1
|
Vojtek I, Larson H, Plotkin S, Van Damme P. Evolving measles status and immunization policy development in six European countries. Hum Vaccin Immunother 2022; 18:2031776. [PMID: 35180372 PMCID: PMC9009904 DOI: 10.1080/21645515.2022.2031776] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Developing and implementing new immunization policies in response to shifting epidemiology is a critical public health component. We adopted a mixed-methods approach (via narrative literature review [101 articles] and 9 semi-structured interviews) to evaluate policy development in response to shifting measles epidemiology in six European countries (Italy, Belgium, Germany, Romania, UK, and Ukraine); where policies and strategies have evolved in response to country-specific disease and vaccination patterns. Periodic outbreaks have occurred in all countries against a background of declining measles-containing-vaccine (MCV) uptake and increasing public vaccine hesitancy (with substantial regional or social differences in measles burden and vaccine uptake). Health-care worker (HCW) vaccine skepticism is also seen. While many outbreaks arise or involve specific susceptible populations (e.g., minority/migrant communities), the broader pattern is spread to the wider (and generally older) population; often among incompletely/non-vaccinated individuals as a legacy of previous low uptake. Immunization policy and strategic responses are influenced by political and social factors, where public mistrust contributes to vaccine hesitancy. A strong centralized immunization framework (allied with effective regional implementation and coherent political commitment) can effectively increase uptake. Mandatory vaccination has increased childhood MCV uptake in Italy, and similar benefits could be anticipated for other countries considering vaccine mandates. Although possible elsewhere, socio-political considerations render mandating impractical in other countries, where targeted immunization activities to bolster routine uptake are more important. Addressing HCW skepticism, knowledge gaps, improving access and increasing public/community engagement and education to address vaccine hesitancy/mistrust (especially in communities with specific unmet needs) is critical.
Collapse
Affiliation(s)
| | - Heidi Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Stanley Plotkin
- University of Pennsylvania School of Medicine, Doylestown, PA, USA.,Vaxconsult, Doylestown, PA, USA
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
2
|
Chen J, Jia H, Cai Z, Zhou Y, Ma S, Chen Y, Chen C, Pan W. Economic burden of measles and its influencing factors in Fujian, China. Hum Vaccin Immunother 2021; 17:5367-5371. [PMID: 34714722 DOI: 10.1080/21645515.2021.1989917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Measles is a highly-contagious, serious diseases that can lead to potentially fatal illness, disability and death . We conducted an investigation to calculate the economic burden of measles cases from 2018 to 2019 and to analyze factors that influenced the total costs of measles cases in Fujian Province, China. METHODS We investigated confirmed cases of measles by telephone interview, from 2018 to 2019, including demographic characteristics, therapeutic measures, self-treatment and nutritional supplement expenditure, transportation fees, and lost wages. Medical expenses in the hospitals were obtained from the hospital service charge system. RESULTS A total of 131 measles cases were investigated, the average direct cost, indirect cost, and total cost were $518, $284, and $802, respectively. The total cost was 15.5% of Annual Per Capita Disposable Income of Households ($5 162) in Fujian. Hospitalization (OR = 98.6, 95%CI: 21.1 ~ 460.6) and complication (OR = 8.7, 95%CI: 1.3 ~ 58.0) significantly influenced the total cost according to binary logistic regression, and an outbreak of measles may pose a significant threat to household finances in a short term. CONCLUSIONS The economic burden of measles was high when compared with Annual Per Capita Disposable Income of Households. The resurgence of measles and measles outbreaks increased economic burden of household finances.
