scholarly journals Reduction patterns of Japanese encephalitis incidence following vaccine introduction into long-term expanded program on immunization in Yunnan Province, China

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Xiao-Ting Hu ◽  
Qiong-Fen Li ◽  
Chao Ma ◽  
Zhi-Xian Zhao ◽  
Li-Fang He ◽  
...  
Keyword(s):  
Japanese Encephalitis ◽  
Vaccination Coverage ◽  
Surveillance System ◽  
Yunnan Province ◽  
Immunization Coverage ◽  
Epidemiological Data ◽  
Incidence Rates ◽  
Vaccine Introduction ◽  
Before And After ◽  
Expanded Program On Immunization

Abstract Background Japanese encephalitis (JE) is a leading cause of childhood viral encephalitis both at global level and in China. Vaccination is recommended as a key strategy to control JE. In China most JE cases have been reported in southwest provinces, which include Yunnan. In this study, we quantify the epidemiological shift of JE in Yunnan Province from 2005 to 2017, covering before and after the introduction of JE vaccination into routine Expanded Program on Immunization (EPI) in 2007. Methods We used routinely collected data in the case-based JE surveillance system from 2005 through 2017 in Yunnan. Cases were reported from hospital and county-level Centers for Disease Control in line with the National JE Surveillance Guideline. Epidemiological data were extracted, analysed and presented in appropriate ways. Immunization coverage was estimated from actual JE doses administered and new births for each year. Results A total 4780 JE cases (3077 laboratory-confirmed, 1266 clinical and 437 suspected) were reported in the study period. Incidence of JE (per 100 000 population) increased from 0.95 in 2005 to 1.69 in 2007. With increase in vaccination coverage, incidence rates decreased steadily from 1.16 in 2009 to 0.17 in 2017. However, seasonality remained similar across the years, peaking in June–September. Banna (bordering Myanmar and Laos), Dehong (bordering Myanmar), and Zhaotong (an inland prefecture) had the highest incidence rates of 2.3, 1.9, and 1.6, respectively. 97% of all cases were among local residents. As vaccination coverage increased (and incidence decreased), proportion of JE cases among children < 10 years old decreased from 70% in 2005 to 32% in 2017, while that among adults ≥20 years old increased from 12 to 48%. There were a large number of JE cases with unknown treatment outcomes, especially in the earlier years of the surveillance system. Conclusions The 13-year JE surveillance data in Yunnan Province showed dramatic decrease of total incidence and a shift from children to adults. Improving vaccination coverage, including access to adults at risk, and strengthening the JE surveillance system is needed to further control or eliminate JE in the province.

scholarly journals The Impact of War in Yemen on Immunization Coverage of Children Under One Year of Age: Descriptive Study

10.2196/14461 ◽  
2019 ◽  
Vol 5 (4) ◽  
pp. e14461
Author(s):  
Amr Torbosh ◽  
Mohammed Abdulla Al Amad ◽  
Abdulwahed Al Serouri ◽  
Yousef Khader
Keyword(s):  
Vaccination Coverage ◽  
Negative Impact ◽  
Vaccine Coverage ◽  
National Health System ◽  
Immunization Coverage ◽  
Measles Vaccine ◽  
One Year ◽  
Expanded Program On Immunization ◽  
The Impact ◽  
Marked Drop

Background After 2 years of war that crippled the capacity of the Yemeni National Health System and left only 45% of health facilities functioning, Yemen faced increasing vaccine-preventable disease (VPD) outbreaks and may be at high risk of polio importation. Objective The aim of this study was to determine the impact of the 2015 war on the immunization coverage of children under 1 year. Methods Data on vaccination coverage for 2012-2015 were obtained from the national Expanded Program on Immunization (EPI). The vaccination coverage was calculated at the national and governorate levels by dividing the number of actually vaccinated children by the estimated population of children under 1 year. Results Although there was an increase from 2012 to 2014 in the national coverage for penta-3 vaccine (82% in 2012 vs 88% in 2014) and measles vaccine (70% in 2012 vs 75% in 2014), the coverage was still below the national target (≥95%). Furthermore, the year 2015 witnessed a marked drop in the national coverage compared with 2014 for the measles vaccine (66% in 2015 vs 75% in 2014), but a slight drop in penta-3 vaccine coverage (84% in 2015 vs 88% in 2014). Bacillus Calmette–Guérin vaccine also showed a marked drop from 73% in 2014 to 49% in 2015. These reductions were more marked in governorates that witnessed armed confrontations (eg, Taiz, Lahj, and Sa’dah governorates). On the other hand, governorates that did not witness armed confrontations showed an increase in coverage (eg, Raymah and Ibb), owing to an increase in their population because of displacement from less secure and confrontation-prone governorates. Conclusions This analysis demonstrated the marked negative impact of the 2015 war on immunization coverage, especially in the governorates that witnessed armed confrontations. This could put Yemen at more risk of VPD outbreaks and polio importation. Besides the ongoing efforts to stop the Yemeni war, strategies for more innovative vaccine delivery or provision and fulfilling the increasing demands are needed, especially in governorates with confrontations. Enhancing EPI performance through supportable investments in infrastructure that was destroyed by the war and providing decentralized funds are a prerequisite.

