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1.
BMC Med ; 19(1): 2, 2021 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-33397366

RESUMO

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.


Assuntos
Erradicação de Doenças , Programas de Imunização , Imunização Secundária , Sarampo , Regionalização/organização & administração , Cobertura Vacinal/tendências , África/epidemiologia , Ásia Sudeste/epidemiologia , /prevenção & controle , Criança , Erradicação de Doenças/métodos , Erradicação de Doenças/estatística & dados numéricos , Humanos , Programas de Imunização/métodos , Programas de Imunização/organização & administração , Imunização Secundária/métodos , Imunização Secundária/estatística & dados numéricos , Sarampo/epidemiologia , Sarampo/prevenção & controle , Vacina contra Sarampo/uso terapêutico , Região do Mediterrâneo/epidemiologia
2.
Artigo em Inglês | MEDLINE | ID: mdl-33374998

RESUMO

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.


Assuntos
Programas de Imunização , Sarampo , Pandemias , Rubéola (Sarampo Alemão) , Adulto , Criança , Humanos , Japão/epidemiologia , Sarampo/epidemiologia , Sarampo/prevenção & controle , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/prevenção & controle , Vacinação
3.
Pan Afr Med J ; 36: 304, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33282087

RESUMO

Introduction: on October 4th, 2018, a measles outbreak was declared in Madagascar. This study describes challenges related to resources mobilization for the outbreak response. Methods: data were collected using minutes of coordination committee meetings, activities reports, operational action plans and situation reports. Results: the total cost of the outbreak response was estimated to US$ 11,281,381. Operational cost was the leading cost driver (42.45%) followed by vaccine cost (33.74%). Cases management, epidemiological surveillance, communication and social mobilization and routine immunization strengthening represented 23.81% of the total cost. The main funder of the outbreak response was the measles and rubella initiative. Conclusion: good coordination, open dialogue, good use of financial resources and accountability of government and partners have enabled to gain the confidence of national and international donors.


Assuntos
Programas de Imunização/organização & administração , Vacina contra Sarampo/administração & dosagem , Sarampo/prevenção & controle , Vacinação/estatística & dados numéricos , Surtos de Doenças/economia , Surtos de Doenças/prevenção & controle , Humanos , Programas de Imunização/economia , Madagáscar , Sarampo/economia , Sarampo/epidemiologia , Vacina contra Sarampo/economia , Vacinação/economia
4.
Proc Natl Acad Sci U S A ; 117(48): 30118-30125, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33203683

RESUMO

Political and environmental factors-e.g., regional conflicts and global warming-increase large-scale migrations, posing extraordinary societal challenges to policymakers of destination countries. A common concern is that such a massive arrival of people-often from a country with a disrupted healthcare system-can increase the risk of vaccine-preventable disease outbreaks like measles. We analyze human flows of 3.5 million (M) Syrian refugees in Turkey inferred from massive mobile-phone data to verify this concern. We use multilayer modeling of interdependent social and epidemic dynamics to demonstrate that the risk of disease reemergence in Turkey, the main host country, can be dramatically reduced by 75 to 90% when the mixing of Turkish and Syrian populations is high. Our results suggest that maximizing the dispersal of refugees in the recipient population contributes to impede the spread of sustained measles epidemics, rather than favoring it. Targeted vaccination campaigns and policies enhancing social integration of refugees are the most effective strategies to reduce epidemic risks for all citizens.


Assuntos
Surtos de Doenças , Sarampo/epidemiologia , Difusão , Geografia , Humanos , Sarampo/imunologia , Fatores de Risco , Turquia/epidemiologia
6.
Clin Ter ; 171(6): e486-e489, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33151246

RESUMO

OBJECTIVES: Measles still has a high impact on the health of the population in Italy and therefore requires a strong commitment to prevention at national level. In addition to Italy, measles outbreaks have also been reported in other EU countries, with a high number of cases and a rapid spread of the disease even in the nosocomial context between patients and health personnel. The aim of this study is to evaluate the prevalence of measles in a group of health workers working at a university hospital in southern Italy. MATERIALS AND METHODS: A seroepidemiological study was conducted on 458 health workers. Measles antibody IgG and IgM levels were evaluated by immunoenzymatic testing. RESULTS: The highest percentage of susceptible subjects was ≤30 years old, with a statistically significant difference compared to the age group ≥51 years. With regard to gender, susceptibility to measles in males was significantly higher than in females (p<0.05). Additional statistically significant differences were found in the different age groups in both genders. CONCLUSIONS: Although the results show that most health workers are immune to measles, a 20% susceptibility certainly represents a risk for the spread of the disease among operators and patients. Vaccination and control of suspected cases, especially in community settings such as the hospital environment, are the main measures to prevent the transmission and spread of the disease.


