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1.
Euro Surveill ; 25(19)2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32431288

RESUMO

Using electronic health records, we assessed the early impact of coronavirus disease (COVID-19) on routine childhood vaccination in England by 26 April 2020. Measles-mumps-rubella vaccination counts fell from February 2020, and in the 3 weeks after introduction of physical distancing measures were 19.8% lower (95% confidence interval: -20.7 to -18.9) than the same period in 2019, before improving in mid-April. A gradual decline in hexavalent vaccination counts throughout 2020 was not accentuated by physical distancing.


Assuntos
Infecções por Coronavirus/epidemiologia , Coronavirus , Surtos de Doenças/prevenção & controle , Vacina contra Sarampo-Caxumba-Rubéola , Pandemias , Pneumonia Viral/epidemiologia , Vacinação/estatística & dados numéricos , Betacoronavirus , Pré-Escolar , Inglaterra , Acesso aos Serviços de Saúde , Humanos , Lactente , Sarampo/prevenção & controle , Caxumba/prevenção & controle , Quarentena , Rubéola (Sarampo Alemão)/prevenção & controle
3.
Pergunta e resposta em Português | SOF - Segunda opinião formativa | ID: sof-43269

RESUMO

Mulheres que amamentam podem ser vacinadas com a tríplice viral. A vacina tríplice viral é contraindicada para gestantes e crianças abaixo dos 6 (seis) meses de idade, mesmo em situações de surto de sarampo ou rubéola(1).


Assuntos
Aleitamento Materno , Vacina contra Sarampo-Caxumba-Rubéola , Contraindicações
4.
Washington, D.C.; PAHO; 2020-04-17.
em Inglês, Espanhol | PAHO-IRIS | ID: phr-52147

RESUMO

Between 1 January and 10 April 2020, 7 countries have reported 1,104 confirmed cases in the Region of the Americas: Argentina (54 cases, including 1 death), Brazil (909 cases, including 4 deaths), Canada (1 case), Chile (2 cases), Mexico (124 cases), the United States of America (12 cases), and Uruguay (2 cases).


Entre el 1 de enero y el 10 de abril de 2020, 7 países notificaron 1.104 casos confirmados: Argentina (54 casos, incluida una defunción), Brasil (909 casos, incluidas 4 defunciones), Canadá (1 caso), Chile (2 casos), Estados Unidos de América (12 casos), México (124 casos) y Uruguay (2 casos).


Assuntos
Emergências , Regulamento Sanitário Internacional , Sarampo , Emergências , Sarampo , Regulamento Sanitário Internacional
8.
J Korean Med Sci ; 35(12): e76, 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32233157

RESUMO

BACKGROUND: Healthcare personnel (HCP) are at risk of being exposed to or transmitting infections in hospitals, and vaccination against vaccine-preventable diseases (VPDs) is a well-known preventive strategy. Vaccination against influenza, hepatitis B virus, measles-mumps-rubella, varicella, and pertussis is recommended for HCP. However, there is no information on the current status of hospitals' vaccination policies for HCP in Korea. METHODS: We conducted a nationwide survey on hospital vaccination policies and barriers to implementing recommended vaccination programs in 2018. The online survey questionnaire was distributed to 652 hospitals, and 200 of them responded. RESULTS: Of the 200 surveyed hospitals, 151 (75.5%) conducted a pre-employment screening program for at least one VPD, and 196 (98%) had vaccination programs that included at least one vaccine. Influenza vaccine was most commonly included in their programs (97.5%, n = 195), followed by hepatitis B vaccines (69%, n = 138). However, < 25% of the hospitals included other vaccines in their policies (measles-mumps-rubella, 24.5%; varicella, 18.5%; pertussis, 11%). Only 13 hospitals (6.5%) included the five recommended vaccines for HCP in their policies. Influenza vaccination coverage had a mean of 89.9% and was significantly higher in hospitals fully funding the vaccination cost (91.8% vs. 80.4%, P < 0.001). Among hospitals funding influenza vaccines, the coverage was lower in hospitals with ≥ 700 beds (-6.5%, P = 0.003). Hospitals' financial burden was the most important barrier to implementing vaccination polices as recommended (78.6%, 121/154), followed by lack of awareness (21%) or campaign (21%) and lack of leadership (17%). CONCLUSION: Despite the recommendations on vaccination for HCP, the vaccination policies for HCP differ in hospitals and appear to be insufficient to protect HCP and prevent nosocomial transmission. Strong leadership of each hospital to protect HCP and financial support from the government are required to implement appropriate vaccination policies in hospitals.