scholarly journals Pentavalent Vaccination in Rural Kenya: Coverage and Geographical Accessibility to Health Facilities Using Data from a Community Demographic and Health Surveillance System in Kilifi County.

2020 ◽  
Author(s):  
Morris Ogero ◽  
James Orwa ◽  
Rachael Odhiambo ◽  
Felix Agoi ◽  
Adelaide Lusambili ◽  
...  
Keyword(s):  
Travel Time ◽  
Health Facility ◽  
Vaccination Coverage ◽  
Surveillance System ◽  
Immunization Coverage ◽  
Health Facilities ◽  
Spatial Accessibility ◽  
Immunisation Coverage ◽  
Spatial Access ◽  
Routine Immunisation

Abstract BackgroundThere is substantial evidence that immunization is one of the most significant and cost-effective pillars of preventive and promotive health interventions. Effective childhood immunization coverage is thus essential in stemming persistent childhood illnesses. The main indicator of performance of the immunisation programme is the third dose of diphtheria-tetanus-pertussis (DTP3) vaccine for children because it mirrors the completeness of a child’s immunisation schedule. Spatial access to a health facility, especially in SSA countries, is a significant determinant of DTP3 vaccination coverage, as the vaccine is mainly administered during routine immunisation schedules at health facilities. Rural areas and densely populated informal settlements are most affected by poor access to healthcare services. We therefore sought to determine vaccination coverage of DTP3, estimate the travel time to health facilities offering immunisation services, and explore its effect on immunisation coverage in one of the predominantly rural counties on the coast of Kenya.MethodsCoordinates of health facilities, information on land cover, digital elevation models, and road networks were used to compute spatial accessibility to immunizing health facilities for eligible children within the Kaloleni-Rabai Community Health Demographic Surveillance System (HDSS). To explore the effect of travel time on DTP3 coverage, we fitted a hierarchical multivariable model adjusting for other a priori identified confounding factors.ResultsSpatial access to health facilities that offer immunization services significantly affected DTP3 coverage, with travel times of more than one hour to a health facility significantly associated with reduced odds of receiving DTP3 vaccine (AOR= 0.84 (95% CI 0.74 – 0.94).ConclusionIncreased travel time is a significant barrier to the uptake of facility-delivered immunizations in this rural community. To improve immunisation coverage, local health authorities and policy makers in remote settings can use high-resolution maps to identify areas where distance and travel time may impede the achievement of high immunization coverage and identify appropriate interventions. These could include improving the road network, establishing new health centres and/or stepping up health outreach activities that include vaccinations in hard-to-reach areas within the county.

scholarly journals Epidemiological characteristics of hand, foot, and mouth disease in Yunnan Province, China, 2008–2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Jiang ◽  
Hongchao Jiang ◽  
Xin Tian ◽  
Xueshan Xia ◽  
Tian Huang
Keyword(s):  
Vaccination Coverage ◽  
Yunnan Province ◽  
Enterovirus 71 ◽  
Case Fatality ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Vaccination Coverage Rate ◽  
Foot And Mouth ◽  
Before And After ◽  
Epidemiological Characteristics

