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1.
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
2.
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
3.
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
6.
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
7.
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
9.
Rev Med Suisse ; 15(666): 1807-1811, 2019 Oct 09.
Artigo em Francês | MEDLINE | ID: mdl-31599522

RESUMO

Measles is a disease that was considered as relegated to medical history, since an extremely efficient vaccine had been developed. However, in Switzerland and elsewhere there has been an increasing number of epidemics in the past years, and the highest number of new cases this year. Based on two clinical cases showing very different outcomes, we discuss the disease, its clinic, complications, management, and the challenges remaining in obtaining a sufficient vaccination coverage worldwide as well as in our country.


Assuntos
Exantema/etiologia , Sarampo/epidemiologia , Sarampo/prevenção & controle , Evolução Fatal , Humanos , Sarampo/complicações , Sarampo/terapia , Vacina contra Sarampo , Suíça/epidemiologia , Vacinação/estatística & dados numéricos
10.
MMWR Morb Mortal Wkly Rep ; 68(40): 893-896, 2019 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-31600181

RESUMO

During January 1-October 1, 2019, a total of 1,249 measles cases and 22 measles outbreaks were reported in the United States. This represents the most U.S. cases reported in a single year since 1992 (1), and the second highest number of reported outbreaks annually since measles was declared eliminated* in the United States in 2000 (2). Measles is an acute febrile rash illness with an attack rate of approximately 90% in susceptible household contacts (3). Domestic outbreaks can occur when travelers contract measles outside the United States and subsequently transmit infection to unvaccinated persons they expose in the United States. Among the 1,249 measles cases reported in 2019, 1,163 (93%) were associated with the 22 outbreaks, 1,107 (89%) were in patients who were unvaccinated or had an unknown vaccination status, and 119 (10%) measles patients were hospitalized. Closely related outbreaks in New York City (NYC) and New York State (NYS; excluding NYC), with ongoing transmission for nearly 1 year in large and close-knit Orthodox Jewish communities, accounted for 934 (75%) cases during 2019 and threatened the elimination status of measles in the United States. Robust responses in NYC and NYS were effective in controlling transmission before the 1-year mark; however, continued vigilance for additional cases within these communities is essential to determine whether elimination has been sustained. Collaboration between public health authorities and undervaccinated communities is important for preventing outbreaks and limiting transmission. The combination of maintenance of high national vaccination coverage with measles, mumps, and rubella vaccine (MMR) and rapid implementation of measles control measures remains the cornerstone for preventing widespread measles transmission (4).


Assuntos
Surtos de Doenças/estatística & dados numéricos , Sarampo/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Sarampo/prevenção & controle , Vacina contra Sarampo-Caxumba-Rubéola/administração & dosagem , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Vacinação/estatística & dados numéricos , Adulto Jovem
11.
PLoS Comput Biol ; 15(9): e1007305, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31513578

RESUMO

A key question in ecology is the relative impact of internal nonlinear dynamics and external perturbations on the long-term trajectories of natural systems. Measles has been analyzed extensively as a paradigm for consumer-resource dynamics due to the oscillatory nature of the host-pathogen life cycle, the abundance of rich data to test theory, and public health relevance. The dynamics of measles in London, in particular, has acted as a prototypical test bed for such analysis using incidence data from the pre-vaccination era (1944-1967). However, during this timeframe there were few external large-scale perturbations, limiting an assessment of the relative impact of internal and extra demographic perturbations to the host population. Here, we extended the previous London analyses to include nearly a century of data that also contains four major demographic changes: the First and Second World Wars, the 1918 influenza pandemic, and the start of a measles mass vaccination program. By combining mortality and incidence data using particle filtering methods, we show that a simple stochastic epidemic model, with minimal historical specifications, can capture the nearly 100 years of dynamics including changes caused by each of the major perturbations. We show that the majority of dynamic changes are explainable by the internal nonlinear dynamics of the system, tuned by demographic changes. In addition, the 1918 influenza pandemic and World War II acted as extra perturbations to this basic epidemic oscillator. Our analysis underlines that long-term ecological and epidemiological dynamics can follow very simple rules, even in a non-stationary population subject to significant perturbations and major secular changes.