Collapse
Affiliation(s)
- Junlei Chen
- Department of Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Haimei Jia
- Department of Immunization Program, Fuzhou Center for Disease Control and Prevention, Fuzhou, China
| | - Zhikun Cai
- Department of Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Yong Zhou
- Department of Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Shanshan Ma
- Department of Immunization Program, Xiamen Center for Disease Control and Prevention, Xiamen, China
| | - Yahong Chen
- Department of Immunization Program, Quanzhou Center for Disease Control and Prevention, Quanzhou, China
| | - Changfu Chen
- Department of Immunization Program, City Center for Disease Control and Prevention, Ningde, China
| | - Weiyi Pan
- Department of Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| |
Collapse
|
3
|
Deal A, Halliday R, Crawshaw AF, Hayward SE, Burnard A, Rustage K, Carter J, Mehrotra A, Knights F, Campos-Matos I, Majeed A, Friedland JS, Edelstein M, Mounier-Jack S, Hargreaves S. Migration and outbreaks of vaccine-preventable disease in Europe: a systematic review. THE LANCET. INFECTIOUS DISEASES 2021; 21:e387-e398. [PMID: 34626552 DOI: 10.1016/s1473-3099(21)00193-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/04/2021] [Accepted: 03/17/2021] [Indexed: 12/25/2022]
Abstract
Migrant populations are one of several underimmunised groups in the EU or European Economic Area (EU/EEA), yet little is known about their involvement in outbreaks of vaccine-preventable diseases. This information is vital to develop targeted strategies to improve the health of diverse migrant communities. We did a systematic review (PROSPERO CRD42019157473; Jan 1, 2000, to May 22, 2020) adhering to PRISMA guidelines, to identify studies on vaccine-preventable disease outbreaks (measles, mumps, rubella, diphtheria, pertussis, polio, hepatitis A, varicella, Neisseria meningitidis, and Haemophilus influenzae) involving migrants residing in the EU/EEA and Switzerland. We identified 45 studies, reporting on 47 distinct vaccine-preventable disease outbreaks across 13 countries. Most reported outbreaks involving migrants were of measles (n=24; 6496 cases), followed by varicella (n=11; 505 cases), hepatitis A (n=7; 1356 cases), rubella (n=3; 487 cases), and mumps (n=2; 293 cases). 19 (40%) outbreaks, predominantly varicella and measles, were reported in temporary refugee camps or shelters. Of 11 varicella outbreaks, nine (82%) were associated with adult migrants. Half of measles outbreaks (n=11) were associated with migrants from eastern European countries. In conclusion, migrants are involved in vaccine-preventable disease outbreaks in Europe, with adult and child refugees residing in shelters or temporary camps at particular risk, alongside specific nationality groups. Vulnerability varies by disease, setting, and demographics, highlighting the importance of tailoring catch-up vaccination interventions to specific groups in order to meet regional and global vaccination targets as recommended by the new Immunisation Agenda 2030 framework for action. A better understanding of vaccine access and intent in migrant groups and a greater focus on co-designing interventions is urgently needed, with direct implications for COVID-19 vaccine delivery.
Collapse
Affiliation(s)
- Anna Deal
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK; Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Rae Halliday
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Alison F Crawshaw
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Sally E Hayward
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK; Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Amelia Burnard
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Kieran Rustage
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Jessica Carter
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | | | - Felicity Knights
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Ines Campos-Matos
- Public Health England, London, UK; UCL Collaborative Centre for Inclusion Health, University College London, London, UK
| | - Azeem Majeed
- Department of Primary Care & Public Health, Imperial College London, London, UK
| | - Jon S Friedland
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | | | - Sandra Mounier-Jack
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Sally Hargreaves
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
| | | |
Collapse
|
4
|
Bryden GM, Browne M, Rockloff M, Unsworth C. The privilege paradox: Geographic areas with highest socio-economic advantage have the lowest rates of vaccination. Vaccine 2019; 37:4525-4532. [DOI: 10.1016/j.vaccine.2019.06.060] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 06/04/2019] [Accepted: 06/18/2019] [Indexed: 12/17/2022]
|
5
|
Deng X, He H, Zhou Y, Xie S, Fang Y, Zeng Y, Yan R, Tang X, Fu J. Economic burden and associated factors of measles patients in Zhejiang Province, China. Hum Vaccin Immunother 2019; 15:2571-2577. [PMID: 31009298 DOI: 10.1080/21645515.2019.1599673] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
This study aimed to figure out the economic burden of measles patients and explore the associated factors for total cost in measles cases that occurred in the year 2015 from Jiaxing, Jinhua, and Taizhou cities in Zhejiang Province, China. Direct interviews were conducted to collect information on patient expenses during treatment, including outpatient expenses, hospitalization expenses, self-treatment fees, productivity loss, and transportation fees. Descriptive epidemiological methods and chi-square tests were used to assess the direct and indirect cost of measles patients. Ordinal logistic regression was applied to explore the possible factors contributing to cost. A total of 136 measles cases were investigated and the average direct cost, indirect cost, and total cost were #747.14, #520.12, and #1,267.26, respectively. Direct cost accounted for 58.96% of the total cost, which was significantly higher than the indirect cost (P < 0.001). In 2015, 1,386 confirmed cases were reported in the Zhejiang Province, and the overall direct, indirect, and total economic burden reached #1.04 million, #0.72 million, and #1.76 million, respectively. Quality-adjusted life years for measles patient were calculated to be 76.06 in Zhejiang, 2015. Hospitalization, occupation, complication, disease duration, age, and site had a significant influence on the total cost according to ordinal logistic regression, with the maximum contribution from hospitalization. Measles resulted in heavy economic burdens, and local public health departments or community health service centers should spare no effort to maintain a high rate of vaccination coverage and protect susceptible populations.
