宁夏2004—2007年麻疹监测分析

为了客观评价宁夏麻疹监测系统现状,探讨控制和消除麻疹的策略。对宁夏2004—2007年麻疹流行病学和实验室监测工作进行分析。结果显示,宁夏麻疹监测系统的灵敏性较高,疑似麻疹病例标本采集率和血清学诊断率等主要监测指标已达较高水平。同时,对监测到的36株麻疹野病毒基因型进行了探讨,全部为H1基因型H1a亚型,未发现其它基因亚型。因此,宁夏亟需加速控制麻疹,应继续做好麻疹监测和麻疹疫苗免疫接种。     

Evaluation of the eight-year period of compulsory measles vaccination in the Czech Socialist Republic (CSR)

The object of the study is the evaluation of a more than 8-year period of compulsory vaccination against measles in the CSR. So far, a total of 1,850,000 children have been vaccinated. A pronounced decrease has been achieved in morbidity while mortality and lethality reached zero values as early as in 1973. Changes occur in the epidemiological characteristic of measles manifested primarily by the shift of the age distribution of notified cases into older age groups, by continuous prolongation of interepidemic intervals and by gradual disappearances of typical seasonal incidence. Regular immunological surveys have become the most efficient tools in epidemiological surveillance of this infection and in monitoring the vaccination programme. The results of immunological surveys indeed led to the introduction in 1975 of so-called second vaccination compulsory for children starting the first year of school attendance. Up to the present, a total of 24,000 cases of measles have been recorded in children vaccinated earlier, i.e., 1.5% of the total of vaccinated children. It can be expected that measles as a mass disease will be eliminated from the territory of the CSR in the next few years.     

1999—2010年兰州市安宁区麻疹流行病学特征分析与对策探讨

分析安宁区麻疹发病情况,流行规律和特点,找出消除麻疹的薄弱环节,探讨消除麻疹对策。利用1999-2010年安宁区麻疹疫情资料,包括法定传染病报告系统、麻疹监测系统流行病学个案调查及实验室监测资料,分析安宁区麻疹病例流行病特征。结果显示,1999-2010年兰州市安宁区报告本地麻疹病例142例,年平均发病率5.88/10万。发病年龄主要集中在6-25岁,占54.93%。学生发病占50%;3-7月龄发病占88.03%。安宁区麻疹发病呈现出<8月龄和成人发病增高的趋势,须在加强常规免疫接种的同时,还应加强重点人群的麻疹监测工作,尤其要密切关注各中小学和大学麻疹发病和爆发疫情,及时采取对应措施。     

日照市2005—2011年麻疹监测分析

目的分析日照市2005—2011年麻疹流行病学特征,为制定消除麻疹策略及措施提供依据。方法对日照市2005—2011年麻疹监测系统资料进行描述流行病学分析。结果日照市2005—2011年共报告麻疹病例193例,其中2011年无病例报告,年平均报告发病率0.97/100 000。麻疹病例分布各区县,但不同区县之间存在差异,发病高峰在3—6月,以15岁以上大年龄组发病为主;散发和暴发并存,散发以本土病例为主,共暴发疫情3起,均为输入性病例。结论日照市消除麻疹已取得显著进展,应继续保持和巩固高水平儿童基础免疫接种率,高质量地完成MV SIA,加强监测和风险评估,做好暴发疫情的预警与控制工作,实现消除麻疹。     

Epidemiologic effectiveness of mass revaccination against measles

The data on the epidemiological effectiveness of the mass booster immunization of students of high schools, as well as professional and technical schools, against measles are presented. Booster immunization is considered to be a highly effective antiepidemic measure aimed at decreasing morbidity rate in measles.     

枣庄市2008年麻疹减毒活疫苗强化免疫效果评价

为了评价枣庄市麻疹疫苗(MV)强化免疫的效果,于2008年在所辖区开展了流行病学调查、麻疹血清学监测和费用-效益分析等,对MV强化免疫进行了评价。枣庄市麻疹年平均报告发病率在强化免疫前为14.1/10万,对1-6岁儿童开展MV强化免疫后,2010年麻疹发病率为0.8/10万,降低了93.5%;1-6岁儿童麻疹发病构成,强化免疫前为39.87%,强化免疫后为25.90%,大大减少了5岁以下儿童的麻疹发病;强化免疫后,1-6岁儿童麻疹抗体阳性率为99.3%,抗体几何平均滴度(GMT)从强化免疫前的1∶563.0增长到强化免疫后的1∶814.9。开展MV强化免疫费用-效益比值为1∶2.23~1∶3.12。开展MV初始化强化免疫是加速麻疹控制最有效的措施之一。     