Assuntos
Surtos de Doenças/prevenção & controle , Pessoal de Saúde , Sarampo/epidemiologia , Adulto , Feminino , Hospitais Universitários , Humanos , Itália/epidemiologia , Masculino , Sarampo/imunologia , Sarampo/prevenção & controle , Pessoa de Meia-Idade , Prevalência , Estudos Soroepidemiológicos , Vacinação
7.
Artigo em Alemão | MEDLINE | ID: mdl-33185709

RESUMO

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.


Assuntos
Vacina contra Sarampo , Sarampo , Conflitos Armados , Criança , Alemanha/epidemiologia , Saúde Global , Humanos , Programas de Imunização , Sarampo/epidemiologia , Sarampo/prevenção & controle , Vacinação
8.
MMWR Morb Mortal Wkly Rep ; 69(45): 1700-1705, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33180759

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 <5 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 describes progress toward WHA milestones and regional measles elimination during 2000-2019 and updates a previous report (2). During 2000-2010, estimated MCV1 coverage increased globally from 72% to 84% but has since plateaued at 84%-85%. All countries conducted measles surveillance; however, approximately half did not achieve the sensitivity indicator target of two or more discarded measles and rubella cases per 100,000 population. Annual reported measles incidence decreased 88%, from 145 to 18 cases per 1 million population during 2000-2016; the lowest incidence occurred in 2016, but by 2019 incidence had risen to 120 cases per 1 million population. During 2000-2019, the annual number of estimated measles deaths decreased 62%, from 539,000 to 207,500; an estimated 25.5 million measles deaths were averted. To drive progress toward the regional measles elimination targets, additional strategies are needed to help countries reach all children with 2 doses of measles-containing vaccine, identify and close immunity gaps, and improve surveillance.


Assuntos
Erradicação de Doenças , Saúde Global/estatística & dados numéricos , Sarampo/prevenção & controle , Objetivos , Humanos , Programas de Imunização , Incidência , Lactente , Sarampo/epidemiologia , Sarampo/mortalidade , Vacina contra Sarampo/administração & dosagem , Organização Mundial da Saúde
9.
Praxis (Bern 1994) ; 109(15): 1179-1181, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33234038

RESUMO

CME Dermatology 22/Answers: Measles - Empidemiology and Clinical Manifestations Abstract. Measles is a highly contagious, acute and febrile illness that results from infection with measles virus. The World Health Organization (WHO) estimates a worldwide prevalence of ten million patients per year, leading to approximately 142 000 deaths (case fatality rate 1.4 %). The illness begins with fever, malaise and typically with at least one of the following signs: cough, coryza and/or conjunctivitis. Three to four days later, the characteristical rash appears. The primary clinical diagnosis needs to be confirmed by detection of specific IgM antibodies in serum or viral RNA by a throat swap. The management mainly consists of supportive therapy, a specific antiviral treatment does not exist. Therefore, prevention by widespread measles vaccination has absolute priority.


Assuntos
Dermatologia , Exantema , Sarampo , Exantema/etiologia , Humanos , Sarampo/diagnóstico , Sarampo/epidemiologia , Vírus do Sarampo , Vacinação
10.
Med Sci (Paris) ; 36(11): 1034-1037, 2020 Nov.
Artigo em Francês | MEDLINE | ID: mdl-33151866

RESUMO

Coronavirus disease (COVID)-19 is an emerging pandemic infection whose significant ability to spread in a naïve population is well established. The first response of states to the COVID-19 outbreak was to impose lock-down and social barrier measures, such as wearing a surgical mask or social distancing. One of the consequences of this pandemic in terms of public health was the suspension or slowdown of infant vaccination campaigns, in almost all countries. The indirect effects of COVID-19 may therefore weigh on mortality from measles and polio in developing countries. In this pandemic chaos, the only hope lies in the rapid development of an effective vaccine against severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). However, acceptance of this vaccine has not yet been won, as beyond the many unknowns that will inevitably weigh around such rapid development, skepticism among vaccine hesitants is growing.


