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1.
Saudi Med J ; 42(11): 1229-1236, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34732556

RESUMO

OBJECTIVES: To detect single nucleotide polymorphism in toll-like receptor 2 (TLR2) gene in complicated cases of measles, in order to understand the genetic basis of complex human immune responses against measles complications. METHODS: A total of 100 children consisted of 50 measles complicated cases while rest were gender matched disease-free individuals who served as controls for this study. Patient demographic data and clinical information were recorded on a separate pre-designed model form. All exonic regions of TLR2 gene of the patients and control samples were amplified through polymerase chain reaction. Various in-silico mutation verification tools like protein variation effect analyzer, MUPRO, sorting intolerant from tolerant, functional analysis through hidden Markov models, and polymorphism phenotyping v2 to study the effect of novel non-synonymous polymorphism on structure and function of TLR2 protein. RESULTS: Synonymous and novel non-synonymous polymorphisms were identified in measles complicated cases. Among these, rs1816702 was marked to 5 untranslated region section of TLR2 gene, while rs3804099 and rs3804100 were identified in the coding region. Novel non-synonymous polymorphisms were shown in the coding region of TLR2 gene. No significant association was established between the observed genetic polymorphisms and measles complications. However, rs3804100 increased the risk of lower respiratory tract infection. CONCLUSION: The overall impact of novel non-synonymous polymorphism of TLR2 protein structure and functions was neutral and tolerated.


Assuntos
Sarampo , Receptor 2 Toll-Like , Estudos de Casos e Controles , Criança , Predisposição Genética para Doença , Humanos , Sarampo/genética , Paquistão , Polimorfismo de Nucleotídeo Único , Centros de Atenção Terciária , Receptor 2 Toll-Like/genética
2.
BMC Med ; 19(1): 281, 2021 11 17.
Artigo em Inglês | MEDLINE | ID: mdl-34784922

RESUMO

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.


Assuntos
COVID-19 , Sarampo , Criança , Humanos , Programas de Imunização , Lactente , Sarampo/epidemiologia , Sarampo/prevenção & controle , SARS-CoV-2 , Vacinação
4.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(6): 1086-1091, 2021 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814512

RESUMO

Objective: To investigate the immunogenicity and safety of a boost dose of measles, mumps, and rubella combined vaccine (MMR) for children 4 to 6 years old. Methods: Children, aged 4 to 6 years old, had vaccinated with 1 dose of measles and rubella combined vaccine(MR) at the age of 8 months and 1 dose of MMR vaccine at 18-months, were recruited in Shanxi, Inner Mongolia, and Beijing, respectively. All children were assigned into 4, 5 and 6-year-old group. The children who met inclusion and exclusion criteria were vaccinated with 1 dose MMR vaccine, and were collected blood samples before vaccination and 35 to 42 d after the vaccination. During the study period, adverse events were collected at 30 min, 1 d, 2 d, 3 d, 4-12 d, and 13 to 42 days after vaccination. Serum was tested for IgG antibodies against measles, mumps and rubella. Geometric mean concentrations (GMC) of measles, mumps, and rubella antibodies were compared among groups by analysis of variance or non-parametric test. Seropositive rates and adverse event rates were compared among groups by Chi-square test or Fisher exact test. Results: A total of 500 children were included in immunogenicity analysis and 535 children were included in safety analysis. The overall adverse event rate was 20.37%, the most of severity for adverse events was mild. The rates of local and systemic adverse events were 0.37% and 20.00%, respectively. Symptoms of local adverse events were redness. The main systemic adverse events were fever, followed by cough, rash and runny nose. Received a dose of MMR vaccine for booster immunization, the seropositive rates of measles antibody, mumps antibody and rubella antibody were above 99% for all 3 age groups, and there was no significant difference between groups. There were significant differences in mumps antibody GMC among groups (P=0.042), but no significant differences in measles and rubella antibodies GMC. Conclusion: The immunogenicity and safety of a boosted MMR vaccintion in children aged 4, 5 and 6 years were all similar good.