Epidemiology and Genetic Characterization of Measles Strains in Senegal, 2004-2013

BackgroundIn Senegal, with the variable routine vaccination coverage, the risk for illness and death from measles still exists as evidenced by the measles epidemic episode in 2009. Since 2002 a laboratory-based surveillance system of measles was established by the Ministry of Health and the Institut Pasteur de Dakar. The present study analysed the data collected over the 10 years inclusive between 2004-2013 in order to define a measles epidemiological profile in Senegal, and we carried out a phylogenetic analysis of measles virus circulating in Senegal over the period 2009-2012.ConclusionImprovements in the measles surveillance in Senegal are required and the introduction of oral fluid and FTA cards as an alternative to transportation of sera should be investigated to improve surveillance. The introduction of a national vaccine database including number of doses of measles-containing vaccine will greatly improve efforts to interrupt and ultimately eliminate measles virus transmission in Senegal.     

佛山市南海区2004—2010年麻疹流行病学特征分析及控制策略探讨

了解佛山市南海区2004—2010年麻疹流行病学特征,为进一步完善和制订消除麻疹策略与措施提供科学依据。采用流行病学方法对佛山市南海区2004—2010年麻疹发病资料进行分析。结果显示,佛山市南海区2004—2010年累计确诊麻疹病例1 376例,年平均发病率为9.24/10万;全年均有发病,3～8月是麻疹高发季节,但近年来随着麻疹防控措施的落实,季节性已不明显;麻疹发病以5岁以下儿童为主,占总发病数的55.7%,,近年来麻疹发病年龄趋势向<1岁人群组和≥15岁人群组发展,这两个年龄组发病数占总发病人数的62.8%;病例中无免疫史或免疫史不详者占92.2%。佛山市南海区麻疹发病年龄分布已逐步呈现"双向位移"现象,加强对重点人群、重点地区的免疫规划管理,提高麻疹疫苗接种率,是控制麻疹发病的有效措施。同时适时开展强化免疫接种是保护易感人群,进而实现消除麻疹的重要策略.     

Real-time investigation of measles epidemics with estimate of vaccine efficacy

As part of measles elimination effort, evaluation of the vaccination program and real-time assessment of the epidemic dynamics constitute two important tasks to improve and strengthen the control. The present study aimed to develop an epidemiological modeling method which can be applied to estimating the vaccine efficacy at an individual level while conducting the timely investigation of the epidemic. The multivariate renewal process model was employed to describe the temporal evolution of infection by vaccination history, jointly estimating the time-dependent reproduction number and the vaccine efficacy. Analyzing the enhanced surveillance data of measles in Aichi prefecture, Japan from 2007-08, the vaccine efficacy was estimated at 96.7% (95% confidence interval: 95.8, 97.4). Using an age structured model, the vaccine efficacy among those aged from 5-19 years was shown to be smaller than that among those from 0-4 years. The age-dependent vaccine efficacy estimate informs the age-groups to be targeted for revaccination. Because the estimation method can rest on readily available epidemiological data, the proposed model has a potential to be integrated with routine surveillance.     

The epidemic process of diphtheria infection in the RSFSR during the introduction of epidemiological surveillance

In this work the characterization of the epidemic process of diphtheria infection on the territory of the RSFSR under the conditions of epidemiological surveillance (1983-1986) is presented. In comparison with the period of 1979-1982, an increase in morbidity rate occurred, which accounts for more complete detection of patients with mild forms of diphtheria, including persons found to be carriers of toxigenic Corynebacterium diphtheriae. Beginning from 1983, the leveling out of seasonal morbidity rises is observed. In the total number of persons affected by this infection the prevalence of adults is noted. Among them, a decrease in the morbidity rate was registered in 1986 (the maximum decrease was observed in age and professional groups of risk), which confirms the effectiveness of measures carried out for the protection of the adult population from diphtheria. Among children, a tendency towards a decrease in morbidity rate was noted in all age groups. The existing system of epidemiological surveillance on the territory of the RSFSR is capable of stabilizing diphtheria morbidity on a sporadic level and minimizing the number of fatal outcomes. The intensification of the epidemic process in some areas of the RSFSR is due to shortcomings in the realization of different measures of epidemiological surveillance.     

