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Sun X, Zhu Y, Sun H, Xu Y, Zhang L, Wang Z. Comparison of varicella outbreaks in schools in China during different vaccination periods. Hum Vaccin Immunother 2022; 18:2114255. [PMID: 35993917 DOI: 10.1080/21645515.2022.2114255] [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: 12/15/2022] Open
Abstract
The purpose of this study was to investigate the outbreak trend of chickenpox and the epidemiological characteristics of outbreak related cases from 2017 to 2021, and compare the impact of voluntary self-funded single dose vaccination versus mandatory two-dose vaccine vaccination on varicella outbreaks. The data of varicella outbreaks in Jiangsu Province from 2017 to 2021 come from the national public health emergency management information system. We randomly chose 70 outbreaks from 2019 to 2020 for study in order to better understand the features and regularity of breakthrough varicella(BV). In pilot cities with two doses of free VarV, the number of outbreaks decreased from 306 in 2017 to 123 in 2021, while the total number of cases related to the outbreak decreased by 64.6% (P < .01), the median size of the outbreak decreased from 24 cases (range:6-146) to 21 cases (range:10-93) (P < .01), and the incidence rate also decreased from 2.01/100 to 1.33/100. The proportion of cases with high fever, severe rash and complications in the BV group was lower than that in the primary varicella (PV), and the differences were statistically significant. The incidence rate of varicella among students who had post-exposure prophylaxis (PEP) activities was 1.42% (488/ 33,878), and 1.63% (2468/ 148,943) among those who did not (p = .005). The single-dose varicella vaccination was less effective in controlling the outbreaks, and the success of the full implementation of the routine two-dose varicella vaccination plan in the pilot cities provided a basis for implementation in the whole province, and long-term follow-up studies are needed to evaluate the effect of the new strategy in the future.
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Affiliation(s)
- Xiang Sun
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Yanhong Zhu
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Hui Sun
- Medical Department, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, China
| | - Yan Xu
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Lei Zhang
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Zhiguo Wang
- Department of Expanded Program on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
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Wang J, Xu Z, Gao Q. Varicella outbreaks in schools and kindergartens in Shanghai, China from 2011 to 2020. PLoS One 2022; 17:e0270630. [PMID: 35772068 PMCID: PMC9246396 DOI: 10.1371/journal.pone.0270630] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 06/15/2022] [Indexed: 11/18/2022] Open
Abstract
Background Varicella is a contagious disease caused by varicella-zoster virus and varicella vaccine (VarV) is the most effective way to prevent and control varicella. Despite high VarV coverage there were still varicella outbreaks in schools and kindergartens. We aim to analyze the epidemiological characteristics of varicella outbreaks in Huangpu District, Shanghai, China from 2011 to 2020. Methods For varicella outbreaks, case information and vaccination history were collected. Mann–Kendall test and descriptive methods were used to analyzed the trend and epidemiological catachrestic of varicella outbreaks. Results A total of 57 varicella outbreaks were reported from 2011 to 2020, including 30 outbreaks (52.6%) in primary schools. The results of the Mann–Kendall trend test (z = 1.97, p = 0.049) showed an upward trend in the number of cases during the study period, but the trend change was not statistically significant. Emergency vaccination was carried out in 42 (73.7%) outbreaks which influenced the duration of the epidemic (F = 4.53, p = 0.0379). A total of 573 varicella cases were reported, including 357 cases (62.3%) who had received at least one dose of varicella vaccine. Conclusions The number of varicella outbreaks has not changed significantly in the decade from 2011 to 2020. The strategy of varicella vaccination, the development and application of varicella vaccine, and the control measures after the occurrence of varicella outbreaks need to be optimized. In addition to vaccination, as a disease transmitted by contact, quarantine measures, good personal hygiene, environmental disinfection, and ventilation are also important.