Assuntos
Sarampo , Caxumba , Rubéola (Sarampo Alemão) , Criança , Pré-Escolar , Humanos , Sarampo/prevenção & controle , Vacina contra Sarampo-Caxumba-Rubéola/efeitos adversos , Caxumba/prevenção & controle , Vírus da Caxumba , Rubéola (Sarampo Alemão)/prevenção & controle
5.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(3): 544-548, 2021 Mar 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814427

RESUMO

Objective: To evaluate the value of measles IgG antibody avidity assay in identifying the measles cases. Methods: Data from the Measles Surveillance Information System was used to collect laboratory confirmed or discarded cases in 2013-2015, and then tracing back the blood specimens from all measles network laboratories in Tianjin. Measles antibody avidity assay was used to detect and to redefine cases from the discarded ones. Results: A total of 326 measles cases including 267 laboratory-confirmed and 59 discarded cases were enrolled into this study, with 92.33% (301/326) of them aged ≥20 years. Result from the measles IgG antibody avidity assay showed that the ratio of high-avidity was 91.23%(52/57) of the discarded cases, which was significantly higher than 66.95% (158/236) of the laboratory confirmed cases (χ2=13.33, P<0.001). According to the case criterion, 15.25% (9/59) of the discarded cases were redefined as measles cases. Eight out of the nine cases were high-avidity with measles containing vaccine (MCV) vaccination history that named as SVF cases. One in nine cases with low-avidity was with typical clinical symptomatic measles but with no vaccination history of MCV. Conclusion: Measles IgG antibody avidity assay could provide reference serological evidence to reduce the error from those discarded cases caused by false negative results on IgM antibody, when diagnosing the measles cases.


Assuntos
Vírus do Sarampo , Sarampo , Anticorpos Antivirais , Afinidade de Anticorpos , Humanos , Imunoglobulina G , Sarampo/diagnóstico , Sarampo/epidemiologia , Vacina contra Sarampo
6.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(4): 608-612, 2021 Apr 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814438

RESUMO

Objective: To understand the spatial-temporal distribution and spatial clusters of measles cases in China. Methods: Measles incidence data was collected from the National Notifiable Disease Reporting System of Chinese Center for Disease Control and Prevention. The global and local spatial autocorrelation analyses were conducted by using software ArcGIS 10.2 and spatial-temporal scan was conducted by using software SaTScan 9.6. Results: A total of 1 012 537 cases of measles were reported in China from 2001 to 2016 and the annual incidence showed a sharp downward trend. There was global spatial clustering of measles cases during 2001-2004, 2005-2008, and 2009-2012, and their Moran's I coefficients were 0.29, 0.26, and 0.31, respectively. The results of local spatial autocorrelation analysis showed that there were high- high clustering areas of measles at all time periods, especially in western China. Guangdong province was detected as a separate high-low scattered area from 2005 to 2008 and no low-low clustering area was detected. The spatial-temporal scan statistics showed that there was a wide clustering area covering western, central and northern China, and Shanxi province and Guangxi Zhuang Autonomous Region from 2001-2008. Conclusion: The incidence of measles in China has a certain clustering in both space and time during 2001-2016, the results provide evidence for the development of future strategy of measles prevention and control in China.


Assuntos
Sarampo , China/epidemiologia , Análise por Conglomerados , Humanos , Incidência , Sarampo/epidemiologia , Análise Espacial , Análise Espaço-Temporal
7.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(6): 1012-1017, 2021 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814499