The theory and practice of an epidemic control service for the population

The data on the epidemic-control medical care of the population of the Kuznetsk coal fields and on the creation of the specialized system of the epidemiological surveillance of influenza, measles, viral hepatitis, hospital infections are presented. The possibility of using the theory of the self-regulation of the epidemic process in practical work is discussed.     

The monitoring of the spread of drug abuse as an element in the epidemiological surveillance of socially significant infections

The necessity of monitoring the spread of drug addiction in the system of epidemiological surveillance on HIV infection and parenteral virus hepatitides is shown. The results of the epidemiological diagnostics of registered drug addiction are presented. The criteria for the assessment of the epidemiological effectiveness of epidemiological surveillance on drug addiction are determined. As revealed in this study, during the period of 1991-1998 morbidity in drug addiction rose 57-fold in Perm Province, while the number of HIV-infected persons increased 75-fold. Pronounced direct relationship between the number of drug addicts, as well as persons belonging to groups of high risk of developing drug addiction, and the dynamics of morbidity in HIV infection and parenteral virus hepatitides B and C was established.     

On the epidemiological situation in quarantine, natural focal and other infections on the territory of the Southern Federal District

The data on the sanitary and epidemiological situation in the Southern Federal District are presented. The analysis of morbidity in tuberculosis, measles, HIV infection, viral hepatitis A, typhoid fever, cholera and quarantine infections, Crimean hemorrhagic fever, West Nile fever, rabies, malaria has been carried out. Special attention has been given to "new and newly returning infections", and among them to the spread of SARS ("atypical pneumonia"). The role of regional epidemiological safety programs, in particular such program as "The prophylaxis of quarantine and natural focal infections and the sanitary protection of the territory of the Southern Federal District of the Russian Federation from the import and spread infectious diseases in 2003-2005", has been substantiated.     

Prevention of acute enteric infections and viral hepatitis A in the Krasnodar Territory appearing in connection with a natural disaster in 2002

Materials on the sanitary and epidemiological situation in the Krasnodar Territory in connection with emergency situations (intensive snowfalls, heavy showers, high floods) in 2002 are presented. The scope of the destruction of the systems ensuring the life provision of the population in the affected regions of the territory is shown. To carry out the epidemiological surveillance on acute enteric infections, to make corrections of the planned prophylactic measures, as well as the timely solutions of problems connected with controlling the epidemiological situation, the daily monitoring of the level and dynamics of infectious morbidity in individual settlements among different age and professional groups, as well as the foci of infections, was established. 65 cases of acute enteric infection and 4 cases of viral hepatitis A were registered in the affected areas, which did not exceed the average morbidity figures for many years. A complex of sanitary, hygienic and prophylactic measures was carried out by the sanitary and epidemiological service of the territory, which made it possible to maintain human morbidity in acute enteric infections and viral hepatitis A in the affected areas on the sporadic level.     

Case Based Measles Surveillance in Pune: Evidence to Guide Current and Future Measles Control and Elimination Efforts in India

Background

According to WHO estimates, 35% of global measles deaths in 2011 occurred in India. In 2013, India committed to a goal of measles elimination by 2020. Laboratory supported case based measles surveillance is an essential component of measles elimination strategies. Results from a case-based measles surveillance system in Pune district (November 2009 through December 2011) are reported here with wider implications for measles elimination efforts in India.

Methods

Standard protocols were followed for case identification, investigation and classification. Suspected measles cases were confirmed through serology (IgM) or epidemiological linkage or clinical presentation. Data regarding age, sex, vaccination status were collected and annualized incidence rates for measles and rubella cases calculated.

Results

Of the 1011 suspected measles cases reported to the surveillance system, 76% were confirmed measles, 6% were confirmed rubella, and 17% were non-measles, non-rubella cases. Of the confirmed measles cases, 95% were less than 15 years of age. Annual measles incidence rate was more than 250 per million persons and nearly half were associated with outbreaks. Thirty-nine per cent of the confirmed measles cases were vaccinated with one dose of measles vaccine (MCV1).

Conclusion

Surveillance demonstrated high measles incidence and frequent outbreaks in Pune where MCV1 coverage in infants was above 90%. Results indicate that even high coverage with a single dose of measles vaccine was insufficient to provide population protection and prevent measles outbreaks. An effective measles and rubella surveillance system provides essential information to plan, implement and evaluate measles immunization strategies and monitor progress towards measles elimination.     