Abstract Background Since 2016, enterovirus 71 (EV71) vaccines have been approved for market entry, and little is known about how the epidemiology of hand, foot, and mouth disease (HFMD) has been affected by the introduction of the vaccines in Yunnan Province. The study describes the epidemiological characteristics of HFMD before and after the introduction of EV71 vaccination in Yunnan Province. Methods Surveillance data collected between 2008 and 2019 were analyzed to produce epidemiological distribution on cases, etiologic composition, and EV71 vaccination coverage, as well as to compare these characteristics before and after EV71 vaccination. Results A total of 1,653,533 children received EV71 vaccines from 2016 through 2019 in Yunnan. The annual EV71 vaccination coverage rate ranged from 5.53 to 15.01% among children ≤5 years old. After the introduction of EV71 vaccines, the overall incidence of HFMD increased and reached over 200 cases per 100,000 population-years in 2018 and 2019. However, the case severity and case fatality rate decreased and remained lower than 1 and 0.005% after 2016, respectively. EV71-associated mild, severe and fatal cases sharply decreased. The predominant viral serotype changed to non-EV71/non-CV-A16 enteroviruses which were detected across the whole province. Conclusions Non-EV71/non-CV-A16 enteroviruses became the predominant strain and led to a higher incidence in Yunnan. Expanding EV71 vaccination and strengthening laboratory-based surveillance could further decrease the burden of severe HFMD and detect and monitor emerging enteroviruses.

scholarly journals Ongoing Epidemiological Changes in Hand, Foot, and Mouth Disease Following the Introduction of Enterovirus 71 Vaccines in Yunnan Province, China, 2008-2019

2021 ◽  
Author(s):  
Li Jiang ◽  
Hongchao Jiang ◽  
Xin Tian ◽  
Xueshan Xia ◽  
Tian Huang
Keyword(s):  
Vaccination Coverage ◽  
Yunnan Province ◽  
Enterovirus 71 ◽  
Case Fatality ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Vaccination Coverage Rate ◽  
Foot And Mouth ◽  
Before And After ◽  
Epidemiological Changes

Abstract Background:Since 2016, enterovirus 71 (EV71) vaccines have been approved for market entry, and litter is known about how the epidemiology of hand, foot, and mouth disease (HFMD) has been affected by the introduction of the vaccines in Yunnan Province. The study describes the ongoing epidemiological changes in HFMD following the introduction of EV71 vaccination in Yunnan.Methods:Surveillance data collected between 2008 and 2019 were analyzed to produce EV71 vaccination coverage, epidemiological distribution on cases, and etiologic composition as well as to compare these characteristics before and after EV71 vaccination.Results:A total of 1,653,533 people received EV71 vaccines from 2016 through 2019 in Yunnan. The cumulative EV71 vaccination coverage rate was 68.14%. After the introduction of EV71 vaccines, the overall incidence of HFMD increased and reached over 200 cases per 100,000 population-years in 2018 and 2019. However, the case severity and case fatality rate decreased and remained lower than 1% and 0.005% after 2016, respectively. EV71-associated mild, severe and fatal cases sharply decreased. The predominant viral serotype changed to non-EV71/non-CV-A16 enteroviruses which were detected across the whole province.Conclusions: EV71 vaccination helped to reduce severe HFMD. However, other enteroviruses became the predominant strain and let to a higher incidence. Expanding EV71 vaccination and strengthening laboratory-based surveillance could further decrease the burden of severe HFMD and reveal the existence of emerging enteroviruses.

scholarly journals Medical data collection on UK Military Exercise Saif Sareea 3: the EpiNATO-2 surveillance system

2020 ◽  
Vol 166 (6) ◽  
pp. 378-381 ◽  
Author(s):  
Stephanie Chase ◽  
M Kavanagh Williamson ◽  
M Smith
Keyword(s):  
Surveillance System ◽  
Epidemiological Data ◽  
Coding System ◽  
Education Session ◽  
Improvement Project ◽  
Military Exercises ◽  
Medical Issues ◽  
Before And After ◽  
Audit Period ◽  
Treatment Facilities