RESUMO

Objective: To understand the epidemiological and genotypic characteristics of imported cases of measles virus of D8 genotype in Hebei province. Methods: Epidemiological investigation of measles cases in surveillance was carried out. The throat swabs of the measles cases in acute phase were collected for real time RT-PCR identification, measles virus culture and genotype identification. Results: A total of 36 imported measles cases of genotype D8 were detected. The cases were mainly distributed in 8 counties of Handan city. Number of confirmed measles cases in Cheng'an county was the highest, accounting for 58.33% (21/36) of all the reported cases. All patients had fever and rash, and 55.55% (20/36) of the cases were under 2 years old and 86.11% (31/36) of the cases had no immunization history. The children with pneumonia accounted for 44.12% (15/34) of the total children with D8 genotype measles virus infection. The nucleotide and amino acid homologies between the imported measles virus genotype D8 and the WHO reference strain of D8 genotype (D8-Manchester.UNK/30.94) were 98.4%-98.6% and 97.3%, respectively. Compared with the strains of H1 genotype in China, the nucleotide and amino acid homologies were 92.8%-93.1% and 93.3%, respectively. Conclusions: The imported cases of measles virus of D8 genotype might have caused local transmission in Hebei province. Molecular epidemiological surveillance for measles virus needs to be further strengthened. It is necessary to detect and control the epidemic early and improve the coverage rate and timely rate of measles vaccination. It is also important to prevent cross infection in hospitals.


Assuntos
Infecção Hospitalar , Sarampo , Criança , Pré-Escolar , China/epidemiologia , Surtos de Doenças , Genótipo , Humanos , Sarampo/epidemiologia , Vírus do Sarampo/genética , Filogenia
8.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(10): 1817-1822, 2021 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814617

RESUMO

Objective: To understand the epidemiological characteristics of measles outbreaks in China from 2016 to 2020 and related outbreak investigations and response performances. Methods: The information about the incidence of measles outbreaks, the investigation and response of measles outbreaks in 31 provinces from 2016 to 2020 were collected from Measles Surveillance System, and the incidence of suspected measles outbreaks detected through sporadic case finding during the same period according to the measles outbreak definition was analyzed. Results: From 2016 to 2020, a total of 344 measles outbreaks were reported nationwide, involving 1 886 measles cases. The median of intervals between the first case onsets and reported outbreaks ranged from 4 to 10 days, the median of the numbers of involved cases ranged from 2 to 3, and the median of the duration of the epidemic ranged from 8 to 13 days, and some outbreaks had long durations of 65,44,28,63 and 13 days. The top three provinces with high number of reported outbreaks were Gansu, Beijing and Shandong. Among the reported outbreaks, 115 occurred in communities/villages, accounting for the highest proportion. The genotype identification results indicated that all the outbreaks in 2016 were caused by measles virus H1, and the proportion of the outbreaks caused by measles virus H1 decreased year by year since then, which was 88.57% (31/35) in 2017, 85.00% (17/20) in 2018 and 15.79% (3/19) in 2019 respectively. There was no outbreak caused by measles H1 reported in 2020, the 4 isolates all belonged to genotype D8. Active case findings were conducted in local medical institutions for 313 outbreaks, and measles-containing vaccine coverage surveys were conducted for 266 outbreaks. From 2016 to 2020, a total of 919 suspected measles outbreaks were detected nationwide, involving 4 212 measles cases. The top three provinces with suspected measles outbreaks were Xinjiang, Gansu and Sichuan. The suspected measles outbreaks also mainly occurred in communities/villages (493). Conclusions: The number, scale and duration of measles outbreaks were gradually decreasing, the measles outbreaks at the community level can not be ignored, and the local H1 genotypes tend to be gradually replaced by other genotypes. Improving the sensitivity of outbreak surveillance, promoting vaccination, expanding the vaccine coverage, timely and effective response to the outbreaks are the focus of measles elimination in China in the future.


Assuntos
Sarampo , China/epidemiologia , Surtos de Doenças , Humanos , Sarampo/epidemiologia , Sarampo/prevenção & controle , Vírus do Sarampo , Vacinação
9.
MMWR Morb Mortal Wkly Rep ; 70(45): 1563-1569, 2021 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-34758014

RESUMO

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.