Assuntos
Sarampo , Pandemias/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Biologia Computacional , História do Século XX , Humanos , Incidência , Influenza Humana/epidemiologia , Influenza Humana/história , Londres/epidemiologia , Sarampo/epidemiologia , Sarampo/história , Sarampo/prevenção & controle , Sarampo/transmissão , Pandemias/história , Vacinação/história , I Guerra Mundial , II Guerra Mundial
12.
BMC Infect Dis ; 19(1): 813, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533658

RESUMO

BACKGROUND: Rubella is an RNA virus in the genus Rubivirus within the Matonaviridae family. Rubella remains a leading vaccine-preventable cause of birth defects. Most African countries including Liberia do not currently provide rubella-containing vaccine (RCV) in their immunization program. We analyzed the existing surveillance data to describe rubella cases and identify the at-risk population. METHODS: We conducted a retrospective descriptive statistics on the suspected-measles case-based surveillance data that obtained from the national database. Suspected-measles cases who were negative and indeterminate for measles IgM and tested for rubella IgM were extracted from the database. We used only rubella IgM positive cases to calculate trends and percentages by person, place and time. The cumulative-percent curve was used to visually describe the age distribution of rubella cases. RESULTS: During 2017-2018, a total of 2027 suspected-measles cases with known laboratory results were reported; of which, 1307 were tested for rubella IgM. Among tested cases, 472 (36%) were positive, 769 (59%) were negative and 66 (5%) were indeterminate for rubella IgM. Female contributed 269 (57%) of the confirmed rubella cases respectively. The median age was 7 years with an interquartile range of 5-10 years. From the total rubella cases, 6 (1%) were under 1 year, 109 (23%) were 1-4 years, 207 (44%) were 5-9 years, 87 (18%) were 10-14 years and 56 (12%) were more than or equal to 15 years. Women in their reproductive-age contributed 23 (5%) of rubella cases with 17% positivity rate. Two-thirds or 307 (65%) of the cases were reported from February to May which is dry season in Liberia. CONCLUSIONS: Our analysis revealed that rubella was widely circulating in Liberia. Majority of the cases were reported among children < 15 years. However, rubella was also reported among women of reproductive age and infants < 1 year with no report of congenital rubella syndrome (CRS). Detail investigation of rubella cases among infants of < 1 year and women of reproductive age is important to uncover CRS. Establishment of CRS surveillance and the introduction of RCV in the immunization program are crucial to prevent rubella infection and avert the risk of CRS.


Assuntos
Síndrome da Rubéola Congênita/diagnóstico , Vacina contra Rubéola/imunologia , Adolescente , Adulto , Criança , Pré-Escolar , Bases de Dados Factuais , Feminino , Humanos , Programas de Imunização , Imunoglobulina M/sangue , Lactente , Libéria/epidemiologia , Masculino , Sarampo/epidemiologia , Estudos Retrospectivos , Síndrome da Rubéola Congênita/epidemiologia , Síndrome da Rubéola Congênita/transmissão , Vírus da Rubéola/imunologia , Estações do Ano , Adulto Jovem
13.
BMC Med ; 17(1): 180, 2019 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-31551070

RESUMO

BACKGROUND: Vaccination has reduced the global incidence of measles to the lowest rates in history. However, local interruption of measles virus transmission requires sustained high levels of population immunity that can be challenging to achieve and maintain. The herd immunity threshold for measles is typically stipulated at 90-95%. This figure does not easily translate into age-specific immunity levels required to interrupt transmission. Previous estimates of such levels were based on speculative contact patterns based on historical data from high-income countries. The aim of this study was to determine age-specific immunity levels that would ensure elimination of measles when taking into account empirically observed contact patterns. METHODS: We combined estimated immunity levels from serological data in 17 countries with studies of age-specific mixing patterns to derive contact-adjusted immunity levels. We then compared these to case data from the 10 years following the seroprevalence studies to establish a contact-adjusted immunity threshold for elimination. We lastly combined a range of hypothetical immunity profiles with contact data from a wide range of socioeconomic and demographic settings to determine whether they would be sufficient for elimination. RESULTS: We found that contact-adjusted immunity levels were able to predict whether countries would experience outbreaks in the decade following the serological studies in about 70% of countries. The corresponding threshold level of contact-adjusted immunity was found to be 93%, corresponding to an average basic reproduction number of approximately 14. Testing different scenarios of immunity with this threshold level using contact studies from around the world, we found that 95% immunity would have to be achieved by the age of five and maintained across older age groups to guarantee elimination. This reflects a greater level of immunity required in 5-9-year-olds than established previously. CONCLUSIONS: The immunity levels we found necessary for measles elimination are higher than previous guidance. The importance of achieving high immunity levels in 5-9-year-olds presents both a challenge and an opportunity. While such high levels can be difficult to achieve, school entry provides an opportunity to ensure sufficient vaccination coverage. Combined with observations of contact patterns, further national and sub-national serological studies could serve to highlight key gaps in immunity that need to be filled in order to achieve national and regional measles elimination.


