenças (CDC) dos Estados Unidos, os casos de sarampo notificados em todo o mundo aumentaram para 869.770 em 2019, o maior número registrado desde 1996 com aumentos em todas as regiões da OMS. As mortes globais por sarampo aumentaram quase 50% desde 2016, ceifando cerca de 207,5 mil vidas apenas em 2019.


Asunto(s)
Sarampión/mortalidad ,
20.
Artículo en Alemán | MEDLINE | ID: mdl-33185709

RESUMEN

BACKGROUND AND AIM: Despite a safe and effective vaccine being available for many years, the number of measles cases has been increasing again worldwide since 2018. Our report aims to identify putative reasons for this development. METHODS: We conducted a selective literature search. Further, current reports and data from the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), and the World Bank were evaluated. RESULTS: According to the WHO, Madagascar, the Ukraine, and Israel had the highest incidences of measles worldwide between 1 July 2018 and 30 June 2019. Measles outbreaks are a sign of inadequate vaccination rates caused by multiple structural and psychological barriers. Structural barriers to measles vaccination, such as a lack of routine vaccination programs, have been identified as the main cause of low measles vaccination rates, particularly in fragile countries e.g. due to armed conflicts, but also in some subpopulations of higher-income countries e.g. due to lacking resources for vaccination services. Psychological barriers leading to vaccination skepticism were prevalent mainly in developed countries with well-functioning health systems and a high standard of living. CONCLUSION: The reasons for the global measles crisis are manifold and in some cases have existed for decades. However, the consequences appear to be accumulating and have had a dramatic impact on case numbers since 2018. The goal of measles elimination and maintenance of the necessary vaccination programs is a constant challenge that requires strict and permanent compliance with WHO recommendations. The number of measles cases reported in Germany is still at a level above the key target for measles elimination specified in the national immunization plan. Timely and/or locally restricted as well as nationwide outbreaks continue to occur. Since infectious agents can be transmitted across borders, the international perspective is an essential component of national health policy in Germany.


Asunto(s)
Vacuna Antisarampión , Sarampión , Conflictos Armados , Niño , Alemania/epidemiología , Salud Global , Humanos , Programas de Inmunización , Sarampión/epidemiología , Sarampión/prevención & control , Vacunación
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