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Affiliation(s)
- Jing Wang
- Department of Immunization, Huangpu District Center for Disease Control and Prevention, Shanghai, China
| | - Zhenhui Xu
- Department of Immunization, Huangpu District Center for Disease Control and Prevention, Shanghai, China
| | - Qiang Gao
- Department of Immunization, Huangpu District Center for Disease Control and Prevention, Shanghai, China
- * E-mail:
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Kim EY, Park C, Lee G, Jeong S, Song J, Lee DH. Epidemiological characteristics of varicella outbreaks in the Republic of Korea, 2016–2020. Osong Public Health Res Perspect 2022; 13:133-141. [PMID: 35538685 PMCID: PMC9091637 DOI: 10.24171/j.phrp.2022.0087] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/04/2022] [Indexed: 11/10/2022] Open
Abstract
Objectives We described the trends and epidemiological characteristics of varicella outbreaks from 2016 to 2020 in the Republic of Korea. Methods We investigated variables such as the outbreak setting, age of patients, vaccination status, and lesion count. The collected data were analyzed with the Cochrane-Armitage trend test and Kruskal-Wallis test. These statistical tests were performed using R ver. 4.0.3. Results The number of varicella outbreaks increased from 2016 to 2018; however, after a slight decrease in the number of outbreaks in 2019, the number fell sharply in 2020. The median size of outbreaks decreased from 8 to 9 cases during 2016−2019 to 6 cases in 2020. The median duration of outbreaks was 18 days during 2016−2017, 28 days in 2018, 29 days in 2019, and 15 days in 2020. Varicella outbreaks occurred most frequently in elementary schools, and vaccination coverage of patients increased from 89.4% in 2016 to 97.2% in 2019. The median age of patients with outbreak-related varicella decreased from 8 years in 2016 to 6 years in 2020. Conclusion Significant changes were observed in the age of patients with outbreak-related varicella. Ongoing monitoring of varicella outbreaks should be conducted. Further research will be needed to measure the disease burden of varicella and enable evidence-based policy decisions.
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Kombe Kombe AJ, Xie J, Zahid A, Ma H, Xu G, Deng Y, Nsole Biteghe FA, Mohammed A, Dan Z, Yang Y, Feng C, Zeng W, Chang R, Zhu K, Zhang S, Jin T. Detection of Circulating VZV-Glycoprotein E-Specific Antibodies by Chemiluminescent Immunoassay (CLIA) for Varicella-Zoster Diagnosis. Pathogens 2022; 11:pathogens11010066. [PMID: 35056014 PMCID: PMC8778750 DOI: 10.3390/pathogens11010066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 02/01/2023] Open
Abstract
Varicella and herpes zoster are mild symptoms-associated diseases caused by varicella–zoster virus (VZV). They often cause severe complications (disseminated zoster), leading to death when diagnoses and treatment are delayed. However, most commercial VZV diagnostic tests have low sensitivity, and the most sensitive tests are unevenly available worldwide. Here, we developed and validated a highly sensitive VZV diagnostic kit based on the chemiluminescent immunoassay (CLIA) approach. VZV-glycoprotein E (gE) was used to develop a CLIA diagnostic approach for detecting VZV-specific IgA, IgG, and IgM. The kit was tested with 62 blood samples from 29 VZV-patients classified by standard ELISA into true-positive and equivocal groups and 453 blood samples from VZV-negative individuals. The diagnostic accuracy of the CLIA kit was evaluated by receiver-operating characteristic (ROC) analysis. The relationships of immunoglobulin-isotype levels between the two groups and with patient age ranges were analyzed. Overall, the developed CLIA-based diagnostic kit demonstrated the detection of VZV-specific immunoglobulin titers depending on sample dilution. From the ELISA-based true-positive patient samples, the diagnostic approach showed sensitivities of 95.2%, 95.2%, and 97.6% and specificities of 98.0%, 100%, and 98.9% for the detection of VZV-gE-specific IgA, IgG, and IgM, respectively. Combining IgM to IgG and IgA detection improved diagnostic accuracy. Comparative analyses on diagnosing patients with equivocal results displaying very low immunoglobulin titers revealed that the CLIA-based diagnostic approach is overall more sensitive than ELISA. In the presence of typical VZV symptoms, CLIA-based detection of high titer of IgM and low titer of IgA/IgG suggested the equivocal patients experienced primary VZV infection. Furthermore, while no difference in IgA/IgG level was found regarding patient age, IgM level was significantly higher in young adults. The CLIA approach-based detection kit for diagnosing VZV-gE-specific IgA, IgG, and IgM is simple, suitable for high-throughput routine analysis situations, and provides enhanced specificity compared to ELISA.