Assuntos
Erradicação de Doenças , Saúde Global/estatística & dados numéricos , Sarampo/prevenção & controle , Criança , Humanos , Programas de Imunização , Incidência , Lactente , Sarampo/epidemiologia , Vacina contra Sarampo/administração & dosagem , Organização Mundial da Saúde
10.
Pan Afr Med J ; 39: 192, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34603573

RESUMO

Introduction: following the declaration of the COVID-19 pandemic, many countries imposed restrictions on public gatherings, health workers were repurposed for COVID-19 response, and public demand for preventive health services declined due to fear of getting COVID-19 in health care settings. These factors led to the disruption in health service delivery, including childhood immunization, in the first months of the pandemic. Measles surveillance supported with laboratory confirmation, is implemented in the African Region as part of the strategies towards attaining measles elimination. World Health Organisation developed guidelines to assist countries to continue to safely provide essential health services including immunization and the surveillance of vaccine preventable diseases during the pandemic. Methods: we analysed the measles case-based surveillance and laboratory databases for the years 2014 to 2020, to determine the impact of the COVID-19 pandemic on measles surveillance, comparing the performance in 2020 against the preceding years. Results: the weekly reporting of suspected measles cases declined starting in April 2020. Twelve countries had more than 50% decline in both the number of reported cases as well as in the number of specimens collected in 2020, as compared to the mean for the years 2014-2018. In 2020, only 30% of the specimens from suspected measles cases arrived at the national laboratory within 3 days of collection. At Regional level, 86% of the districts reported suspected measles cases in 2020, while the non-measles febrile rash illness rate was 2.1 per 100,000 population, which was the lowest rate documented since 2014. Only 11 countries met the targets for the two principal surveillance performance indicators in 2020 as compared to an average of 21 countries in the years 2014-2019. Conclusion: the overall quality of measles surveillance has declined during the COVID pandemic in many countries. Countries should implement immediate and proactive measures to revitalise active surveillance for measles and monitor the quality of surveillance. We recommend that countries consider implementing specimen collection and testing methods that can facilitate timely confirmation of suspected measles cases in remote communities and areas with transportation challenges.


Assuntos
COVID-19 , Sarampo/epidemiologia , Vigilância da População/métodos , África/epidemiologia , Humanos , Programas de Imunização , Sarampo/prevenção & controle , Vacina contra Sarampo/administração & dosagem , Vacinação , Organização Mundial da Saúde
11.
Artigo em Inglês | MEDLINE | ID: mdl-34703631

RESUMO

The World Health Organization verified that Singapore had eliminated endemic transmission of measles in October 2018. This report summarizes the evidence presented to the Regional Verification Commission for Measles and Rubella Elimination, comprising information about immunization schedules; laboratory testing protocols and the surveillance system; and data on immunization coverage and the epidemiology of cases. Between 2015 and 2017, a total of 246 laboratory confirmed cases of measles were reported. The source or country of infection was unknown for most cases (195; 79.3%). There were 22 clusters, ranging from two to five cases. The most common genotypes detected were D8 and D9. Transmission of B3 was interrupted in 2017, and H1 cases were sporadic and imported. Phylogenetic analyses of the D8 isolates showed the existence of 13 lineages or clusters. Although a few lineages were circulating concurrently, no lineage propagated continuously for a prolonged period, and transmission of each lineage eventually stopped. Although cases and clusters were reported yearly, molecular data showed that none of the lineages resulted in prolonged transmission. There were fewer measles cases in 2017 compared with 2016. The higher number of clusters was likely due to the overall increase in cases because cluster sizes remained small. The occurrence of small clusters is not unexpected since measles is highly infectious. The majority of imported cases did not result in secondary transmission. With the global increase in the number of measles cases, Singapore needs to stay vigilant and continue to promptly test suspected cases; vaccination is the key to preventing infection.