Assuntos
Hospitais/estatística & dados numéricos , Política Organizacional , Vacinação/estatística & dados numéricos , Doenças Preveníveis por Vacina , Vacinas , Vacina contra Varicela , Infecção Hospitalar/prevenção & controle , Humanos , Vacinas contra Influenza , Vacina contra Sarampo-Caxumba-Rubéola , Vacina contra Coqueluche , República da Coreia , Doenças Preveníveis por Vacina/prevenção & controle , Vacinas/uso terapêutico
9.
Vestn Oftalmol ; 136(1): 124-129, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32241979

RESUMO

The article reviews literature and proprietary data on the role of pathogens in the etiology of infectious and non-infectious uveitis. Infectious uveitis is caused by active intraocular replication of the virus (herpesvirus, acute stage of enterovirus), or by long-term persistence of the viruses in eye tissues (Fuchs syndrome associated with rubella virus, late complications of enterovirus uveitis). Clinical picture, severity, outcomes of infectious uveitis depend on the pathogen, adequacy of the immune response and genetic characteristics of the patient. Infections trigger the development of non-infectious uveitis, including autoimmune. Their trigger mechanisms involve antigenic mimicry, bystander activation, epitope spreading, presence of superantigens, intestinal microbiota. An uncontrolled, excessive host immune response contributes to cell destruction even after removal of the infection.


Assuntos
Infecções Oculares Virais , Uveíte , Humanos , Vírus da Rubéola , Simplexvirus
11.
MMWR Morb Mortal Wkly Rep ; 69(15): 439-445, 2020 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-32298253

RESUMO

In 1997, during the 41st session of the Regional Committee for the Eastern Mediterranean, the 21 countries in the World Health Organization (WHO) Eastern Mediterranean Region* (EMR) passed a resolution to eliminate† measles (1). In 2015, this goal was included as a priority in the Eastern Mediterranean Vaccine Action Plan 2016-2020 (EMVAP) (2), endorsed at the 62nd session of the Regional Committee (3). To achieve this goal, the WHO Regional Office for the Eastern Mediterranean developed a four-pronged strategy: 1) achieve ≥95% vaccination coverage with the first dose of measles-containing vaccine (MCV1) among children in every district of each country through routine immunization services; 2) achieve ≥95% vaccination coverage with a second MCV dose (MCV2) in every district of each country either through implementation of a routine 2-dose vaccination schedule or through supplementary immunization activities§ (SIAs); 3) conduct high-quality, case-based surveillance in all countries; and 4) provide optimal measles clinical case management, including dietary supplementation with vitamin A (4). This report describes progress toward measles elimination in EMR during 2013-2019 and updates a previous report (5). Estimated MCV1 coverage increased from 79% in 2013 to 82% in 2018. MCV2 coverage increased from 59% in 2013 to 74% in 2018. In addition, during 2013-2019, approximately 326.4 million children received MCV during SIAs. Reported confirmed measles incidence increased from 33.5 per 1 million persons in 2013 to 91.2 in 2018, with large outbreaks occurring in Pakistan, Somalia, and Yemen; incidence decreased to 23.3 in 2019. In 2019, the rate of discarded nonmeasles cases¶ was 5.4 per 100,000 population. To achieve measles elimination in the EMR, increased visibility of efforts to achieve the measles elimination goal is critically needed, as are sustained and predictable investments to increase MCV1 and MCV2 coverage, conduct high-quality SIAs, and reach populations at risk for not accessing immunization services or living in areas with civil strife.