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Affiliation(s)
- Arnaud John Kombe Kombe
- Department of Dermatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; (A.J.K.K.); (J.X.); (R.C.); (K.Z.)
| | - Jiajia Xie
- Department of Dermatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; (A.J.K.K.); (J.X.); (R.C.); (K.Z.)
| | - Ayesha Zahid
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Huan Ma
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Guangtao Xu
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Yiyu Deng
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Fleury Augustin Nsole Biteghe
- Gabonese Scientific Research Consortium, Libreville, Gabon;
- Department of Radiation Oncology, Cedars Sinai Hospital, Los Angeles, CA 90048, USA
| | - Ahmed Mohammed
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Zhao Dan
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Yunru Yang
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Chen Feng
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Weihong Zeng
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
| | - Ruixue Chang
- Department of Dermatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; (A.J.K.K.); (J.X.); (R.C.); (K.Z.)
| | - Keyuan Zhu
- Department of Dermatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; (A.J.K.K.); (J.X.); (R.C.); (K.Z.)
| | - Siping Zhang
- Department of Dermatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; (A.J.K.K.); (J.X.); (R.C.); (K.Z.)
- Correspondence: (S.Z.); (T.J.); Tel.: +86-0551-62283151 (S.Z.); +86-551-63600720 (T.J.)
| | - Tengchuan Jin
- Department of Dermatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; (A.J.K.K.); (J.X.); (R.C.); (K.Z.)
- Hefei National Laboratory for Physical Sciences at Microscale, The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Basic Medical Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; (A.Z.); (H.M.); (G.X.); (Y.D.); (A.M.); (Z.D.); (Y.Y.); (C.F.); (W.Z.)
- CAS Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, Shanghai 200031, China
- Correspondence: (S.Z.); (T.J.); Tel.: +86-0551-62283151 (S.Z.); +86-551-63600720 (T.J.)
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Chen D, Li Y, Wu Q. Effectiveness of varicella vaccine as post-exposure prophylaxis: a meta-analysis. Hum Vaccin Immunother 2021; 17:5316-5324. [PMID: 34893015 DOI: 10.1080/21645515.2021.2009729] [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: 10/19/2022] Open
Abstract
BACKGROUND To evaluate the effectiveness of varicella vaccine (VarV) as post-exposure prophylaxis (PEP) among children during varicella outbreaks. MATERIAL AND METHODS A comprehensive literature search was performed in PubMed, Embase, Web of Science, SinoMed, Wanfang and CNKI. Relevant outcomes included the incidence of varicella. Pooled estimates were calculated using a fixed-effects or random-effects model according to the heterogeneity among studies. RESULTS A total of 15 studies with 7,474 children that received one or two dosages of VarV as PEP and 183,827 children who received no VarV were included in the meta-analysis. In total, one-dose and two-dose VarV as PEP had 43% (95% confidence interval (CI):27%, 55%) and 60% (95%CI: 35%, 75%) efficacy, respectively. When PEP was applied within 3 days, the pooled VarV as PEP for prevention of varicella was 80% (95%CI: 68%, 88%); when PEP was administered beyond 3 days, the pooled VarV as PEP for the prevention of varicella was 50% (95%CI: 11%, 72%). If the PEP was implemented with a coverage of more than 80%, the VarV could prevent 82% of varicella cases from occurring (95%CI: 15%, 96%); if the PEP covered a maximum of 80% of the susceptible cases, the VarV could prevent 65% of varicella cases from occurring (95%CI: 50%, 76%). CONCLUSION The two-dose VarV had better efficacy than one-dose VarV in the control of varicella outbreaks, especially if PEP was applied within 3 days of an outbreak and in conjunction with a high coverage rate ≥80%.
