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1.
Euro Surveill ; 25(3)2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31992389

RESUMO

Recognition of measles is crucial to prevent transmissions in the hospital settings. Little is known about the level of recognition of measles and possible causes of not recognising the disease by physicians in the post-vaccine era. We report on a measles outbreak in a paediatric hospital in Austria in January to February 2017 with strikingly high numbers of not recognised cases. The extent and course of the outbreak were assessed via retrospective case finding. Thirteen confirmed measles cases were identified, two with atypical clinical picture. Of eight cases with no known epidemiological link, only one was diagnosed immediately; four were recognised with delay and three only retrospectively. Eleven typical measles cases had four 'unrecognised visits' to the outpatient clinic and 28 on the ward. Two atypical cases had two 'unrecognised visits' to the outpatient clinic and 19 on the ward.Thirteen clinicians did not recognise typical measles (atypical cases not included). Twelve of 23 physicians involved had never encountered a patient with measles before. The direct and indirect costs related to the outbreak were calculated to be over EUR 80,000. Our findings suggest the need to establish regular training programmes about measles, including diagnostic pitfalls in paediatric hospitals.


Assuntos
Surtos de Doenças/estatística & dados numéricos , Vírus do Sarampo/genética , Vírus do Sarampo/imunologia , Sarampo/epidemiologia , Adolescente , Adulto , Áustria/epidemiologia , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Feminino , Hospitais Pediátricos , Hospitais Universitários , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Lactente , Masculino , Vírus do Sarampo/isolamento & purificação , RNA Viral/análise , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
2.
Artigo em Inglês | MEDLINE | ID: mdl-31802153

RESUMO

Immunization has made an enormous contribution to global health. Global vaccination coverage has dramatically improved and mortality rates among children due to vaccine-preventable diseases have been significantly reduced since the creation of the Expanded Programme of Immunization in 1974, the formation of Gavi, the Vaccine Alliance, in 2000, and the development of the Global Vaccine Action Plan in 2012. However, challenges remain and persisting inequities in vaccine uptake contribute to the continued occurrence and outbreaks of vaccine-preventable diseases. Inequalities in immunization coverage by geography, urban-rural, and socio-economic status jeopardize the achievement of global immunization goals and call for renewed immunization strategies. These should take into account emerging opportunities for building better immunization systems and services, as well as the development of new vaccine products and delivery technologies. Such strategies need to achieve equity in vaccination coverage across and within countries. This will require the participation of communities, a better understanding of vaccine acceptance and hesitancy, the expansion of vaccination across the life course, approaches to improve immunization in middle-income countries, enhanced use of data and possible financial and non-financial incentives. Vaccines also have an important role to play in comprehensive disease control, including the fight against antimicrobial resistance. Lessons learned from disease eradication and elimination efforts of polio, measles and maternal and neonatal tetanus are instrumental in further enhancing global immunization strategies in line with the revised goals and targets of the new Immunization Agenda 2030, which is currently being developed.


Assuntos
Programas de Imunização , Imunização , Criança , Alemanha , Saúde Global , Humanos , Sarampo , Vacinação
4.
Nursing ; 50(1): 39-43, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31855986

RESUMO

Measles has re-emerged in the US for a variety of reasons, including misinformation spread by antivaccination advocates and imported cases from countries where infected children may be too young for immunization. Prompt diagnosis and isolation can help reduce measles transmission.


Assuntos
Doenças Transmissíveis Emergentes/enfermagem , Sarampo/enfermagem , Doenças Transmissíveis Emergentes/epidemiologia , Humanos , Sarampo/epidemiologia , Sarampo/fisiopatologia , Vacina contra Sarampo-Caxumba-Rubéola/administração & dosagem , Diagnóstico de Enfermagem , Educação de Pacientes como Assunto , Fatores de Risco , Estados Unidos/epidemiologia
5.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46933

RESUMO

Mais de 140 mil pessoas no mundo morreram em decorrência do sarampo em 2018, de acordo com novas estimativas da Organização Mundial da Saúde (OMS) e dos Centros para Controle e Prevenção de Doenças (CDC) dos Estados Unidos. Essas mortes ocorreram em um momento em que os casos de sarampo aumentaram globalmente, com surtos devastadores em todas as regiões.