Assuntos
Sarampo , Rubéola (Sarampo Alemão) , Genótipo , Humanos , Sarampo/epidemiologia , Sarampo/prevenção & controle , Vírus do Sarampo/genética , Filogenia , Singapura/epidemiologia
12.
PLoS Pathog ; 17(10): e1009841, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34648591

RESUMO

In general, in mammalian cells, cytosolic DNA viruses are sensed by cyclic GMP-AMP synthase (cGAS), and RNA viruses are recognized by retinoic acid-inducible gene I (RIG-I)-like receptors, triggering a series of downstream innate antiviral signaling steps in the host. We previously reported that measles virus (MeV), which possesses an RNA genome, induces rapid antiviral responses, followed by comprehensive downregulation of host gene expression in epithelial cells. Interestingly, gene ontology analysis indicated that genes encoding mitochondrial proteins are enriched among the list of downregulated genes. To evaluate mitochondrial stress after MeV infection, we first observed the mitochondrial morphology of infected cells and found that significantly elongated mitochondrial networks with a hyperfused phenotype were formed. In addition, an increased amount of mitochondrial DNA (mtDNA) in the cytosol was detected during progression of infection. Based on these results, we show that cytosolic mtDNA released from hyperfused mitochondria during MeV infection is captured by cGAS and causes consequent priming of the DNA sensing pathway in addition to canonical RNA sensing. We also ascertained the contribution of cGAS to the in vivo pathogenicity of MeV. In addition, we found that other viruses that induce downregulation of mitochondrial biogenesis as seen for MeV cause similar mitochondrial hyperfusion and cytosolic mtDNA-priming antiviral responses. These findings indicate that the mtDNA-activated cGAS pathway is critical for full innate control of certain viruses, including RNA viruses that cause mitochondrial stress.


Assuntos
Imunidade Inata/imunologia , Sarampo/metabolismo , Mitocôndrias/metabolismo , Nucleotidiltransferases/metabolismo , Animais , Regulação para Baixo , Humanos , Vírus do Sarampo , Camundongos , Camundongos Endogâmicos C57BL , Mitocôndrias/virologia , Biogênese de Organelas , Infecções por Vírus de RNA/metabolismo , Vírus de RNA
13.
PLoS One ; 16(10): e0258961, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34673828

RESUMO

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.


Assuntos
Programas de Imunização , Vacina contra Sarampo/uso terapêutico , Sarampo/epidemiologia , Cobertura Vacinal , Adolescente , Adulto , Criança , Pré-Escolar , Erradicação de Doenças , Feminino , Gâmbia/epidemiologia , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Sarampo/prevenção & controle , Vigilância da População , Estudos Retrospectivos
14.
Washington, D.C.; PAHO; 2021-10-26.
em Inglês | PAHO-IRIS | ID: phr-55074

RESUMO

The Regional Framework for the Monitoring and Re-verification of Measles, Rubella, and Congenital Rubella Syndrome Elimination in the Americas aims to guide Member States and the National Sustainability Committees of the Pan American Health Organization on the requirements and procedures for monitoring and re-verifying the measles and rubella elimination. The Regional Framework maintains some elements from the original 2011 Plan of Action for documenting and verifying elimination, while providing sound and updated guidance adjusted to the new epidemiological scenarios. Endemic countries will now have to document absence of measles virus transmission for more than one year and the national capability to sustain measles and rubella elimination, to meet re-verification criteria. The Framework was developed and critically reviewed by the Measles and Rubella Elimination Regional Monitoring and Re-Verification Commission, a new body of independent experts appointed in 2019 that will guide the process for re-verifying and monitoring sustainability of elimination.


Assuntos
Imunização , Programas de Imunização , Rubéola (Sarampo Alemão) , Sarampo , Síndrome da Rubéola Congênita , Vacinação , Vacinas , Vacina contra Rubéola , Vacina contra Sarampo
15.
Washington, D.C.; PAHO; 2021-10-14.
em Inglês, Espanhol | PAHO-IRIS | ID: phr-54998

RESUMO

In 2021, between epidemiological week (EW)1 and EW 38, two countries in the Region of the Americas have reported confirmed cases of measles: Brazil with 552 confirmed cases, including 2 deaths in 6 federal units; and United States of America with 20 measles cases confirmed in 3 jurisdictions, including 18 cases reported among evacuees recently arriving from Afghanistan during the resettlement process. In 2020, a total of 9 countries in the Region of the Americas reported cases and deaths due to measles.