Assuntos
Infecções por Coronavirus/epidemiologia , Programas de Imunização/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia , Saúde Pública/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Betacoronavirus/fisiologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/prevenção & controle , Surtos de Doenças/prevenção & controle , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Programas de Imunização/organização & administração , Programas de Imunização/normas , Programas de Imunização/tendências , Sarampo/epidemiologia , Sarampo/prevenção & controle , Pandemias/prevenção & controle , Participação do Paciente/estatística & dados numéricos , Participação do Paciente/tendências , Pneumonia Viral/imunologia , Pneumonia Viral/prevenção & controle , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Saúde Pública/normas , Saúde Pública/tendências , Cobertura Vacinal/organização & administração , Cobertura Vacinal/estatística & dados numéricos , Vacinas Virais/uso terapêutico
11.
Pan Afr Med J ; 37: 20, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33062122

RESUMO

Introduction: on October 4th, 2018, a measles outbreak was declared in Madagascar. This study describes the outbreak response in terms of coordination, case management, vaccination response and epidemiological surveillance. Methods: data were collected using a line list and vaccination tally sheet. Serum samples were collected within 30 days of rash onset for laboratory testing; confirmation was made by detection of measles immunoglobulin M antibody. Results: from September 2018 to May 2019, a total of 146,277 measles cases were reported which included 1394 (1%) laboratory-confirmed cases and 144,883 (99%) epidemiological link-confirmed cases. The outbreak affected equally males (72,917 cases; 49.85%) and females (73,233 cases; 50.06%). The sex was not specified for 127 (0.09%) cases. Case fatality rate and attack rate were high among children less than 5 years. Responses interventions include effective coordination, free of charge case management, reactive vaccination, strengthened real-time surveillance, communication and community engagement and the revitalization of the routine immunization. Reactive vaccination was implemented in different phases. A total of 7,265,990 children aged from 6 months to 9 years were vaccinated. Post campaign survey coverage was 95%, 96% and 97% for phase 1, 2, 3 respectively. Conclusion: elimination of measles will be challenging in Madagascar because of low routine immunization coverage and the absence of a second dose of measles vaccine in the routine immunization schedule.


Assuntos
Surtos de Doenças/prevenção & controle , Vacina contra Sarampo/administração & dosagem , Sarampo/prevenção & controle , Vacinação/estatística & dados numéricos , Criança , Pré-Escolar , Monitoramento Epidemiológico , Feminino , Humanos , Programas de Imunização , Esquemas de Imunização , Imunoglobulina M/sangue , Lactente , Madagáscar , Masculino , Sarampo/epidemiologia , Cobertura Vacinal
12.
PLoS One ; 15(10): e0240734, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33057405

RESUMO

BACKGROUND: Serosurveys are a valuable surveillance tool because they provide a more direct measure of population immunity to infectious diseases, such as measles and rubella, than vaccination coverage estimates. However, there is concern that serological surveys are costly. We adapted a framework to capture the costs associated with conducting a serosurvey in Zambia. METHODS: We costed a nested serosurvey in Southern Province, Zambia that collected dried blood spots from household residents in a post-campaign vaccine coverage survey. The financial costs were estimated using an ingredients-based costing approach. Inputs included personnel, transportation, field consumable items, social mobilization, laboratory supplies, and capital items, and were classified by serosurvey function (survey preparation, data collection, biospecimen collection, laboratory testing, and coordination). Inputs were stratified by whether they were applicable to surveys in general or attributable specifically to serosurveys. Finally, we calculated the average cost per cluster and participant. RESULTS: We estimated the total nested serosurvey cost was US $68,558 to collect dried blood spots from 658 participants in one province in Zambia. A breakdown of the cost by serosurvey phase showed data collection accounted for almost one third of the total serosurvey cost (32%), followed by survey preparation (25%) and biospecimen collection (20%). Analysis by input categories indicated personnel costs were the largest contributing input to overall serosurvey costs (51%), transportation was second (23%), and field consumables were third (9%). By combining the serosurvey with a vaccination coverage survey, there was a savings of $43,957. We estimated it cost $4,285 per average cluster and $104 per average participant sampled. CONCLUSIONS: Adding serological specimen collection to a planned vaccination coverage survey provided a more direct measurement of population immunity among a wide age group but increased the cost by approximately one-third. Future serosurveys could consider ways to leverage existing surveys conducted for other purposes to minimize costs.