Assuntos
Busca de Comunicante/estatística & dados numéricos , Erradicação de Doenças/métodos , Imunidade Coletiva , Vírus do Sarampo/imunologia , Sarampo/epidemiologia , Sarampo/imunologia , Sarampo/prevenção & controle , Adolescente , Adulto , Criança , Pré-Escolar , Erradicação de Doenças/organização & administração , Surtos de Doenças/prevenção & controle , Surtos de Doenças/estatística & dados numéricos , Feminino , Geografia , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Humanos , Imunidade Coletiva/fisiologia , Incidência , Lactente , Recém-Nascido , Masculino , Sarampo/transmissão , Vacina contra Sarampo/uso terapêutico , Modelos Estatísticos , Estudos Soroepidemiológicos , Vacinação/estatística & dados numéricos , Adulto Jovem
14.
Artigo em Alemão | MEDLINE | ID: mdl-31529181

RESUMO

Trends of frequent chronic diseases and health problems, e.g. allergic diseases, have already been published based on the KiGGS Wave 2 study as part of the health monitoring of children and adolescents in Germany. The present work complements these findings with results on less frequent noncommunicable diseases and the trend of communicable, vaccine-preventable diseases.Information from parents about diagnoses and diseases of their 0­ to 17-year-old children from the representative cross-sectional survey KiGGS Wave 2 (2014-2017) are compared with those from the KiGGS baseline survey (2003-2006) and KiGGS Wave 1 (2009-2012).The current KiGGS results show almost unchanged prevalences for the noncommunicable diseases epilepsy, migraine, and heart disease. However, the data from KiGGS Wave 2 are supportive of an increased prevalence of diabetes mellitus, which nevertheless continues to be relatively rare and predominantly type 1 diabetes in children and adolescents.The decline in measles, chicken pox, and whooping cough diseases related to changes in vaccination recommendations shows that preventive measures can effectively benefit children and adolescents.However, the data on vaccine-preventable diseases indicate regionally varying immunity gaps in certain age groups, so the prevention potential of the vaccination recommendations of the Standing Vaccination Commission (STIKO) at the Robert Koch Institute does not seem to have been sufficiently exploited.


Assuntos
Saúde do Adolescente/estatística & dados numéricos , Doença Crônica/epidemiologia , Viroses/epidemiologia , Adolescente , Varicela/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Epilepsia/epidemiologia , Alemanha/epidemiologia , Inquéritos Epidemiológicos , Cardiopatias/epidemiologia , Humanos , Lactente , Recém-Nascido , Sarampo/epidemiologia , Transtornos de Enxaqueca/epidemiologia , Convulsões Febris/epidemiologia , Coqueluche/epidemiologia
15.
BMC Infect Dis ; 19(1): 771, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31481053

RESUMO

BACKGROUND: Although worldwide measles elimination achieved great progress for decades, outbreaks were still reported in certain countries. This study describes the epidemiologic features of a substantial measles outbreak in an office building in Beijing and explores control strategies in a crowded city. METHODS: We performed descriptive analyses of data on demographic characteristic, laboratory testing and epidemiological information. RESULTS: From February 25 to March 28, 2016, 43 outbreak-related measles cases occurred in an office building in Beijing. The total crude attack rate was 1.20% in the building. The age range of patients was 23 to 45 years old, of whom 30 (69.8%) were migrants and 5 (11.6%) were vaccinated but without documentation. The attack rate of the department and the company of the source case was 22.73 and 11.86%, respectively. The attack rate in the building was 1.78%, except for the commercial center on the lower floors, which was 0.34%. Of the 43 measles cases, only 19 cases (53.5%) were reported by hospitals through the National Notifiable Disease Reporting System (NNDRS), and the rest were found through active surveillance. Outbreak response immunization was conducted for 6216 persons. CONCLUSIONS: Office buildings in crowded metropolis are prone to large-scale measles outbreaks, and require a rapid outbreak response. Early Outbreak response immunization and active surveillance are important strategies to control outbreaks such as the one reported herein.