Assuntos
Erradicação de Doenças , Sarampo/prevenção & controle , Vigilância da População , África do Norte/epidemiologia , Genótipo , Humanos , Programas de Imunização , Incidência , Sarampo/epidemiologia , Vacina contra Sarampo/administração & dosagem , Oriente Médio/epidemiologia
12.
Gac Med Mex ; 156(2): 124-131, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32285860

RESUMO

From 1990 to 2012, the Sanitary and Tropical Diseases Institute experienced the most important changes. In 1989, its name and orientation were modified to become the National Institute of Epidemiological Diagnosis and Reference. Shortly before, it had been formalized as the apex of the National Network of Public Health Laboratories and had incorporated laboratories for preventive programs such as exfoliative cytology and rabies, malaria and tuberculosis diagnosis; subsequently, it would incorporate other networks that emerged as part of the response to major epidemic outbreaks and to the new epidemiological outlook. In this period, 27 priority diagnostic algorithms were defined, organized in 18 networks, some of which began to collaborate with global networks. In 2001, the Institute started working with pathogens related to bioterrorism. By then, space restrictions of the headquarter's building were evident; in 2008, starting the construction of new facilities was decided. The Institute and its diagnostic networks constitute a milestone in Latin American public health of the 21st century.


Assuntos
Academias e Institutos , Surtos de Doenças , Humanos , Malária/diagnóstico , Malária/epidemiologia , Saúde Pública , Fatores de Tempo , Tuberculose/diagnóstico , Tuberculose/epidemiologia
13.
Medicina (B Aires) ; 80(2): 162-168, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32282323

RESUMO

In April 2019, UNICEF denounced that more than 20 million children worldwide had not been vaccinated and alerted on possible outbreaks of measles which, due to the high transmissibility of this virus, is the first disease preventable by vaccination to emerge. If the decline in vaccinations continues, pertussis, tetanus and other diseases, which require less coverage to achieve population protection, may also reappear. In Argentina, the current outbreak began in late August 2019. Measles virus is transmitted by air, infects multiple organs, and is associated with immunosuppression. Its genome consists of single stranded RNA. Genotyping is carried out by sequencing a 450-nucleotide fragment of the N protein, which contains the highest density of nucleotide variation. In South America, D8 is the circulating genotype and in North America, B3 accounts for 8% of the cases. Each person with measles infects, on average, another 12-18 people in a susceptible population. Vaccination confers direct and indirect protection, and induces both antibodies and cellular immunity. Newborns are protected by maternal antibodies transmitted via the placenta, up to 6 months. In Argentina, the Vaccination Calendar includes two doses of triple viral vaccine, at 12 months and 5 years, and a zero dose (6-11 months of age) in districts with disease cases. The protection conferred by the vaccine is 93% at 12 months with a dose, and with 2 doses 97% for life.

18.
An Bras Dermatol ; 95(2): 238-240, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32146012

RESUMO

Some epidermal alterations in measles has been described, such as keratinocytes apoptotic, parakeratosis, giant-cell formation, intranuclear and cytoplasmic inclusions, dyskeratosis, spongiosis, and intracellular edema. The authors report for the first time in human a case of measles with the presence of multinucleated giant cells in the hair follicle and dyskeratosis in acrosyringium.


Assuntos
Epiderme/patologia , Folículo Piloso/patologia , Sarampo/patologia , Biópsia , Criança , Células Gigantes/patologia , Humanos , Queratinócitos/patologia , Masculino , Paraceratose/patologia
19.
PLoS One ; 15(3): e0228163, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32130229

RESUMO

Anti-retroviral therapy (ART) has been highly successful in controlling HIV replication, reducing viral burden, and preventing both progression to AIDS and viral transmission. Yet, ART alone cannot cure the infection. Even after years of successful therapy, ART withdrawal leads inevitably to viral rebound within a few weeks or months. Our hypothesis: effective therapy must control both the replicating virus pool and the reactivatable latent viral reservoir. To do this, we have combined ART and immunotherapy to attack both viral pools simultaneously. The vaccine regimen consisted of DNA vaccine expressing SIV Gag, followed by a boost with live attenuated rubella/gag vectors. The vectors grow well in rhesus macaques, and they are potent immunogens when used in a prime and boost strategy. We infected rhesus macaques by high dose mucosal challenge with virulent SIVmac251 and waited three days to allow viral dissemination and establishment of a reactivatable viral reservoir before starting ART. While on ART, the control group received control DNA and empty rubella vaccine, while the immunotherapy group received DNA/gag prime, followed by boosts with rubella vectors expressing SIV gag over 27 weeks. Both groups had a vaccine "take" to rubella, and the vaccine group developed antibodies and T cells specific for Gag. Five weeks after the last immunization, we stopped ART and monitored virus rebound. All four control animals eventually had a viral rebound, and two were euthanized for AIDS. One control macaque did not rebound until 2 years after ART release. In contrast, there was only one viral rebound in the vaccine group. Three out of four vaccinees had no viral rebound, even after CD8 depletion, and they remain in drug-free viral remission more than 2.5 years later. The strategy of early ART combined with immunotherapy can produce a sustained SIV remission in macaques and may be relevant for immunotherapy of HIV in humans.