Collapse
Affiliation(s)
- Xuan Deng
- Department of Immunization Program , Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, PR China
| | - Hanqing He
- Department of Immunization Program , Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, PR China
| | - Yang Zhou
- Department of Immunization Program , Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, PR China
| | - Shuyun Xie
- Department of Immunization Program , Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, PR China
| | - Ya Fang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, PR China
| | - Yanbing Zeng
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, PR China
| | - Rui Yan
- Department of Immunization Program , Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, PR China
| | - Xuewen Tang
- Department of Immunization Program , Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, PR China
| | - Jian Fu
- Department of Immunization Program , Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, PR China
| |
Collapse
|
6
|
Fournet N, Mollema L, Ruijs WL, Harmsen IA, Keck F, Durand JY, Cunha MP, Wamsiedel M, Reis R, French J, Smit EG, Kitching A, van Steenbergen JE. Under-vaccinated groups in Europe and their beliefs, attitudes and reasons for non-vaccination; two systematic reviews. BMC Public Health 2018; 18:196. [PMID: 29378545 PMCID: PMC5789742 DOI: 10.1186/s12889-018-5103-8] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 01/19/2018] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Despite effective national immunisation programmes in Europe, some groups remain incompletely or un-vaccinated ('under-vaccinated'), with underserved minorities and certain religious/ideological groups repeatedly being involved in outbreaks of vaccine preventable diseases (VPD). Gaining insight into factors regarding acceptance of vaccination of 'under-vaccinated groups' (UVGs) might give opportunities to communicate with them in a trusty and reliable manner that respects their belief system and that, maybe, increase vaccination uptake. We aimed to identify and describe UVGs in Europe and to describe beliefs, attitudes and reasons for non-vaccination in the identified UVGs. METHODS We defined a UVG as a group of persons who share the same beliefs and/or live in socially close-knit communities in Europe and who have/had historically low vaccination coverage and/or experienced outbreaks of VPDs since 1950. We searched MEDLINE, EMBASE and PsycINFO databases using specific search term combinations. For the first systematic review, studies that described a group in Europe with an outbreak or low vaccination coverage for a VPD were selected and for the second systematic review, studies that described possible factors that are associated with non-vaccination in these groups were selected. RESULTS We selected 48 articles out of 606 and 13 articles out of 406 from the first and second search, respectively. Five UVGs were identified in the literature: Orthodox Protestant communities, Anthroposophists, Roma, Irish Travellers, and Orthodox Jewish communities. The main reported factors regarding vaccination were perceived non-severity of traditional "childhood" diseases, fear of vaccine side-effects, and need for more information about for example risk of vaccination. CONCLUSIONS Within each UVG identified, there are a variety of health beliefs and objections to vaccination. In addition, similar factors are shared by several of these groups. Communication strategies regarding these similar factors such as educating people about the risks associated with being vaccinated versus not being vaccinated, addressing their concerns, and countering vaccination myths present among members of a specific UVG through a trusted source, can establish a reliable relationship with these groups and increase their vaccination uptake. Furthermore, other interventions such as improving access to health care could certainly increase vaccination uptake in Roma and Irish travellers.