IntroductionEpidemiological data from military exercises are important to identify trends in medical presentations and treatment requirements to aid planning for future operations. UK Military exercises use the EpiNATO-2 surveillance system for this purpose, however it has some limitations in the spectrum of data it can collect. An enhanced reporting system titled EpiNATO-2 PLUS was developed and introduced in all LAND (Army) Role 1 Medical Treatment Facilities (MTFs) as part of Exercise Saif Sareea 3 (SS3). It was assessed as part of a Quality Improvement Project for its utility in terms of spectrum and validity of data capture.MethodEpidemiological data were collected over a 2-month period from medical consultations in Camp Shafa during SS3 by EpiNATO-2 or EpiNATO-2 PLUS. This involved categorisation of symptoms into a coding system which represents a spectrum of clinical presentations, as well as collecting data on the effect of medical issues on personnel productivity. Halfway through the collection period, an EpiNATO-2 PLUS education session and Summary Guide were introduced. Data were audited for the period before and after these introductions.ResultsOf the 1163 consultations conducted in the 2-month period, the use of EpiNATO-2 PLUS captured an additional 169 patient contacts not collected by EpiNATO-2. The provision of a summary guide and teaching session decreased coding errors in the second audit period from 12.9% to 6.8% for EpiNATO-2 and from 19.4% to 6.6% for EpiNATO-2 PLUS, respectively.ConclusionsThe use of EpiNATO-2 PLUS collected a broader spectrum of medical activity in the Role 1 MTF, by capturing an additional 10% of the clinical workload compared with EpiNATO-2. The increase in coding accuracy correlates with the introduction of the education session and EpiNATO-2 PLUS Summary Guide. It is recommended that EpiNATO-2 PLUS is used in future deployments.

scholarly journals 1382. Varicella Burden Disease in Argentina: 4 Years after National Vaccination Strategy

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S701-S701
Author(s):  
Silvina Neyro ◽  
Maria del Valle Juarez ◽  
Marina Pasinovich ◽  
Carolina Rancaño ◽  
Nathalia Katz ◽  
...  
Keyword(s):  
Varicella Vaccine ◽  
Age Groups ◽  
Vaccination Strategy ◽  
Dose Schedule ◽  
Incidence Rates ◽  
Transmission Risk ◽  
Post Vaccination ◽  
Vaccine Introduction ◽  
National Immunization ◽  
Before And After

Abstract Background In Argentina, around 150,000-180,000 total Varicella (VZV) cases per year (c/y) are registered; however, underreport exists and some 400,000 cases are estimated to occur annually. Varicella vaccine (VV) was included in the National Immunization Schedule (NIS) in 2015, with a 1-dose schedule administered at 15 months-of-age. We aimed to describe and to compare the epidemiological situation of VZV infections in Argentina in two periods: pre (2010-2014) and post (2016-2018) vaccine introduction in NIS. Global Incidence rates and vaccine coverages Incidence rates (age groups) Methods Before-and-after study comparing cases and incidence rates (100,000) of varicella reported to the National Health Surveillance System between pre-vaccination period (Pre-VV) and post-vaccination (Post-VV), excluding year of intervention (2015) since it was considered a transition year. Epi Info 7 was used for data analysis. Results Vaccination coverage (VC) for 2015 was 44.7%; 74.4% in 2016; 76.8% in 2017 and 81% in 2018 (Figure 1). 728,392 cases of VZV were notified (R=363.1) in Pre-VV period and 222,305 cases in Post-VV (R=180.7), with a global incidence rate reduction of 49% (95%CI= 40.9-56.2; p&lt; 0.001). Both 12-24 months of age and 2-4 years old groups (Pre-VV R=2,253 and Post-VV R=900; Pre-VV R=2,399 and Post-VV R=875, respectively) showed the greatest reductions in incidence rates (-59.3% [95%CI 58.7-60] p&lt; 0.001 and -61.7% [95%CI 61.3-62] p&lt; 0.001). Age groups not affected by vaccination (&lt; 1 year, 5-9 years and 10-14 years) presented minor but significant reductions (-56.4% [95%CI 55.6-57.3] p&lt; 0.001; -35% [95%CI 34.5-35.4] p&lt; 0.001; and -28.6% [95%IC 27.6-29.7] p&lt; 0.001 respectively) (Figure 2). Conclusion A decreasing trend in VZV number of cases and incidence rates was observed, especially in children less than 5 years old, despite suboptimal VC. The reduction of VZV cases in non-vaccinated age groups could be related to a decline in the transmission risk. Improving VC will likely reflect a greater impact on the burden of disease. Disclosures All Authors: No reported disclosures

scholarly journals Are we progressing towards elimination of diphtheria, pertusis, tetanus from Nepal?