Assuntos
Custos e Análise de Custo , Imunidade , Sarampo/sangue , Sarampo/economia , Rubéola (Sarampo Alemão)/sangue , Rubéola (Sarampo Alemão)/economia , Inquéritos e Questionários , Humanos , Sarampo/epidemiologia , Vacina contra Sarampo/economia , Rubéola (Sarampo Alemão)/epidemiologia , Vacina contra Rubéola/economia , Estudos Soroepidemiológicos , Zâmbia/epidemiologia
13.
Proc Natl Acad Sci U S A ; 117(45): 28506-28514, 2020 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-33106403

RESUMO

The United States experienced historically high numbers of measles cases in 2019, despite achieving national measles vaccination rates above the World Health Organization recommendation of 95% coverage with two doses. Since the COVID-19 pandemic began, resulting in suspension of many clinical preventive services, pediatric vaccination rates in the United States have fallen precipitously, dramatically increasing risk of measles resurgence. Previous research has shown that measles outbreaks in high-coverage contexts are driven by spatial clustering of nonvaccination, which decreases local immunity below the herd immunity threshold. However, little is known about how to best conduct surveillance and target interventions to detect and address these high-risk areas, and most vaccination data are reported at the state-level-a resolution too coarse to detect community-level clustering of nonvaccination characteristic of recent outbreaks. In this paper, we perform a series of computational experiments to assess the impact of clustered nonvaccination on outbreak potential and magnitude of bias in predicting disease risk posed by measuring vaccination rates at coarse spatial scales. We find that, when nonvaccination is locally clustered, reporting aggregate data at the state- or county-level can result in substantial underestimates of outbreak risk. The COVID-19 pandemic has shone a bright light on the weaknesses in US infectious disease surveillance and a broader gap in our understanding of how to best use detailed spatial data to interrupt and control infectious disease transmission. Our research clearly outlines that finer-scale vaccination data should be collected to prevent a return to endemic measles transmission in the United States.


Assuntos
Epidemias/estatística & dados numéricos , Vacina contra Sarampo/administração & dosagem , Sarampo/epidemiologia , Modelos Estatísticos , Conglomerados Espaço-Temporais , Vacinação/estatística & dados numéricos , Viés , Confiabilidade dos Dados , Epidemias/prevenção & controle , Monitoramento Epidemiológico , Humanos , Sarampo/prevenção & controle , Vacina contra Sarampo/uso terapêutico , Estados Unidos
14.
Praxis (Bern 1994) ; 109(14): 1109-1116, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-33108997

RESUMO

CME Dermatology 22: Measles - Empidemiology and Clinical Manifestations Abstract. Measles is a highly contagious, acute and febrile illness that results from infection with measles virus. The World Health Organization (WHO) estimates a worldwide prevalence of ten million patients per year, leading to approximately 142 000 deaths (case fatality rate 1.4 %). The illness begins with fever, malaise and typically with at least one of the following signs: cough, coryza and/or conjunctivitis. Three to four days later, the characteristical rash appears. The primary clinical diagnosis needs to be confirmed by detection of specific IgM antibodies in serum or viral RNA by a throat swap. The management mainly consists of supportive therapy, a specific antiviral treatment does not exist. Therefore, prevention by widespread measles vaccination has absolute priority.


Assuntos
Exantema , Sarampo , Dermatologia , Humanos , Sarampo/diagnóstico , Sarampo/epidemiologia , Vírus do Sarampo , Vacinação
15.
Am J Public Health ; 110(S3): S312-S318, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33001718