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Affiliation(s)
- Daoyong Chen
- Department of Immunization Program, Hongkou District Center for Disease Control and Prevention, Shanghai, China
| | - Yue Li
- Department of Immunization Program, Hongkou District Center for Disease Control and Prevention, Shanghai, China
| | - Qiangsong Wu
- Department of Immunization Program, Xuhui District Center for Disease Control and Prevention, Shanghai, China
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Li Z, Yao Y, Lu X, Liu J, Huang Z, Sun X, Lu Y. Impact of a two-dose varicella immunization program on the incidence of varicella: a multi-year observational study in Shanghai, China. Expert Rev Vaccines 2021; 20:1177-1183. [PMID: 34343035 DOI: 10.1080/14760584.2021.1963236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND It remains hesitant to include a two-dose varicella vaccine (VarV) in a national routine immunization program in China. We aimed to quantify the impact of the two-dose VarV on varicella incidence in Shanghai. RESEARCH DESIGN AND METHODS We directly extracted the data of varicella cases and VarV doses in 2013-2020 in Shanghai, and then estimated the effects of two-dose VarV using a Serfling model. RESULTS A two-dose VarV immunization program has been extensively implemented since October 2017 and become free since August 2018 in Shanghai. Before and after this program, varicella cases significantly declined in children (P < 0.01), whereas did not in adults aged >18 years (P = 0.22). Compared to the predicted number of varicella cases, actual number was significantly lower by 8% in 2018 and 28% in 2019. Among children aged 4-6 years, the reduction in varicella cases was largest. Moreover, there was a significant reduction in varicella cases throughout 2020 (P < 0.001), in which the decrease due to social distancing for the COVID-19 was 54%. CONCLUSIONS A two-dose VarV immunization program may further reduce approximately one-third of varicella cases in Shanghai. Children <4 years and adults benefit less in this program, which warrants enhancing the immunization.
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Affiliation(s)
- Zhi Li
- Division Of Immunization, Shanghai Municipal Center For Disease Control And Prevention, Shanghai China
| | - Ye Yao
- Department Of Biostatistics, Ministry Of Education Key Laboratory Of Public Health Safety, School Of Public Health, Fudan University, Shanghai, China
| | - Xinyue Lu
- Department Of Epidemiology, Ministry Of Education Key Laboratory Of Public Health Safety, School Of Public Health, Fudan University, Shanghai China
| | - Jiechen Liu
- Division Of Immunization, Shanghai Municipal Center For Disease Control And Prevention, Shanghai China
| | - Zhuoying Huang
- Division Of Immunization, Shanghai Municipal Center For Disease Control And Prevention, Shanghai China
| | - Xiaodong Sun
- Division Of Immunization, Shanghai Municipal Center For Disease Control And Prevention, Shanghai China
| | - Yihan Lu
- Department Of Epidemiology, Ministry Of Education Key Laboratory Of Public Health Safety, School Of Public Health, Fudan University, Shanghai China
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Qin W, Song J, Wang Y, Nie T, Pan F, Xu X, Tao H, Meng X, Ni R, Cheng S, Xie S, Su H. Upgrading the school entry vaccination record check strategy to improve varicella vaccination coverage: results from a quasi-experiment study. Hum Vaccin Immunother 2021; 17:3137-3144. [PMID: 34019470 DOI: 10.1080/21645515.2021.1904759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND The school entry vaccination record check strategy (SECS) is an appropriate opportunity to recommend vaccines for students to improve vaccination coverage (VC). However, it is only utilized for providing necessary catch-up vaccination for students who are missing the Expanded Program on Immunization (EPI) vaccines in China. We aimed to address that gap and quantify the relationship between the SECS policy and the increase of coverage in varicella vaccine (VarV). METHODS We employed a pretest and posttest quasi-experimental design to examine the effect of the upgraded SECS policy on the change of VarV coverage in newly enrolled students in Lu'an, 2019-2020. RESULTS Eight hundred participants were randomly divided into the control group (C group, 31.8%), the telephone-based intervention group (T group, 31.2%), and the written notification intervention group (W group, 37.0%). Totally, 84 students received VarV during the study period, with a VC of 10.5%. The possibility of vaccination in the T group (RR = 4.9, 95% CI:2.2-10.9) and W group (RR = 5.2, 95% CI:2.4-11.5) was significantly higher than that in the C group (p< .001). CONCLUSIONS Our study demonstrates that the upgraded SECS produce a positive effect on improving the VC of VarV. This nudge strategy may decrease varicella outbreaks in schools in China, especially in provinces where VarV is not introduced into EPI.