En 2021, entre la semana epidemiológica (SE) 1 y la SE 38, dos países en la Región de las Américas notificaron casos confirmados de sarampión: Brasil con 552 casos confirmados, incluidas 2 defunciones, en 6 unidades federales; y Estados Unidos de América con 20 casos confirmados en 3 jurisdicciones, incluyendo 18 casos notificados en evacuados que recientemente llegaron de Afganistán durante el proceso de reubicación. En 2020, un total de 9 países de la Región de las Américas notificaron casos y defunciones por sarampión.


Assuntos
Sarampo , Vacina contra Sarampo , Rubéola (Sarampo Alemão) , Vacina contra Rubéola , Vacina contra Sarampo-Caxumba-Rubéola , Regulamento Sanitário Internacional , Emergências , América , Sarampo , Rubéola (Sarampo Alemão) , Vacina contra Sarampo-Caxumba-Rubéola , Vacina contra Sarampo , Regulamento Sanitário Internacional , Emergências , América
16.
Glob Health Promot ; 28(3): 23-31, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34672238

RESUMO

With 675 confirmed cases of measles in Romania in September 2016, the Ministry of Health launched the online campaign called 'Vaccines Save Lives'. This study seeks to apply the Health Belief Model (HBM) constructs to the online communication among the Romanian Ministry of Health and online users throughout this vaccination campaign. Using a mixed-method approach, we demonstrate how cluster analysis can help in visualizing the overall relationship among codes (HBM constructs) in the thematic interpretation related to vaccination. Results of the cluster analysis show that the Romanian Ministry of Health used three main themes (shaping credibility, reality versus conspiracy, and unbiased information). Focusing on the diseases that vaccinations could prevent, the Romanian authority also addressed the issues related to conspiracy theory, the possible side effects, and collateral victims if parents refuse to vaccinate their children. The online users' comments were structured on two themes: multi-faceted reluctance and vaccination gain. Despite the anti-vaccination comments and anti-work-related content directed toward the campaign and the Ministry of Health, there were pro-vaccination comments in which online users encouraged parents to report cases of side effects and accused them of using their personal stories to provoke vaccination hesitancy. These findings may provide important information to (inter)national communication practitioners who design and implement health campaigns to increase vaccination rates.


Assuntos
Sarampo , Criança , Surtos de Doenças/prevenção & controle , Grupos Étnicos , Humanos , Sarampo/epidemiologia , Sarampo/prevenção & controle , Romênia/epidemiologia , Vacinação
18.
Pan Afr Med J ; 39: 132, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34527148

RESUMO

Introduction: rubella is vaccine-preventable and vaccination is the most cost-effective approach to control the disease and avoid the management of congenital rubella syndrome cases. Ghana introduced the rubella vaccine into the routine immunization program in 2013. Since then there have not been any evaluation of the epidemiology of rubella. We determined the disease trends and the population demographics of rubella cases, in the Ghana national measles case-based surveillance system. Methods: we reviewed the measles case-based surveillance data from 2007 to 2017. Descriptive data statistics was done and expressed as frequencies and proportions. Chi-square test was used to establish associations. Results: a total of 11,483 suspected cases for measles received and tested for measles IgM antibodies and 1,137(12.98%) confirmed positive for the period. Of these 10,077 were negative and 250 indeterminate for measles and tested for rubella and 2,090 (20.23%) confirmed positive for rubella IgM antibodies. More females (21.45%) were affected than males (19.48%). Majority of the confirmed positives were recorded in the urban areas. Children aged 15 years or less were mostly affected. There was a statistical difference between incidence cases and sex (χ2=6.03, p-value = 0.014), or age (χ2=283.56, p-value < 0.001) or area (χ2= 6.17, p-value = 0.013). Most infections occurred during the dry season. Conclusion: children less than 15 years were mostly affected with majority being females. The highest incidence of cases was before the rains and occurred mostly in urban areas. The incidence of cases has declined significantly with the introduction of the rubella vaccine.