RESUMO

Objectives. To understand changes in how Facebook pages frame vaccine opposition.Methods. We categorized 204 Facebook pages expressing vaccine opposition, extracting public posts through November 20, 2019. We analyzed posts from October 2009 through October 2019 to examine if pages' content was coalescing.Results. Activity in pages promoting vaccine choice as a civil liberty increased in January 2015, April 2016, and January 2019 (t[76] = 11.33 [P < .001]; t[46] = 7.88 [P < .001]; and t[41] = 17.27 [P < .001], respectively). The 2019 increase was strongest in pages mentioning US states (t[41] = 19.06; P < .001). Discussion about vaccine safety decreased (rs[119] = -0.61; P < .001) while discussion about civil liberties increased (rs[119] = 0.33; Py < .001]). Page categories increasingly resembled one another (civil liberties: rs[119] = -0.50 [P < .001]; alternative medicine: rs[84] = -0.77 [P < .001]; conspiracy theories: rs[119] = -0.46 [P < .001]; morality: rs[106] = -0.65 [P < .001]; safety and efficacy: rs[119] = -0.46 [P < .001]).Conclusions. The "Disneyland" measles outbreak drew vaccine opposition into the political mainstream, followed by promotional campaigns conducted in pages framing vaccine refusal as a civil right. Political mobilization in state-focused pages followed in 2019.Public Health Implications. Policymakers should expect increasing attempts to alter state legislation associated with vaccine exemptions, potentially accompanied by fiercer lobbying from specific celebrities.


Assuntos
Movimento contra Vacinação , Direitos Civis , Surtos de Doenças , Sarampo/epidemiologia , Mídias Sociais , Recusa de Vacinação , California/epidemiologia , Humanos , Vacina contra Sarampo/administração & dosagem , Saúde Pública , Estados Unidos/epidemiologia
17.
BMC Infect Dis ; 20(1): 735, 2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028283

RESUMO

BACKGROUND: The pandemic of COVID-19 has occurred close on the heels of a global resurgence of measles. In 2019, an unprecedented epidemic of measles affected Samoa, requiring a state of emergency to be declared. Measles causes an immune amnesia which can persist for over 2 years after acute infection and increases the risk of a range of other infections. METHODS: We modelled the potential impact of measles-induced immune amnesia on a COVID-19 epidemic in Samoa using data on measles incidence in 2018-2019, population data and a hypothetical COVID-19 epidemic. RESULTS: The young population structure and contact matrix in Samoa results in the most transmission occurring in young people < 20 years old. The highest rate of death is the 60+ years old, but a smaller peak in death may occur in younger people, with more than 15% of total deaths in the age group under 20 years old. Measles induced immune amnesia could increase the total number of cases by 8% and deaths by more than 2%. CONCLUSIONS: Samoa, which had large measles epidemics in 2019-2020 should focus on rapidly achieving high rates of measles vaccination and enhanced surveillance for COVID-19, as the impact may be more severe due to measles-induced immune paresis. This applies to other severely measles-affected countries in the Pacific, Europe and elsewhere.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Sarampo/epidemiologia , Sarampo/mortalidade , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Adolescente , Adulto , Distribuição por Idade , Idoso , Criança , Pré-Escolar , Comorbidade , Infecções por Coronavirus/virologia , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Sarampo/imunologia , Sarampo/prevenção & controle , Pessoa de Meia-Idade , Modelos Estatísticos , Pandemias , Pneumonia Viral/virologia , Samoa/epidemiologia , Vacinação , Adulto Jovem
18.
Bol Med Hosp Infant Mex ; 77(5): 282-286, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33064699

RESUMO

Measles is an exanthematous disease caused by a virus of the Morbillivirus genus. On February 23, 2020, the exanthema began in the first confirmed case of measles this year. At the same time, on February 28, 2020, the first case of the new coronavirus disease (COVID-19) was confirmed. Up to June 6, 2020, 176 measles cases have been confirmed: 137 in Mexico City, 37 in the state of Mexico, and two in the state of Campeche. In Mexico City, municipalities with more cases were Gustavo A. Madero, Miguel Hidalgo, and Iztapalapa; in the State of Mexico were Ecatepec, Tlalnepantla, and Netzahualcoyotl; in Campeche, there are only two cases reported. On the other hand, 7,065,133 cases of COVID-19 have been registered worldwide with a global case fatality rate of 5.7%. In Mexico, there have been 113,619 confirmed cases and 13,511 deaths, while in Mexico City, there have been 30,223 cases and 3062 deaths. Iztapalapa and Gustavo A. Madero are the locations with more cases reported. Hence, a campaign of social distancing started as part of the strategies to control the spread of the infection. The potential threat is that as social confinement measures are relaxed and mobility is initiated, both viruses could continue to spread. It is expected that due to the time that has passed since the last reported measles case, control of this disease will be achieved.