Collapse
Affiliation(s)
- N. Fournet
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - L. Mollema
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- National Institute for Public Health and the Environment, Epidemiology and Surveillance Unit, P.O. Box 1 (internal P.O. Box 75), 3720 BA Bilthoven, the Netherlands
| | - W. L. Ruijs
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - I. A. Harmsen
- Municipal Health Service (GGD) Amsterdam, Amsterdam, The Netherlands
| | - F. Keck
- Laboratoire d’anthropologie sociale - Centre National de la Recherche Scientifique, Paris, France
| | - J. Y. Durand
- Centre for Research in Anthropology, Universidade do Minho (CRIA - UMinho), Braga, Portugal
| | - M. P. Cunha
- Centre for Research in Anthropology, Universidade do Minho (CRIA - UMinho), Braga, Portugal
| | - M. Wamsiedel
- Department of Public Health at Xi’an Jiaotong-Liverpool University, Suzhou, China
| | - R. Reis
- Leiden University Medical Centre, Leiden, The Netherlands
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
- The Children’s Institute, University of Cape Town, Cape Town, South Africa
| | - J. French
- Strategic Social Marketing, Liphook, UK
- Brighton University Business School, Brighton, UK
| | - E. G. Smit
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, The Netherlands
| | - A. Kitching
- Department of Public Health, Health Service Executive, St Finbarr’s Hospital, Cork, Republic of Ireland
| | - J. E. van Steenbergen
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Centre for Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands
| |
Collapse
|
7
|
Damm O, Witte J, Wetzka S, Prosser C, Braun S, Welte R, Greiner W. Epidemiology and economic burden of measles, mumps, pertussis, and varicella in Germany: a systematic review. Int J Public Health 2016; 61:847-60. [PMID: 27488917 PMCID: PMC5002040 DOI: 10.1007/s00038-016-0842-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 04/21/2016] [Accepted: 06/02/2016] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVES Despite the availability of vaccines and the existence of public vaccination recommendations, outbreaks of vaccine-preventable childhood diseases still cause public health debate. The objective of this systematic review was to provide an overview of the current epidemiology and economic burden of measles, mumps, pertussis, and varicella in Germany. METHODS We systematically reviewed studies published since 2000. The literature search was conducted using PubMed and EMBASE. Also, we used German notification data to give an up-to-date overview of the epidemiology of the four diseases under consideration. RESULTS Thirty-six studies were included in our review. Results suggest that there is still considerable morbidity due to childhood diseases in Germany. Studies providing cost estimates are scarce. Comparative analyses of different data sources (notification data vs. claims data) revealed a potential underestimation of incidence estimates when using notification data. Furthermore, several studies showed regional differences in incidence of some of the diseases under consideration. CONCLUSIONS Our findings underline the need for improved vaccination and communication strategies targeting all susceptible age and risk groups on a national and local level.
Collapse
Affiliation(s)
- Oliver Damm
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany.
| | - Julian Witte
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany
| | - Stefanie Wetzka
- GlaxoSmithKline Germany, Prinzregentenplatz 9, 81675, Munich, Germany
| | | | | | - Robert Welte
- GlaxoSmithKline Germany, Prinzregentenplatz 9, 81675, Munich, Germany
| | - Wolfgang Greiner
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany
| |
Collapse
|
8
|
[Vaccination coverage against measles and sero-epidemiology of measles-specific IgG antibodies in German children and adolescents]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2014; 56:1243-52. [PMID: 23990086 DOI: 10.1007/s00103-013-1790-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Measles is a vaccine-preventable disease that could be eliminated by global vaccination strategies with two-dose measles vaccination. The World Health Organization (WHO) European Region aims at achieving measles elimination by 2015. Target control is mainly based on verification of 95 % vaccination coverage. In Germany, target verification cannot be based on data from centrally collected registers on vaccination and seroprevalence of measles-specific antibodies. OBJECTIVE This paper provides an overview of measles vaccination coverage and the timeliness of measles vaccination in birth cohorts 1989-2008. In addition, factors associated with vaccination gaps are described. METHODS Primary data on vaccination coverage (annual school entrance health examination) and on vaccination coverage and immune status (population-based German Health Interview and Examination Survey for Children and Adolescents - KiGGS) and secondary data (insurance refund claim data) are described and discussed. RESULTS AND CONCLUSION The measles immunization coverage (two doses) obtained in the 2010 school entrance examinations was 91.5 %. The range was 87.6-95.3 % between Federal States. Regional differences were even more pronounced between districts. The timeliness of the two-dose measles immunization increased from 41 % (birth cohorts 2001/2002) to 66 % (birth cohorts 2006/2008). Despite progress in recent years, measles vaccination coverage is still inadequate in adolescents, young adults, and young children. The German Standing Committee on Vaccination (STIKO) recommends a combined MMR vaccination of adults who were born after 1970 and who were not fully vaccinated against measles during childhood. Successful implementation of this recommendation is crucial just as it is important to step up efforts to improve the timeliness of measles vaccination in young children. Regional vaccination gaps and susceptible clusters defined by age or sociodemographic parameters are of particular importance to the epidemiology of measles disease. Knowledge of the factors associated with nonimmunization should be used to tailor vaccination strategies.