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Affiliation(s)
- Wei Qin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.,Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yao Wang
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Tingyue Nie
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Fan Pan
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Xiaokang Xu
- Department of Chronic Non-communicable Diseases Prevention and Control, Jin'an District Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Hailin Tao
- Department of Expanded Program on Immunization, Shucheng District Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Xiangmei Meng
- Department of Expanded Program on Immunization, Shucheng District Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Ruyu Ni
- Department of Preventive Medicine, School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Shishi Cheng
- Department of Preventive Medicine, School of Public Health, Wannan Medical College, Wuhu, Anhui, China
| | - Shaoyu Xie
- Department of Expanded Program on Immunization, Lu'an Municipal Center for Disease Control and Prevention, Lu'an, Anhui, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
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Wu Q, Zaid M, Xuan Z, Wang C, Gu H, Shi M, Zhu J, Hu Y, Liu J. Changes in epidemiological features of vaccine preventable infectious diseases among three eras of national vaccination strategies from 1953 to 2018 in Shanghai, China. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 7:100092. [PMID: 34327419 PMCID: PMC8315356 DOI: 10.1016/j.lanwpc.2021.100092] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/08/2020] [Accepted: 01/04/2021] [Indexed: 12/04/2022]
Abstract
Background Recurring outbreaks of infectious diseases highlight the importance of population vaccination strategies. We aimed to assess the impact of national vaccination strategies on vaccine-preventable infectious diseases (VPDs) in Shanghai, China and to identify vulnerable groups that may benefit from future vaccination policies. Methods Infectious disease data from 1953 to 2018 was obtained from Xuhui District Center for Disease Control and Prevention, Shanghai China. We used joinpoint regression to show incidence, mortality and fatality trends and to determine annual percent change in incidence of 12 VPDs among three eras of national immunization strategies: (1)1953–1977, (2)1978–2007, and(3)2008–2018. Findings Incidence, mortality, and fatality from VPDs have decreased drastically over the three eras, despite the inclusion of more diseases over time. Strikingly, the overall yearly incidence of VPDs shows an increasing trend from 2000 to 2018 in Shanghai (annual percentage changes, APC:7.7, p = 0.025). In the third era (2008–2018), the three VPDs with the highest incidence were varicella (80.2 cases/100,000), hand, foot, and mouth disease (HFMD) (73.6 cases/100,000), and hepatitis (43.5 cases/100,000). A significant upward trend was also observed in hepatitis (APC:24.9, p<0.001), varicella (APC:5.9, p = 0.006), and HFMD (APC:11.8, p = 0.003) from 2008–2018. Hepatitis and tuberculosis are the only VPDs with fatality cases in this period. Interpretation Focus is needed in controlling adult hepatitis and tuberculosis, either by introducing adult booster vaccines or by research into more effective vaccines. Varicella and HFMD are on the rise, but vaccines for these are not included in national programs. Strategies funded by government agencies or encouraged by research incentives are needed for varicella and HFMD, such as two-dose and novel multi-valent vaccines, respectively. Funding Chinese Ministry of Education, Shanghai Municipal Government.
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Affiliation(s)
- Qiangsong Wu
- Xuhui District Center for Disease Control and Prevention, Shanghai 200237, China
| | - Maryam Zaid
- Department of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China
| | - Zeliang Xuan
- Xuhui District Center for Disease Control and Prevention, Shanghai 200237, China
| | - Chenxi Wang
- Xuhui District Center for Disease Control and Prevention, Shanghai 200237, China
| | - Haiyan Gu
- Xuhui District Center for Disease Control and Prevention, Shanghai 200237, China
| | - Min Shi
- Xuhui District Center for Disease Control and Prevention, Shanghai 200237, China
| | - Jiahui Zhu
- Department of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China
| | - Yi Hu
- Department of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China
| | - Jingyi Liu
- Xuhui District Center for Disease Control and Prevention, Shanghai 200237, China
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Álvarez García FJ, Cilleruelo Ortega MJ, Álvarez Aldeán J, Garcés-Sánchez M, García Sánchez N, Garrote Llanos E, Hernández Merino Á, Iofrío de Arce A, Montesdeoca Melián A, Navarro Gómez ML, Ruiz-Contreras J. [Immunisation schedule of the Pediatric Spanish Association: 2021 recommendations]. An Pediatr (Barc) 2021; 94:53.e1-53.e10. [PMID: 33419517 DOI: 10.1016/j.anpedi.2020.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 10/03/2020] [Indexed: 10/22/2022] Open
Abstract
The CAV-AEP annually publishes the immunisation schedule considered optimal for all children and adolescent resident in Spain, taking into account the available evidence. The 2+1 schedule is recommended (2, 4, and 11 months) with hexavalent vaccines (DTPa-VPI-Hib-HB) and with 13-valent pneumococcal conjugate.A 6-year booster is recommended, preferably with DTPa (if available), with a dose of polio for those who received 2+1 schemes, as well as vaccination with Tdpa in adolescents and in each pregnancy, preferably between 27 and 32 weeks. Rotavirus vaccine should be systematic for all infants. Meningococcal B vaccine, with a 2+1 schedule, should be included in routine calendar. In addition to the inclusion of the conjugated tetravalent meningococcal vaccine (MenACWY) at 12 years of age with catch up to 18 years, inclusive, the CAV recommends this vaccine to be also included at 12 months of age, replacing MenC. Likewise, it is recommended in those over 6 weeks of age with risk factors or who travel to countries with a high incidence of these serogroups. Two-dose schedules for triple viral (12 months and 3-4 years) and varicella (15 months and 3-4 years) will be used. The second dose could be applied as a tetraviral vaccine. Universal systematic vaccination against HPV is recommended, regardless of gender, preferably at 12 years, and greater effort should be made to improve coverage. The 9 genotype extends coverage for both genders.