Assuntos
Aglomeração , Surtos de Doenças , Sarampo/epidemiologia , Adulto , Pequim/epidemiologia , China/epidemiologia , Surtos de Doenças/prevenção & controle , Feminino , Hospitais , Humanos , Incidência , Masculino , Sarampo/prevenção & controle , Pessoa de Meia-Idade , Urbanização , Vacinação/normas , Vacinação/estatística & dados numéricos , Adulto Jovem
16.
BMC Public Health ; 19(1): 1194, 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31470822

RESUMO

BACKGROUND: In Ethiopia, despite considerable improvement of measles vaccination, measles outbreaks is occurring in most parts of the country. Understanding the neighborhood variation in childhood measles vaccination is crucial for evidence-based decision-making. However, the spatial pattern of measles-containing vaccine (MCV1) and its predictors are poorly understood. Hence, this study aimed to explore the spatial pattern and associated factors of childhood MCV1 coverage. METHODS: An in-depth analysis of the 2016 Ethiopia demographic and health survey data was conducted, and a total of 3722 children nested in 611 enumeration areas were included in the analysis. Global Moran's I statistic and Poisson-based purely spatial scan statistics were employed to explore spatial patterns and detect spatial clusters of childhood MCV1, respectively. Multilevel logistic regression models were fitted to identify factors associated with childhood MCV1. RESULTS: Spatial hetrogeniety of childhood MCV1 was observed (Global Moran's I = 0.13, p-value < 0.0001), and seven significant SaTScan clusters of areas with low MCV1 coverage were detected. The most likely primary SaTScan cluster was detected in the Afar Region, secondary cluster in Somali Region, and tertiary cluster in Gambella Region. In the final model of the multilevel analysis, individual and community level factors accounted for 82% of the variance in the odds of MCV1 vaccination. Child age (AOR = 1.53; 95%CI: 1.25-1.88), pentavalent vaccination first dose (AOR = 9.09; 95%CI: 6.86-12.03) and third dose (AOR = 7.12; 95%CI: 5.51-9.18, secondary and above maternal education (AOR = 1.62; 95%CI: 1.03-2.55) and media exposure were the factors that increased the odds of MCV1 vaccination at the individual level. Children with older maternal age had lower odds of receiving MCV1. Living in Afar, Oromia, Somali, Gambella and Harari regions were factors associated with lower odds of MCV1 from the community-level factors. Children far from health facilities had higher odds of receiving MCV1 (AOR = 1.31, 95%CI = 1.12-1.61). CONCLUSION: A clustered pattern of areas with low childhood MCV1 coverage was observed in Ethiopia. Both individual and community level factors were significant predictors of childhood MCV1. Hence, it is good to give priority for the areas with low childhood MCV1 coverage, and to consider the identified factors for vaccination interventions.


Assuntos
Vacina contra Sarampo/administração & dosagem , Sarampo/prevenção & controle , Características de Residência/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Pré-Escolar , Etiópia/epidemiologia , Feminino , Geografia , Humanos , Lactente , Masculino , Sarampo/epidemiologia , Análise Multinível , Fatores Socioeconômicos , Análise Espacial
18.
Pan Afr Med J ; 33(Suppl 2): 7, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31402966

RESUMO

Introduction: Measles is an acute viral disease that remains endemic in much of sub-Sahara Africa, including Liberia. The 2014 Ebola epidemic disrupted an already fragile health system contributing to low uptake of immunization services, population immunity remained low thus facilitating recurrent outbreaks of measles in Liberia. We describe lessons learnt from detecting and responding to recurrent outbreaks of measles two years post the 2014 Ebola epidemic in Liberia. Methods: We conducted a descriptive study using the findings from Integrated Diseases Surveillance and Response (IDSR) 15 counties, National Public Health Institute of Liberia (NPHIL), National Public Health Reference Laboratory (NPHRL) and District Health Information Software (DIHS2) data conducted from October to December, 2017. We perused the outbreaks line lists and other key documents submitted by the counties to the national level from January 2016 to December 2017. Results: From January 2016 to December 2017, 2,954 suspected cases of measles were reported through IDSR. Four hundred sixty-seven (467) were laboratory confirmed (IgM-positive), 776 epidemiologically linked, 574 clinically confirmed, and 1,137 discarded (IgM-negative). Nine deaths out of 1817 cases were reported, a case fatality rate of 0.5%; 49% were children below the age of 5 years. Twenty-two percent (405/1817) of the confirmed cases were vaccinated while the vaccination status of 55% (994/1817) was unknown. Conclusion: Revitalization of IDSR contributed to increased detection and reporting of suspected cases of measles thus facilitating early identification and response to outbreaks. Priority needs to be given to increasing the uptake of routine immunization services, introducing a second dose of measles vaccine in the routine immunization program and conducting a high-quality supplementary measles immunization campaign for age group 1 to 10 years to provide protection for a huge cohort of susceptible.


