Panorama atual do sarampo no mundo: Risco de surtos nos grandes eventos no Brasil / Current landscape of measles in the world: risk of outbreaks in major events in Brazil

O sarampo é considerado uma das doenças infecciosas mais contagiosas do mundo (1), capaz de atingir todos os grupos etários, com risco particular em menores de cinco e naqueles entre 15 e 29 anos de idade (2), sendo uma das principais causas de morte evitáveis por vacina entre crianças (3). Frente aos recentes surtos de sarampo ocorridos no mundo, estaria o Brasil, que desde 2000 conseguiu eliminar a circulação do sarampo e na atualidade vem lidando apenas com surtos de pequena monta de casos importados, sob risco de grandes surtos durante a Copa do Mundo de 2014 e as Olimpíadas de 2016? Através de análises dos últimos surtos ocorridos em todo o mundo e pesquisa da cobertura vacinal no Brasil, os autores respondem a estas questões.

Measles is considered one of the most contagious diseases in the world (1). It's able to reach all of age groups with particular risk in under five and 15-29 years old (2). It's one of the main causes for evitable deaths for vaccine between children (3). According to recents measles outbreaks occurred in the world, Brazil is included in it, since 2000 has eliminated measles circulation and actually has been dealing with outbreaks of little dimension of imported cases, at risk of large outbreak during the World Cup 2014 and The Olympics Games 2016? Through analysis of the latest outbreaks ocurred all over the world and research of vaccine coverage in Brazil, the authors will answer to these questions.

Sarampión, Rubéola y SRC: Rubella Watch: Compendio de artículos sobre sarampión(1) / Measles, Rubella and SRC: Rubella Watch: Articles compendium on measles (1)

La publicación busca documentar la experiencia regional, pero sobretodo comunicar a los países y a otras regiones del mundo las lecciones aprendidas, así como las experiencias y mejores prácticas derivadas de la iniciativa de eliminación de enfermedades prevenibles por vacunación. Durante los 15 años de este proceso se ha acumulado conocimiento sobre lo que debe hacerse para llevar adelante estas iniciativas y lograr la meta de eliminación.

Avaliação vacinal e imunológica para sarampo no paciente pediátrico portador de insuficiência renal crônica / Vaccinal an immunological measles evaluation in pediatric patients with chronic renal failure

Objetivo: avaliar a imunidade para o sarampo em crianças e adolescentes portadores de insuficiência renal crônica. Casuística e métodos: no ano 2000, foi realizado um estudo de corte transversal com os pacientes seguidos em uma unidade de nefrologia que preenchessem os critérios seletivos: idade 18 meses e 18 anos, ritmo de filtração glomerular abaixo de 70 ml/min/1,73m2, que tivessem o cartão vacinal preconizado pelo Ministério da Saúde do Brasil...

Objective: to evaluate the immune response to measles vaccination in children and adolescents with chronic renal failure (CRF). Patients and methods: a cross-sectional study was proceeded in year 2000, with registered patients in a nephrologic unit, that fulfilled the study criteria: age range between 18 months and 18 years, glomerular filtration rate...

Desarrollo de anticuerpos y frecuencia de eventos temporalmente asociados a las vacunas contra el sarampión y rubéola en personal de salud universitario de Jalisco / Antibody development and frequency of events temporarily with measles and rubella vaccines among university health personnel in Jalisco

Objetivo: Evaluar el estado inmune y la seroconversión o respuesta anamnésica posterior a inmunización con vacuna de sarampión-rubéola (SR) y eventos temporalmente asociados, en personal de salud universitario. Materiales y métodos: Estudio prospectivo, longitudinal y comparativo de mayo a junio de 2000 en 120 adultos sanos de un Hospital de la Universidad Autónoma de Guadalajara. Previo consentimiento informado se aplicó la vacuna SR de sarampión (Schwarz) y rubéola (RA 27/3). Se realizó seguimiento telefónico semanal para identificar eventos locales y sistémicos temporalmente asociados a la vacunación (30 días posteriores a su aplicación, no atribuibles a otro proceso mórbido). Se tomó suero antes y seis semanas después de la vacunación. Los anticuerpos (IgG) contra sarampión y rubéola fueron cuantificados por análisis inmunoenzimático (Enzygnost®, Dade Behring) con puntos de corte de > 300mUI/mL y > 8UI/mL, respectivamente. Análisis: media, desviación estándar (DS), Prueba t de Student pareada (significancia de P < 0.05). Resultados: Se logró seguimiento en 105/120 (87.5%) durante seis semanas. El 87.4% fue personal de salud y 44.6% varones. Rango de edad 17-71 años (mediana = 21). En la historia clínica hubo antecedente de posible sarampión en 57.1%. Se obtuvo suero pareado en 75 casos. La proporción de voluntarios con anticuerpos para sarampión y rubéola antes (90.7 y 94.7%) y después (100 y 100%) de la vacuna se incrementó de manera significativa (P < 0.001). Dolor, calor, rubor e induración en el sitio de inyección se presentó en 4/105 (~4%). Fiebre, exantema, artralgias y artritis en 9/105 (~9%). Conclusiones: La proporción de susceptibles a sarampión fue alta si tomamos en consideración la potencialidad de transmisión del virus de sarampión a la población que atenderían durante el período de contagiosidad (3-5 días). La respuesta de inmunidad postvacunal fue óptima. La vacunación en personal de salud debe ser prioritaria.

Objective: To evaluate the seroprevalence, seroconversion, anamnesic response and events temporally associated with immune status pre and post immunization with measles and rubella vaccine in health personnel from a public University in Guadalajara, Mexico. Material and methods: We carried out a prospective, longitudinal and comparative study from May to June 2000 among 120 healthy volunteers. Informed consent was obtained from all participants. We administered measles (Schwarz) and rubella (RA 27/3) vaccines. Weekly phone calls during six weeks were recorded from each volunteer to assess local and systemic events temporally associated with immunization non attributable to any other disease. Serum samples were obtained before and after vaccination in 75 volunteers. Antibodies against measles and rubella were measured by an enzyme immunoassay kit (Behring) with cut-off points of ³300mUI/mL and ³8UI/mL respectively. Statistical analysis included mean, standard deviation and paired Student's t-test (P < 0.05). Results: 105/120 participants (87.5%) were followed during 6 weeks. 87.4% were health personnel and 44.6% were males. The age range was 17-71 years (median = 21). We found a prior history of measles in 57.1%. Local events included pain, heat, redness and induration and were reported by 4/105. Systemic events such as fever, exanthema, pain in joints and arthritis was reported by 9/105. The proportion of study subjects with protective antibodies against measles and rubella prior to vaccination was 90.7 and 94.7% respectively. Both groups reached 100% after vaccination. Conclusions: The proportion of non-immune health personnel was low and similar to other reports. However, the potential spread of measles and rubella virus from a non-immunized infected health care provider could be amplified by the number of patients seen daily during the peak period of 3-5 days. The vaccination of health personnel should be encouraged.