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Affiliation(s)
| | - María José Cilleruelo Ortega
- Servicio de Pediatría, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, España; Departamento de Pediatría, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, España
| | | | - María Garcés-Sánchez
- Centro de Salud Nazaret, Valencia, España; Área de Vacunas, FISABIO, Valencia, España
| | - Nuria García Sánchez
- Centro de Salud Delicias Sur, Zaragoza, España; Departamento de Pediatría, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España
| | - Elisa Garrote Llanos
- Sección de Infectología, Hospital Universitario Basurto, Bilbao, España; Facultad de Medicina, Universidad del País Vasco, UPV-EHU, Bilbao, España
| | | | | | | | - María Luisa Navarro Gómez
- Servicio de Pediatría, Hospital Universitario Gregorio Marañón, Madrid, España; Departamento de Pediatría, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | - Jesús Ruiz-Contreras
- Servicio de Pediatría, Hospital Universitario 12 de Octubre, Madrid, España; Departamento de Pediatría, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
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Immunisation schedule of the Pediatric Spanish Association: 2021 recommendations. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2021. [DOI: 10.1016/j.anpede.2020.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Zeng WB, Zhang F, Cheng S, Sun JY, Shen H, Luo MH. Concerns on Vaccine against Varicella Caused by Varicella-Zoster Virus Infection. Virol Sin 2020; 36:159-162. [PMID: 32468419 DOI: 10.1007/s12250-020-00231-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/17/2020] [Indexed: 12/30/2022] Open
Affiliation(s)
- Wen-Bo Zeng
- State Key Laboratory of Virology, CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Fukun Zhang
- Changchun Keygen Biological Products Co. Ltd, Changchun, 130000, China
| | - Shuang Cheng
- State Key Laboratory of Virology, CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Jin-Yan Sun
- State Key Laboratory of Virology, CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Hongjie Shen
- Changchun Keygen Biological Products Co. Ltd, Changchun, 130000, China.
| | - Min-Hua Luo
- State Key Laboratory of Virology, CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China.
- University of Chinese Academy of Sciences, Beijing, 100049, China.
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Characteristics of within-household varicella transmission events associated with school outbreaks in Shanghai, China, 2009-2018. Epidemiol Infect 2020; 148:e127. [PMID: 32054550 PMCID: PMC7339085 DOI: 10.1017/s0950268820000448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Transmission of varicella occurs frequently in schools and households. We investigated the characteristics of varicella cases derived from within-household transmission and the modes of varicella transmission between school and household settings in Shanghai, China, from 2009 to 2018. Within-household transmission occurred in 278 households, of which 134 transmission events were between children. Sixty-one household varicella transmission events may be attributed to isolation procedures for infected students during school outbreaks, and 7.6% of school outbreaks were caused by schoolchildren cases derived from within-household transmission. The frequency of ‘school-household-school’ transmission adds an additional layer of complexity to the control of school varicella outbreaks. Administration of varicella vaccine as post-exposure prophylaxis after exposure is considered to be an effective measure to control varicella spread within households and schools.
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Abstract
This book explores the topic of resilience at the city level. The focus is more on outbreak events at the city level, or how cities should prepare and react in facing the larger events of epidemic and pandemic.
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