Collapse
|
9
|
LASSEN SGILLESBERG, SCHUSTER M, STEMMLER M, STEINMÜLLER A, MATYSIAK-KLOSE D, MANKERTZ A, SANTIBANEZ S, WICHMANN O, FALKENHORST G. Measles outbreak spreading from the community to an anthroposophic school, Berlin, 2011. Epidemiol Infect 2014; 142:789-96. [PMID: 23823129 PMCID: PMC9151084 DOI: 10.1017/s0950268813001398] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 04/26/2013] [Accepted: 05/17/2013] [Indexed: 11/06/2022] Open
Abstract
Between April and July 2011 there was an outbreak of measles virus, genotype D4, in Berlin, Germany. We identified 73 case-patients from the community and among students of an anthroposophic school, who participated in a 4-day school trip, as well as their family and friends. Overall, 27% were aged ≥ 20 years, 57% were female and 15% were hospitalized. Of 39 community case-patients, 38% were aged ≥ 20 years, 67% were female and 63% required hospitalization. Unvaccinated students returning from the school trip were excluded from school, limiting transmission. Within the group of 55 school-trip participants, including 20 measles case-patients, a measles vaccine effectiveness of 97.1% (95% confidence interval 83.4-100) for two doses was estimated using exact Poisson regression. Our findings support school exclusions and the recommendation of one-dose catch-up vaccination for everyone born after 1970 with incomplete or unknown vaccination status, in addition to the two-dose routine childhood immunization recommendation.
Collapse
Affiliation(s)
- S. GILLESBERG LASSEN
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - M. SCHUSTER
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
| | - M. STEMMLER
- District Public Health Authority, Berlin, Germany
| | | | - D. MATYSIAK-KLOSE
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
| | - A. MANKERTZ
- Robert Koch Institute, National Reference Centre Measles, Mumps, Rubella, Berlin, Germany
| | - S. SANTIBANEZ
- Robert Koch Institute, National Reference Centre Measles, Mumps, Rubella, Berlin, Germany
| | - O. WICHMANN
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
| | - G. FALKENHORST
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany
| |
Collapse
|
10
|
Martínez-Ramírez M, González-Praetorius A, Ory-Manchón FD, Martínez-Benito Y, García-Rivera MV, Hübschen J, Echevarría-Mayo JE. [Re-emergence of measles in the province of Guadalajara, Spain. Is it time to establish new strategies for its elimination?]. Enferm Infecc Microbiol Clin 2013; 32:486-90. [PMID: 24210738 DOI: 10.1016/j.eimc.2013.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 07/27/2013] [Accepted: 08/09/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Measles is a viral infection that was almost eradicated, but it is re-emerging in Spain and Europe in recent years. The aim of this study was to describe the microbiological, clinical and epidemiological characteristics of a measles outbreak that occurred in Guadalajara (Spain) from June to August 2012. METHODS A descriptive and retrospective study was conducted. A total of 117 samples (including serum, urine and pharyngeal swabs) from 52 patients were analyzed for measles. RESULTS Measles was diagnosed in 50 patients, 41 of them by microbiological diagnosis, and 9 by epidemiological link. The patients were grouped in four community outbreaks. No imported cases were observed. Positive IgM and positive CRP were detected in 25 patients, positive CRP only in 11 and positive IgM only in 5. The genotype D4 was identified in 13 patients and the genotype A in a post-vaccine case. The age groups most affected were adults between 20-34 years of age (38%) and younger than 15 months (26%). The large majority (86%) of patients were unvaccinated (44% Roma population, 27% younger than 15 months, 11% ideological reasons), 6% had one vaccine dose. The signs/symptoms were: rash and fever, 100%, cough, 82%, and conjunctivitis 50%. Almost one-third (32%) of patients were hospitalized, and 28% had complications. CONCLUSIONS It is very important to intensify the epidemiological surveillance of infections in the elimination phase. The increased incidence of measles was associated to unvaccinated pockets, presenting a challenge for Public Health Centers. These agencies should prepare strategies to obtain a higher vaccine coverage for the eradication of measles.
Collapse
Affiliation(s)
| | | | - Fernando de Ory-Manchón
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, España
| | - Yolanda Martínez-Benito
- Servicio de Epidemiología, Dirección General de Salud Pública de Castilla-La Mancha, Toledo, España
| | - M Victoria García-Rivera
- Servicio de Epidemiología, Dirección General de Salud Pública de Castilla-La Mancha, Toledo, España
| | - Judith Hübschen
- Laboratorio Europeo de Referencia de Sarampión de la OMS para el sur de Europa, Centre de Recherche Public de la Santé, Luxemburgo, Luxemburgo
| | | |
Collapse
|
11
|
Oliveira MID, Figueiredo CA, Afonso AMS, Siqueira MM, Lemos XRMR, Yu ALF, Curti SP. MOLECULAR EPIDEMIOLOGY OF A MEASLES VIRUS IN SAO PAULO, BRAZIL: AN IMPORTED CASE. Rev Inst Med Trop Sao Paulo 2013. [DOI: 10.1590/s0036-46652013000400014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|