Assuntos
Sarampo , Sarampo/mortalidade
6.
MMWR Morb Mortal Wkly Rep ; 68(48): 1105-1111, 2019 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-31805033

RESUMO

In 2010, the World Health Assembly (WHA) set the following three milestones for measles control to be achieved by 2015: 1) increase routine coverage with the first dose of measles-containing vaccine (MCV1) among children aged 1 year to ≥90% at the national level and to ≥80% in every district, 2) reduce global annual measles incidence to less than five cases per 1 million population, and 3) reduce global measles mortality by 95% from the 2000 estimate* (1). In 2012, WHA endorsed the Global Vaccine Action Plan,† with the objective of eliminating measles§ in five of the six World Health Organization (WHO) regions by 2020. This report updates a previous report (2) and describes progress toward WHA milestones and regional measles elimination during 2000-2018. During 2000-2018, estimated MCV1 coverage increased globally from 72% to 86%; annual reported measles incidence decreased 66%, from 145 to 49 cases per 1 million population; and annual estimated measles deaths decreased 73%, from 535,600 to 142,300. During 2000-2018, measles vaccination averted an estimated 23.2 million deaths. However, the number of measles cases in 2018 increased 167% globally compared with 2016, and estimated global measles mortality has increased since 2017. To continue progress toward the regional measles elimination targets, resource commitments are needed to strengthen routine immunization systems, close historical immunity gaps, and improve surveillance. To achieve measles elimination, all communities and countries need coordinated efforts aiming to reach ≥95% coverage with 2 doses of measles vaccine (3).


Assuntos
Erradicação de Doenças , Saúde Global/estatística & dados numéricos , Sarampo/prevenção & controle , Adolescente , Adulto , Criança , Pré-Escolar , Humanos , Programas de Imunização , Incidência , Lactente , Sarampo/epidemiologia , Sarampo/mortalidade , Vacina contra Sarampo/administração & dosagem , Adulto Jovem
7.
MMWR Morb Mortal Wkly Rep ; 68(48): 1112-1116, 2019 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-31805034

RESUMO

In 2005, the World Health Organization (WHO) Western Pacific Region countries, including China, resolved to eliminate measles by 2012 or as soon as feasible thereafter (1). As of 2018, nine* of the 37 Western Pacific Region countries or areas† had eliminated§ measles. China's Measles Elimination Action Plan 2006-2012 included strengthening routine immunization; conducting measles risk assessments, followed by supplementary immunization activities (SIAs) with measles-containing vaccine (MCV) at national and subnational levels; strengthening surveillance and laboratory capacity; and investigating and responding to measles outbreaks. Most recently, progress toward measles elimination in China was described in a 2014 report documenting measles elimination efforts in China during 2008-2012 and a resurgence in 2013 (2). This report describes progress toward measles elimination in China during January 2013-June 2019.¶ Measles incidence per million persons decreased from 20.4 in 2013 to 2.8 in 2018; reported measles-related deaths decreased from 32 in 2015 to one in 2018 and no deaths in 2019 through June. Measles elimination in China can be achieved through strengthening the immunization program's existing strategy by ensuring sufficient vaccine supply; continuing to improve laboratory-supported surveillance, outbreak investigation and response; strengthening school entry vaccination record checks; vaccinating students who do not have documentation of receipt of 2 doses of measles-rubella vaccine; and vaccinating health care professionals and other adults at risk for measles.


Assuntos
Erradicação de Doenças , Surtos de Doenças/prevenção & controle , Sarampo/prevenção & controle , Vigilância da População , Adolescente , Criança , Pré-Escolar , China/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Feminino , Humanos , Programas de Imunização , Incidência , Lactente , Masculino , Sarampo/epidemiologia , Sarampo/mortalidade , Vacina contra Sarampo/administração & dosagem
9.
Rev Med Chil ; 147(5): 650-657, 2019 May.
Artigo em Espanhol | MEDLINE | ID: mdl-31859898

RESUMO

BACKGROUND: There is always a risk of importing infectious diseases when travelling abroad. AIM: To estimate the effective risk of a Chilean of acquiring measles during a travel by countries where measles outbreaks have been reported, considering the present level of immunity in the country. MATERIAL AND METHODS: Previously established mathematical models using differential equations were applied to calculate the risk of acquiring measles of people traveling to endemic areas. RESULTS: The probability of acquiring measles of a voyager is 8.11 x 10-8. CONCLUSIONS: These estimations help decision making about preventive measures for travelers to endemic measles areas.


Assuntos
Sarampo/transmissão , Modelos Teóricos , Medição de Risco/métodos , Doença Relacionada a Viagens , Chile/epidemiologia , Surtos de Doenças , Humanos , Sarampo/epidemiologia , Sarampo/prevenção & controle , Vacina contra Sarampo , Probabilidade , Fatores de Risco , Fatores de Tempo , Vacinação
12.
PLoS Med ; 16(12): e1002994, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31869328