Assuntos
Síndrome de Imunodeficiência Adquirida/terapia , Fármacos Anti-HIV/uso terapêutico , Vacinas contra a SAIDS/administração & dosagem , Síndrome de Imunodeficiência Adquirida dos Símios/terapia , Vírus da Imunodeficiência Símia/imunologia , Síndrome de Imunodeficiência Adquirida/sangue , Síndrome de Imunodeficiência Adquirida/imunologia , Síndrome de Imunodeficiência Adquirida/virologia , Animais , Terapia Combinada/métodos , Modelos Animais de Doenças , Esquema de Medicação , Quimioterapia Combinada/métodos , Produtos do Gene gag/genética , Produtos do Gene gag/imunologia , Vetores Genéticos/administração & dosagem , Vetores Genéticos/genética , Humanos , Macaca mulatta , Plasmídeos/administração & dosagem , Plasmídeos/genética , Vírus da Rubéola/imunologia , Vacinas contra a SAIDS/genética , Síndrome de Imunodeficiência Adquirida dos Símios/sangue , Síndrome de Imunodeficiência Adquirida dos Símios/imunologia , Síndrome de Imunodeficiência Adquirida dos Símios/virologia , Vírus da Imunodeficiência Símia/genética , Vírus da Imunodeficiência Símia/isolamento & purificação , Fatores de Tempo , Resultado do Tratamento , Vacinas Atenuadas/administração & dosagem , Vacinas de DNA/administração & dosagem , Vacinas de DNA/genética , Latência Viral/efeitos dos fármacos , Latência Viral/imunologia , Replicação Viral/efeitos dos fármacos , Replicação Viral/imunologia
20.
BMC Infect Dis ; 20(1): 244, 2020 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-32216754

RESUMO

BACKGROUND: Lebanon has experienced several measles and mumps outbreaks in the past 20 years. In this article, a case-based surveillance of both measles and mumps outbreaks in Lebanon was carried out in an attempt to outline factors contributing to the failure of elimination plans and to provide potential solutions. The relationship between the outbreaks of both diseases was described and explored. METHODS: A retrospective descriptive study of confirmed cases of measles and mumps in Lebanon between 2003 and 2018 collected from the Lebanese Ministry of Public Health Epidemiological Surveillance Unit public database was carried out. The information collected was graphically represented taking into consideration dates of reported cases, age groups affected, and vaccination status. RESULTS: The mean number of measles cases was 150.25 cases/year in the 1-4 years age group, 87 cases/year in individuals aging between 5 and 14, and 63.68 cases/year in those > 14 years old. In the latter group, only 18.05% were unvaccinated. The mean number of mumps cases was 30.4 cases/year in the < 4 year age group and 53.8 cases/year in the 10-19 years age group. During the study period, every spike in measles cases was followed by a similar spike in mumps. 9.66% of measles cases occurred in individuals who received at least 2 doses of the vaccine, 52.26% in the unvaccinated, and 38% in those whose vaccination status was undetermined. CONCLUSIONS: Measles in Lebanon is a disease of the pediatric population, but adults remain at risk. Outbreaks of mumps followed those of measles and were mainly among adolescents. Presence of a large number of Syrian refugees in the country may further complicate the situation. Vaccination activities need to be intensified.


Assuntos
Surtos de Doenças/prevenção & controle , Vacina contra Sarampo-Caxumba-Rubéola/uso terapêutico , Sarampo/epidemiologia , Sarampo/prevenção & controle , Caxumba/epidemiologia , Caxumba/prevenção & controle , Vacinação/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Líbano/epidemiologia , Masculino , Sarampo/virologia , Morbillivirus/imunologia , Morbillivirus/isolamento & purificação , Caxumba/virologia , Vírus da Caxumba/imunologia , Vírus da Caxumba/isolamento & purificação , Vigilância em Saúde Pública , Refugiados , Estudos Retrospectivos , Adulto Jovem
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