A report of outbreaks of measles on the southern coast of Iran from 2009 to 2015

Estimation of measles risk using the World Health Organization Measles Programmatic Risk Assessment Tool, Iran

Introduction

Based on the World Health Organization (WHO) reports the EMRO countries did not reached to eradication of measles at 2010. This study aimed to estimate the risk of measles outbreak in different districts of Iran to identify high-risk areas based on WHO measles programmatic risk assessment tool.

Materials and methods

The WHO measles programmatic risk assessment tool was used to estimate the overall risk of measles in 31 providences and 322 districts of Iran at 2017. The measles risk was calculated by a function of four indicator scores including population immunity, surveillance quality, program performance, and threat assessment and the overall risk of measles for each districts calculated. Then, the tool assigned each district a risk category of low, medium, high, or very high according to the overall risk score.

Results

Of the 322 districts in Iran, all districts were categorized as low risk and there was no very high risk, high risk and medium risk district in Iran. Twenty-six districts (7.4%) received to risk point higher than 20. Based on population immunity and program delivery performance indicators, all districts in Iarn were categorized as low risk and 92.86% of districts were in low risk category by surveillance quality indicator.

Conclusion

The overall risk of measles profile was categorized as low risk and Iranian practices for measles elimination is very good in comparing other studies in this area. However, more attempts should be conducted to sustaining the surveillance quality indicators in all districts.

Comparison of the Filter Efficiency of Medical Nonwoven Fabrics against Three Different Microbe Aerosols

　Exact evaluation of the performance of surgical masks and biohazard protective clothing materials against pathogens is important because it can provide helpful information that healthcare workers can use to select suitable materials to reduce infection risk. Currently, to evaluate the protective performance of nonwoven fabrics used in surgical masks against viral aerosols, a non-standardized test method using phi-X174 phage aerosols is widely performed because actual respiratory viruses pose an infection risk during testing and the phage is a safe virus to humans. This method of using a phage is simply modified from a standard method for evaluation of filter performance against bacterial aerosols using Staphylococcus aureus, which is larger than virus particles. However, it is necessary to perform such evaluations based on the size of the actual pathogen particles. Thus, we developed a new method that can be performed safely using inactivated viral particles and can quantitate the influenza virus in aerosols by antigen-capture ELISA (Shimasaki et al., 2016a) . In this study, we used three different microbial aerosols of phi-X174 phage, influenza virus, and S. aureus and tested the filter efficiency by capturing microbial aerosols for two medical nonwoven fabrics. We compared the filter efficiency against each airborne microbe to analyze the dependency of filter efficiency on the microbial particle size. Our results showed that against the three types of spherical microbe particles, the filter efficiencies against influenza virus particles were the lowest and those against phi-X174 phages were the highest for both types of nonwoven fabrics. The experimental results mostly corresponded with theoretical calculations. We conclude that the filter efficiency test using the phi-X174 phage aerosol may overestimate the protective performance of nonwoven fabrics with filter structure compared to that against real pathogens such as the influenza virus.