Assuntos
Sarampo/epidemiologia , Vacina contra Rubéola/administração & dosagem , Rubéola (Sarampo Alemão)/epidemiologia , Vacinação , Adolescente , Distribuição por Idade , Criança , Pré-Escolar , Feminino , Gana/epidemiologia , Humanos , Programas de Imunização , Imunoglobulina M/imunologia , Incidência , Masculino , Vigilância da População , Rubéola (Sarampo Alemão)/prevenção & controle , Estações do Ano , Distribuição por Sexo , Adulto Jovem
19.
Vaccine ; 39(41): 6041-6049, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34531077

RESUMO

Globally, measles remains a major cause of child mortality, and rubella is the leading cause of birth defects among all infectious diseases. In 2012, the World Health Assembly endorsed the Global Vaccine Action Plan that set a target to eliminate Measles-Rubella (MR) in five of the six World Health Organization (WHO) regions by 2020. This was cross-sectional study employed both quantitative and qualitative research methods. The sample size was calculated to provide overall, age- and sex-specific coverage estimates for MR vaccine among children aged between 9 and 59 months at the national level. Using desired precision of ±5% with an expected coverage of 95%, a total of 15,235 households were required. The age of children, a child who had received the MR vaccine before the campaign, household wealth quintile, the age of caregivers, and their marital status were associated with non-coverage of MR vaccination among children aged 9-59 months in Tanzania. Nationally, an estimated 88.2% (95% CI: 87.3-89%) of children aged 9-59 months received the MR campaign dose, as assessed by caregivers' recall. These estimates revealed slightly higher coverage in Zanzibar 89.6% (95% CI: 84.7-93%) compared to Mainland Tanzania 88.1% (95% CI 87.2-88.9%). These associated factors revealed causes of unvaccinated children and may be some of the reasons for Tanzania's failure to meet the MR campaign target of 95 percent vaccination coverage. Thus, vaccine development must increase programmatic oversight in order to improve immunization activities and communication strategies in Tanzanian areas with low MR coverage.


Assuntos
Sarampo , Rubéola (Sarampo Alemão) , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Programas de Imunização , Lactente , Masculino , Sarampo/epidemiologia , Sarampo/prevenção & controle , Vacina contra Sarampo , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/prevenção & controle , Tanzânia/epidemiologia , Vacinação
20.
Nat Commun ; 12(1): 5233, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34475387

RESUMO

Measles virus (MeV) is a highly contagious pathogen that enters the human host via the respiratory route. Besides acute pathologies including fever, cough and the characteristic measles rash, the infection of lymphocytes leads to substantial immunosuppression that can exacerbate the outcome of infections with additional pathogens. Despite the availability of effective vaccine prophylaxis, measles outbreaks continue to occur worldwide. We demonstrate that prophylactic and post-exposure therapeutic treatment with an orally bioavailable small-molecule polymerase inhibitor, ERDRP-0519, prevents measles disease in squirrel monkeys (Saimiri sciureus). Treatment initiation at the onset of clinical signs reduced virus shedding, which may support outbreak control. Results show that this clinical candidate has the potential to alleviate clinical measles and augment measles virus eradication.


Assuntos
Inibidores Enzimáticos/uso terapêutico , Sarampo/prevenção & controle , Morfolinas/uso terapêutico , Piperidinas/uso terapêutico , Pirazóis/uso terapêutico , RNA Polimerase Dependente de RNA/antagonistas & inibidores , Animais , Avaliação Pré-Clínica de Medicamentos , Inibidores Enzimáticos/farmacocinética , Tolerância Imunológica/efeitos dos fármacos , Imunidade Humoral/efeitos dos fármacos , Vírus do Sarampo/efeitos dos fármacos , Morfolinas/farmacocinética , Piperidinas/farmacocinética , Pirazóis/farmacocinética , Saimiri , Replicação Viral/efeitos dos fármacos , Eliminação de Partículas Virais/efeitos dos fármacos
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