1970 ◽  
Vol 6 (4) ◽  
pp. 520-525 ◽  
Author(s):  
N Jha ◽  
S Kumar
Keyword(s):  
Surveillance System ◽  
Vaccine Coverage ◽  
Immunization Coverage ◽  
Immunization Program ◽  
Vaccine Preventable Diseases ◽  
Tetanus Immunization ◽  
Expanded Program On Immunization ◽  
Key Steps ◽  
Vaccine Surveillance ◽  
Priority Program

Diphtheria, Pertussis and Tetanus (DPT) are the vaccine preventable diseases of childhood. The published literatures and reports related to DPT immunization coverage are relatively more than DPT diseases. The striking reduction in deaths and in the incidence of these diseases has been closely associated with the introduction of specific vaccination program. Expanded Program on Immunization (EPI) is a priority program in the country. Nepal has been running country-wide immunization program since 1989. However, there is no doubt that the program has contributed significantly towards reduction of infants and child mortality. Effective and efficient surveillance system and strengthening the routine immunization against DPT are the key steps for elimination of DPT diseases. Key words: DPT, Diphtheria, Pertussis, Tetanus, Immunization, DPT Vaccine, surveillance, vaccine coverage, Nepal.   doi: 10.3126/kumj.v6i4.1749     Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 520-525   

scholarly journals Pentavalent vaccination in rural Kenya: coverage and geographical accessibility to health facilities using data from a community demographic and health surveillance system in Kilifi County.

2020 ◽  
Author(s):  
Morris Ogero ◽  
James Orwa ◽  
Rachael Odhiambo ◽  
Felix Agoi ◽  
Adelaide Lusambili ◽  
...  
Keyword(s):  
Travel Time ◽  
Health Facility ◽  
Vaccination Coverage ◽  
Surveillance System ◽  
Immunization Coverage ◽  
Health Facilities ◽  
Spatial Accessibility ◽  
Immunisation Coverage ◽  
Spatial Access ◽  
Routine Immunisation

Abstract BackgroundThere is substantial evidence that immunization is one of the most significant and cost-effective pillars of preventive and promotive health interventions. Effective childhood immunization coverage is thus essential in stemming persistent childhood illnesses. The main indicator of performance of the immunisation programme is the third dose of diphtheria-tetanus-pertussis (DTP3) vaccine for children because it mirrors the completeness of a child’s immunisation schedule. Spatial access to a health facility, especially in SSA countries, is a significant determinant of DTP3 vaccination coverage, as the vaccine is mainly administered during routine immunisation schedules at health facilities. Rural areas and densely populated informal settlements are most affected by poor access to healthcare services. We therefore sought to determine vaccination coverage of DTP3, estimate the travel time to health facilities offering immunisation services, and explore its effect on immunisation coverage in one of the predominantly rural counties on the coast of Kenya.MethodsCoordinates of health facilities, information on land cover, digital elevation models, and road networks were used to compute spatial accessibility to immunizing health facilities for eligible children within the Kaloleni-Rabai Community Health Demographic Surveillance System (HDSS). To explore the effect of travel time on DTP3 coverage, we fitted a hierarchical multivariable model adjusting for other a priori identified confounding factors.ResultsSpatial access to health facilities that offer immunization services significantly affected DTP3 coverage, with travel times of more than one hour to a health facility significantly associated with reduced odds of receiving DTP3 vaccine (AOR= 0.84 (95% CI 0.74 – 0.94).ConclusionIncreased travel time is a significant barrier to the uptake of facility-delivered immunizations in this rural community. To improve immunisation coverage, local health authorities and policy makers in remote settings can use high-resolution maps to identify areas where distance and travel time may impede the achievement of high immunization coverage and identify appropriate interventions. These could include improving the road network, establishing new health centres and/or stepping up health outreach activities that include vaccinations in hard-to-reach areas within the county.

scholarly journals The Impact of War in Yemen on Immunization Coverage of Children Under One Year of Age: Descriptive Study (Preprint)

2019 ◽  
Author(s):  
Amr Torbosh ◽  
Mohammed Abdulla Al Amad ◽  
Abdulwahed Al Serouri ◽  
Yousef Khader
Keyword(s):  
Vaccination Coverage ◽  
Negative Impact ◽  
Vaccine Coverage ◽  
National Health System ◽  
Immunization Coverage ◽  
Measles Vaccine ◽  
One Year ◽  
Expanded Program On Immunization ◽  
The Impact ◽  
Marked Drop