RESUMO

BACKGROUND: Vaccine hesitancy, the reluctance or refusal to receive vaccination, is a growing public health problem in the United States and globally. State policies that eliminate nonmedical ("personal belief") exemptions to childhood vaccination requirements are controversial, and their effectiveness to improve vaccination coverage remains unclear given limited rigorous policy analysis. In 2016, a California policy (Senate Bill 277) eliminated nonmedical exemptions from school entry requirements. The objective of this study was to estimate the association between California's 2016 policy and changes in vaccine coverage. METHODS AND FINDINGS: We used a quasi-experimental state-level synthetic control analysis and a county-level difference-in-differences analysis to estimate the impact of the 2016 California policy on vaccination coverage and prevalence of exemptions to vaccine requirements (nonmedical and medical). We used publicly available state-level data from the US Centers for Disease Control and Prevention on coverage of measles, mumps, and rubella (MMR) vaccination, nonmedical exemption, and medical exemption in children entering kindergarten. We used county-level data individually requested from state departments of public health on overall vaccine coverage and exemptions. Based on data availability, we included state-level data for 45 states, including California, from 2011 to 2017 and county-level data for 17 states from 2010 to 2017. The prespecified primary study outcome was MMR vaccination in the state analysis and overall vaccine coverage in the county analysis. In the state-level synthetic control analysis, MMR coverage in California increased by 3.3% relative to its synthetic control in the postpolicy period (top 2 of 43 states evaluated in the placebo tests, top 5%), nonmedical exemptions decreased by 2.4% (top 2 of 43 states evaluated in the placebo tests, top 5%), and medical exemptions increased by 0.4% (top 1 of 44 states evaluated in the placebo tests, top 2%). In the county-level analysis, overall vaccination coverage increased by 4.3% (95% confidence interval [CI] 2.9%-5.8%, p < 0.001), nonmedical exemptions decreased by 3.9% (95% CI 2.4%-5.4%, p < 0.001), and medical exemptions increased by 2.4% (95% CI 2.0%-2.9%, p < 0.001). Changes in vaccination coverage across counties after the policy implementation from 2015 to 2017 ranged from -6% to 26%, with larger increases in coverage in counties with lower prepolicy vaccine coverage. Results were robust to alternative model specifications. The limitations of the study were the exclusion of a subset of US states from the analysis and the use of only 2 years of postpolicy data based on data availability. CONCLUSIONS: In this study, implementation of the California policy that eliminated nonmedical childhood vaccine exemptions was associated with an estimated increase in vaccination coverage and a reduction in nonmedical exemptions at state and county levels. The observed increase in medical exemptions was offset by the larger reduction in nonmedical exemptions. The largest increases in vaccine coverage were observed in the most "high-risk" counties, meaning those with the lowest prepolicy vaccine coverage. Our findings suggest that government policies removing nonmedical exemptions can be effective at increasing vaccination coverage.


Assuntos
Política de Saúde/legislação & jurisprudência , Formulação de Políticas , Cobertura Vacinal/legislação & jurisprudência , Vacinação/legislação & jurisprudência , Vacinas/economia , California , Criança , Pré-Escolar , Humanos , Sarampo/prevenção & controle , Saúde Pública/legislação & jurisprudência , Instituições Acadêmicas/estatística & dados numéricos , Estados Unidos , Vacinação/métodos
13.
Wiad Lek ; 72(11 cz 1): 2145-2148, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31860862

RESUMO

OBJECTIVE: Introduction: During last year's, Ukraine and other European countries are facing outbreaks of well-known and emergency infections. Particularly alarming is the increase in the incidence of measles, which may be the result of a sharp decline of immunization that leads to the accumulation of susceptible individuals in the population. The aim was to assess the incidence of measles and the vaccination coverage for measles during last 5 years among children of Sumy region of Ukraine and factors due to which it is unable to be reached the required level of MMR-vaccination.. RESULTS: Review: Statistical data shown the vaccination coverage rates was dangerously low in Sumy region of Ukraine last 5 years. It began to decrease starting from 2013 year. measles vaccination coverage in 2013 was below 50%, reaching a staggering minimum of ~ 30 % in 2014 and 20 % in 2015. According to our research (questioning), the targeted vaccination coverage for measles was unable to be reached due to several factors, such as the active refusal of parents to vaccinate their children or partly the lack of sufficient vaccine supplies. CONCLUSION: Conclusions: MMR-vaccination uptake in Sumy Region is still below World Health Organization target. In the period 2014-2016, the level of children immunization was critically low and the concept of herd immunity was lost. This is the main reason for the ongoing measles outbreak in 2018. It is of the utmost importance that all medical professionals, physicians, researchers, educators, and governments of Ukraine unite to combat the anti-vaccination movement.