Recurring measles epidemic in Vietnam 2005-2009: implication for strengthened control strategies

Background: Measles remains a serious vaccine preventable cause of mortality in developing nations. Vietnam is aiming to achieve the level of immunity required to eliminate measles by maintaining a high coverage of routine first vaccinations in infants, routine second vaccinations at school entry and supplementary local campaigns in high-risk areas. Regular outbreaks of measles are reported, during 2005-2009.Methods: National measles case-based surveillance data collected during 2005-June 2009 was analyzed to assess the epidemiological trend and risk factors associated with measles outbreak in Vietnam.Results: Of the 36,282 measles suspected cases reported nationwide, only 7,086 cases were confirmed through laboratory examination. Although cyclical outbreaks occurred between 2005 and 2009, there was no definite trend in measles outbreaks during these periods. Overall, 2438 of measles confirmed cases were among children ≤5 years and 3068 cases were among people ≥16 years. The distribution with respect to gender skewed towards male (3667 cases) significant difference was not observed (P= 0.1693). Unsurprisingly, 4493 of the confirmed cases had no history of vaccination (X² <0.01). The northern and highland regions were identified as the main endemic foci and the spatial distribution changed with time. The occurrence of cases, in a considerable proportion of vaccinated population, is not only a reflection of the high vaccination coverage in Vietnam but also portrays a possibility of less than 100% vaccine efficacy. More so, in order to prevent measles in adults, high-risk groups must be identified and catch-up for selected groups selected.Conclusions: This study therefore reinforces the need for continued improvement of surveillance system and to probe into the possible role of changes in age-distribution of cases if the effective control of measles is to be achieved.     

Criteria of the epidemiological surveillance of meningococcal infection

The results of studies carried out with the use of the unified, specially developed methods in eight regions of the USSR are generalized. Basing on the analysis of the results, the leading role of serogroup A meningococci in the rise of morbidity is emphasized, the relation of the morbidity level to the serogroup composition of meningococci circulating among healthy population is revealed, the necessity of carrying out selective bacteriological surveys with a view to establish the serogroups of meningococci circulating among the population is shown. The expedient criteria to be used in the system of epidemiological surveillance of meningococcal infection are presented.     

The Evolutionary and Epidemiological Dynamics of the Paramyxoviridae

Paramyxoviruses are responsible for considerable disease burden in human and wildlife populations: measles and mumps continue to affect the health of children worldwide, while canine distemper virus causes serious morbidity and mortality in a wide range of mammalian species. Although these viruses have been studied extensively at both the epidemiological and the phylogenetic scales, little has been done to integrate these two types of data. Using a Bayesian coalescent approach, we infer the evolutionary and epidemiological dynamics of measles, mumps and canine distemper viruses. Our analysis yielded data on viral substitution rates, the time to common ancestry, and elements of their demographic history. Estimates of rates of evolutionary change were similar to those observed in other RNA viruses, ranging from 6.585 to 11.350 × 10⁻⁴ nucleotide substitutions per site, per year. Strikingly, the mean Time to the Most Recent Common Ancestor (TMRCA) was both similar and very recent among the viruses studied, ranging from only 58 to 91 years (1908 to 1943). Worldwide, the paramyxoviruses studied here have maintained a relatively constant level of genetic diversity. However, detailed heterchronous samples illustrate more complex dynamics in some epidemic populations, and the relatively low levels of genetic diversity (population size) in all three viruses is likely to reflect the population bottlenecks that follow recurrent outbreaks.     

克拉玛依市2008年麻疹监测与控制情况分析

分析克拉玛依市麻疹流行状况及预防控制措施,为消除麻疹提供依据。采用描述流行病学分析方法,对2008年克拉玛依市麻疹资料进行分析。结果显示,克拉玛依市2008年麻疹发病率为38.83/10万(138/355381),呈高度散发,较2007年有所上升。发病高峰在3～5月,发病数占全年的83.33%。年龄分布大年龄组高于小年龄组,>20岁年龄组病例占50.00%,<1岁病例占18.84%;流动人口发病占51.11%。应切实提高麻疹常规免疫接种率和做好入托、入学儿童查验预防接种证工作,加强麻疹监测,提高实验室确诊病例的比例。     

The status of the morbidity and the main trends in the improvement of the epidemiological surveillance of sexually transmitted infections in the city of Moscow

The present situation in sexually transmitted diseases (STD) is regarded as unfavorable. Differing tendencies in morbidity levels for various nosological forms have been established. The continuing growth of syphilis morbidity among children is considered to be specially alarming, and an increase in the number of cases of congenital syphilis is noted. The reasons of the growth of STD morbidity have not only medical, but mainly socio-economical, psychological, ethical and moral character. The main trends in the improvement of epidemiological surveillance on STD have been determined.