BACKGROUND After 2 years of war that crippled the capacity of the Yemeni National Health System and left only 45% of health facilities functioning, Yemen faced increasing vaccine-preventable disease (VPD) outbreaks and may be at high risk of polio importation. OBJECTIVE The aim of this study was to determine the impact of the 2015 war on the immunization coverage of children under 1 year. METHODS Data on vaccination coverage for 2012-2015 were obtained from the national Expanded Program on Immunization (EPI). The vaccination coverage was calculated at the national and governorate levels by dividing the number of actually vaccinated children by the estimated population of children under 1 year. RESULTS Although there was an increase from 2012 to 2014 in the national coverage for penta-3 vaccine (82% in 2012 vs 88% in 2014) and measles vaccine (70% in 2012 vs 75% in 2014), the coverage was still below the national target (≥95%). Furthermore, the year 2015 witnessed a marked drop in the national coverage compared with 2014 for the measles vaccine (66% in 2015 vs 75% in 2014), but a slight drop in penta-3 vaccine coverage (84% in 2015 vs 88% in 2014). Bacillus Calmette–Guérin vaccine also showed a marked drop from 73% in 2014 to 49% in 2015. These reductions were more marked in governorates that witnessed armed confrontations (eg, Taiz, Lahj, and Sa’dah governorates). On the other hand, governorates that did not witness armed confrontations showed an increase in coverage (eg, Raymah and Ibb), owing to an increase in their population because of displacement from less secure and confrontation-prone governorates. CONCLUSIONS This analysis demonstrated the marked negative impact of the 2015 war on immunization coverage, especially in the governorates that witnessed armed confrontations. This could put Yemen at more risk of VPD outbreaks and polio importation. Besides the ongoing efforts to stop the Yemeni war, strategies for more innovative vaccine delivery or provision and fulfilling the increasing demands are needed, especially in governorates with confrontations. Enhancing EPI performance through supportable investments in infrastructure that was destroyed by the war and providing decentralized funds are a prerequisite.

scholarly journals Characteristics of the Epidemiological Situation of Measles in the Period of its Elimination in Republic of Moldova

2019 ◽  
Vol 18 (4) ◽  
pp. 34-40
Author(s):  
A. A. Melnik ◽  
V. E. Bukova ◽  
L. P. Tsurcan ◽  
N. I. Furtuna
Keyword(s):  
Vaccination Coverage ◽  
Measles Virus ◽  
Age Groups ◽  
Immunization Coverage ◽  
Epidemiological Data ◽  
Well Being ◽  
Population Migration ◽  
Republic Of Moldova ◽  
Being There ◽  
Measles Incidence

Relevance Measles continues to be one of the priorities of health care worldwide, due to it high contagiosity, still widespread, severity of the disease and complications. A high degree of population migration contributes to the spread of infection, i.e. global measles virus circulation, clinical change and late diagnosis, inadequate immunization coverage. Aim. Analysis of measles incidence in the Republic of Moldova in 2000–2018. and features of the epidemic process. Materials and Methods. Statistics on measles incidence and immunization coverage in 2000–2018 were used. 340 cases of measles registered in the country in 2018 were subjected to a detailed analysis Results There is a decrease in measles vaccination coverage, in 2017–87.1%. In the same year, the coverage with the first revaccination at 6–7 years was 92.4% and the second at 14–15 years is 94.9%, which is not enough to maintain epidemiological well-being. There are territorial differences in vaccination coverage. In 2018, imported cases of measles were in 62.5% from Ukraine, 25.0% from Russia and 12.5% from Romania. There have been isolated measles cases (14), and epidemic foci or outbreaks (7), with from 2 to 252 cases of measles. The largest measles outbreak in 2018 was registered among those who rest in a religious camp unvaccinated against measles. The average age of the diseased is 14 years, and in outbreaks with a significant number of cases (9 and more) within 7.9–14.9 years. In the age structure of the diseased, children from 1 to 10 years old prevail (66.1%), children under one year old make up 8,2%, teenagers 17,5% and adults 8.2%. Only 11.0% received one dose of measles vaccine, and 3.6% of the relevant age groups received two doses of vaccine. The reason is the refusal of vaccination for religious motive. In 196 (57.6%) cases, the diagnosis was confirmed by laboratory methods, and in the remaining 144 (42.4%) by clinical and epidemiological data. Conclusions Measles remains a childhood infection, but cases of the disease occur among adolescents (17.5%) and adults (8.2%). The uneven of vaccination coverage throughout the country, the low level of responsibility of the population, the increased incidence of measles in neighboring countries, the high level of population migration are risk factors for the importation and spread of measles.

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