Assuntos
Sarampo , Criança , Surtos de Doenças , Europa (Continente) , Humanos , Sarampo/epidemiologia , Vacina contra Sarampo , Ucrânia , Vacinação
15.
BMC Public Health ; 19(1): 1421, 2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31666039

RESUMO

BACKGROUND: Inability to track children's vaccination history coupled with parents' lack of awareness of vaccination due dates compounds the problem of low immunization coverage and timeliness in developing countries. Traditional Reminder/Recall (RR) interventions such as paper-based immunization cards or mHealth based platforms do not yield optimal results in resource-constrained settings. There is thus a need for a low-cost intervention that can simultaneously stimulate demand and track immunization history to help reduce drop-outs and improve immunization coverage and timeliness. The objective of this study is to evaluate the impact of low-cost vaccine reminder and tracker bracelets for improving routine childhood immunization coverage and timeliness in Pakistani children under 2 years of age. METHODS: The study is an individually randomized, three-arm parallel Randomized Controlled Trial with two intervention groups and one control group. Infants in the two intervention groups will be given two different types of silicone bracelets at the time of recruitment, while infants in the control group will not receive any intervention. The two types of bracelets consist of symbols and/or numbers to denote the EPI vaccination schedule and each time the child will come for vaccination, the study staff will perforate a hole in the appropriate symbol to denote vaccine administration. Therefore, by looking at the bracelet, caregivers will be able to see how many vaccines have been received. Our primary outcome measure is the increase in coverage and timeliness of Pentavalent-3/PCV-3/Polio-3 and Measles-1 vaccine in the intervention versus control groups. A total of 1446 participants will be recruited from 4 Expanded Program on Immunization (EPI) centers in Landhi Town, Karachi. Each enrolled child will be followed up till the Measles-1 vaccine is administered, or till eleven months have elapsed since enrolment. DISCUSSION: Participant recruitment commenced on July 19, 2017, and was completed on October 10, 2017. Proposed duration of the study is 18 months and expected end date is December 1, 2018. This study constitutes one of the first attempts to rigorously evaluate an innovative, low-cost vaccine reminder bracelet. TRIAL REGISTRATION: ClinicalTrials.gov NCT03310762 . Retrospectively Registered on October 16, 2017.


Assuntos
Programas de Imunização/métodos , Esquemas de Imunização , Pais , Sistemas de Alerta , Cobertura Vacinal , Vacinação , Vacinas/administração & dosagem , Cuidadores , Pré-Escolar , Análise Custo-Benefício , Países em Desenvolvimento , Feminino , Humanos , Lactente , Masculino , Sarampo/prevenção & controle , Paquistão , Poliomielite/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Sistemas de Alerta/instrumentação , Projetos de Pesquisa , Estudos Retrospectivos , População Urbana
17.
N Engl J Med ; 381(20): 1978, 2019 11 14.
Artigo em Inglês | MEDLINE | ID: mdl-31722164

Assuntos
Sarampo , Humanos
18.
N Engl J Med ; 381(20): 1978-1979, 2019 11 14.
Artigo em Inglês | MEDLINE | ID: mdl-31722165

Assuntos
Sarampo , Humanos
20.
Medicine (Baltimore) ; 98(43): e17507, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651854

RESUMO

This study aimed to investigate measles antibody level and its associated factors in a healthy Chinese population, so as to provide evidence to measles prevention and control measures in the future.We conducted a cross-sectional survey by using probability proportionate to size sampling (PPS) among a healthy population aged 8 months to 45 years. Information on measles vaccination status was obtained from the vaccination certificates. Serum measles IgG antibody was detected by enzyme-linked immunosorbent assay. Multivariate logistic and linear regression models were used to analysis the associated factors of measles antibody.Of the 663 study subjects, the positive rate, protective rate, and geometric mean concentration (GMC) of measles antibodies were 92.76%, 77.53%, 1612.55 mIU/ml, respectively. The antibody concentration was higher in Han ethnical majority than in Hui minority. The positive rate, protective rate and concentration of antibodies in different age groups and regions were clearly disparate. Age, area, and measles-containing vaccine (MCV) immunization history were the prominent influencing factors of antibody positive rate and protective rate. Ethnicity, age, area, and MVC immunization history were the influencing factors of antibody concentration.Our major findings suggest that, children in rural China, especially in impoverished mountainous regions, were more likely to suffer from delays in measles vaccination. Various measures in optimizing vaccination practices should be implemented in order to prevent possible measles epidemic, even outbreak in these regions.


Assuntos
Anticorpos Antivirais/sangue , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Sarampo/imunologia , Morbillivirus/imunologia , Saúde da População/estatística & dados numéricos , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático/etnologia , Criança , Pré-Escolar , China , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Voluntários Saudáveis , Humanos , Imunoglobulina G/imunologia , Lactente , Modelos Lineares , Masculino , Sarampo/prevenção & controle , Vacina contra Sarampo/uso terapêutico , Pessoa de Meia-Idade , Análise Multivariada , Vacinação/estatística & dados numéricos , Adulto Jovem
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