Assuntos
Surtos de Doenças , Programas de Imunização/organização & administração , Vacina contra Sarampo/administração & dosagem , Sarampo/epidemiologia , Criança , Pré-Escolar , Feminino , Doença pelo Vírus Ebola/epidemiologia , Humanos , Imunização/métodos , Lactente , Libéria/epidemiologia , Masculino , Sarampo/prevenção & controle , Vigilância em Saúde Pública , Recidiva
19.
Int J Infect Dis ; 86: 188-190, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31398452

RESUMO

During March-April 2018, an infectious measles index case traveling from Thailand led to two successive generations of measles transmission in Taiwan, with 21 cases confirmed. The median patient age was 30.5 years (range 22-47 years); six (27%) had documented receipt of one (n=3) or more (n=3) previous measles-containing vaccine doses at age ≥12 months. Epidemiological investigation and sequence analysis found that most (n=16, 76%) measles transmissions had occurred in airport and flight settings; secondary and tertiary cases included cabin crew (n=7), airport staff (n=2), and passengers who had been at the same airport or on the same flight (n=7). This investigation serves as a reminder that an international airport can be a hotspot for measles transmission. International travelers, airline cabin crew, and airport employees are recommended to check their vaccination status and ensure that they are fully vaccinated against measles. Furthermore, it is recommended that airline and airport employers have an occupational health vaccination program in place to ensure appropriate pre-employment assessment of measles immunity and vaccination.


Assuntos
Aeroportos , Sarampo/transmissão , Viagem , Adulto , Feminino , Humanos , Masculino , Sarampo/epidemiologia , Vacina contra Sarampo/administração & dosagem , Pessoa de Meia-Idade , Taiwan , Tailândia/epidemiologia , Adulto Jovem
20.
BMC Infect Dis ; 19(1): 705, 2019 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-31399064

RESUMO

BACKGROUND: In recent times, emerging and re-emerging infectious diseases are posing a public health threat in developing countries, and vigilant surveillance is necessary to prepare against these threats. Analyses of multi-year comprehensive infectious disease syndrome data are required in Mongolia, but have not been conducted till date. This study aimed to describe the trends in the incidence of infectious disease syndromes in Mongolia during 2009-2017 using a nationwide syndrome surveillance system for infectious diseases established in 2009. METHODS: We analyzed time trends using monthly data on the incidence of infectious disease syndromes such as acute fever with rash (AFR), acute fever with vesicular rash (AFVR), acute jaundice (AJ), acute watery diarrhea (AWD), acute bloody diarrhea (ABD), foodborne disease (FD) and nosocomial infection (NI) reported from January 1, 2009 to December 31, 2017. Time series forecasting models based on the data up to 2017 estimated the future trends in the incidence of syndromes up to December 2020. RESULTS: During the study, the overall prevalence of infectious disease syndromes was 71.8/10,000 population nationwide. The average number of reported infectious disease syndromes was 14,519 (5229-55,132) per year. The major types were AFR (38.7%), AFVR (31.7%), AJ (13.9%), ABD (10.2%), and AWD (1.8%), accounting for 96.4% of all reported syndromes. The most prevalent syndromes were AJ between 2009 and 2012 (59.5-48.7%), AFVR between 2013 and 2014 (54.5-59%), AFR between 2015 and 2016 (67.6-65.9%), and AFVR in 2017 (62.2%). There were increases in the prevalence of AFR, with the monthly number of cases being 37.7 ± 6.1 during 2015-2016; this could be related to the measles outbreak in Mongolia during that period. The AFVR incidence rate showed winter's multiplicative seasonal fluctuations with a peak of 10.6 ± 2 cases per 10,000 population in 2017. AJ outbreaks were identified in 2010, 2011, and 2012, and these could be associated with hepatitis A outbreaks. Prospective time series forecasting showed increasing trends in the rates of AFVR and ABD. CONCLUSIONS: The evidence-based method for infectious disease syndromes was useful in gaining an understanding of the current situation, and predicting the future trends of various infectious diseases in Mongolia.


Assuntos
Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis Emergentes/epidemiologia , Surtos de Doenças , Doenças Transmitidas por Alimentos/epidemiologia , Humanos , Incidência , Análise de Séries Temporais Interrompida , Sarampo/epidemiologia , Mongólia/epidemiologia , Vigilância da População/métodos , Prevalência , Estudos Prospectivos , Estudos Retrospectivos , Síndrome
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