Assuntos
Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Sarampo/epidemiologia , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Lactente , Masculino , Sarampo/prevenção & controle , México/epidemiologia , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Isolamento Social , Adulto Jovem
19.
Microbes Infect ; 22(10): 505-507, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32961275

RESUMO

The last five years has seen a sharp rise in anti-science rhetoric in the United States, especially from the political far right, mostly focused on vaccines and, of late, anti-COVID-19 prevention approaches. Vaccine coverage has declined in more than 100 US counties leading to measles outbreaks in 2019, while in 2020 the US became the epicenter of the COVID-19 pandemic. Now the anti-science movement in America has begun to globalize, with new and unexpected associations with extremist groups and the potential for tragic consequences in terms of global public health. A new anti-science triumvirate has emerged, comprised of far right groups in the US and Germany, and amplified by Russian media.


Assuntos
/prevenção & controle , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Sarampo/epidemiologia , Pandemias/prevenção & controle , Vacinação/psicologia , /imunologia , Infecções por Coronavirus/imunologia , Alemanha , Humanos , Sarampo/prevenção & controle , Federação Russa , Estados Unidos , Vacinação/efeitos adversos , Vacinas/imunologia , Organização Mundial da Saúde
20.
Vaccine ; 38(45): 7146-7155, 2020 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-32943265

RESUMO

BACKGROUND: COVID-19 pandemic has affected routine immunization globally. Impact will likely be higher in low and middle-income countries with limited healthcare resources and fragile health systems. We quantified the impact, spatial heterogeneity, and determinants for childhood immunizations of 48 million population affected in the Sindh province of Pakistan. METHODS: We extracted individual immunization records from real-time provincial Electronic Immunization Registry from September 23, 2019, to July 11, 2020. Comparing baseline (6 months preceding the lockdown) and the COVID-19 lockdown period, we analyzed the impact on daily immunization coverage rate for each antigen by geographical area. We used multivariable logistic regression to explore the predictors associated with immunizations during the lockdown. RESULTS: There was a 52.5% decline in the daily average total number of vaccinations administered during lockdown compared to baseline. The highest decline was seen for Bacille Cal-mette Guérin (BCG) (40.6% (958/2360) immunization at fixed sites. Around 8438 children/day were missing immunization during the lockdown. Enrollments declined furthest in rural districts, urban sub-districts with large slums, and polio-endemic super high-risk sub-districts. Pentavalent-3 (penta-3) immunization rates were higher in infants born in hospitals (RR: 1.09; 95% CI: 1.04-1.15) and those with mothers having higher education (RR: 1.19-1.50; 95% CI: 1.13-1.65). Likelihood of penta-3 immunization was reduced by 5% for each week of delayed enrollment into the immunization program. CONCLUSION: One out of every two children in Sindh province has missed their routine vaccinations during the provincial COVID-19 lockdown. The pool of un-immunized children is expanding during lockdown, leaving them susceptible to vaccine-preventable diseases. There is a need for tailored interventions to promote immunization visits and safe service delivery. Higher maternal education, facility-based births, and early enrollment into the immunization program continue to show a positive association with immunization uptake, even during a challenging lockdown.


Assuntos
Infecções por Coronavirus/psicologia , Sarampo/prevenção & controle , Pandemias , Pneumonia Viral/psicologia , Quarentena , Infecções por Rotavirus/prevenção & controle , Tuberculose Pulmonar/prevenção & controle , Vacinação/estatística & dados numéricos , Vacina BCG/administração & dosagem , Betacoronavirus/patogenicidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Processamento Eletrônico de Dados , Feminino , Humanos , Programas de Imunização/estatística & dados numéricos , Lactente , Recém-Nascido , Masculino , Sarampo/epidemiologia , Sarampo/imunologia , Vacina contra Sarampo/administração & dosagem , Paquistão/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia , Sistema de Registros , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/imunologia , Vacinas contra Rotavirus/administração & dosagem , População Rural , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/imunologia , População Urbana , Vacinação/psicologia , Cobertura Vacinal/estatística & dados numéricos , Vacinas Atenuadas/administração & dosagem
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