Measles and rubella in the North-West of Russia in period of elimination

Aim: To evaluate the epidemic situation on measles and rubella and to carry out the laboratory diagnostics of these infections in the North-West of Russia in the period of elimination.Materials and Methods. In 2016-2019 a total of 534 blood serum samples from patients with measles diagnosis, 210 – from patients with rubella diagnosis and 1251 – from patients with exanthema were studied by ELISA using “VectoMeasles-IgM” and “EIA-Rubella-IgM” test-systems.Results. Measles incidence in NWR varied from 0 to 0.96 per 100,000 in 2016 and 2019, respectively. Among measles patients the proportion of children and adults changed in 2018-2019, adults constituted 65.9%. Patients not vaccinated against measles and those with the unknown vaccination status were mainly involved in epidemic process (85%). High level of patients with revaccination status was revealed in 2018 (18.4%). These patients demonstrated high levels of IgG (>3.0 IU/ml) as well as high percentage of IgG avidity (>94.3%) on 4-7th day of rash onset thus evidencing secondary immune response. Molecular studies of the samples from patients revealed the circulation of D8 and B3 genotypes of measles virus. Strains of D8 and B3 genotypes were represented by 3 and 4 variants, respectively. Rubella incidence did not exceed 0.13 per 100,000. Strains of rubella virus of genotype 1E were detected.Conclusion. The data of annual measles incidence and molecular studies of circulating wild type measles viruses prove the on-going measles elimination process in the NorthWest of Russia. For rubella, the persistent phase of elimination was demonstrated in the region.

Analysis and Outlook for the Development of Measles Epidemic Situation during the COVID-19 Pandemic

Relevance. The success of the global community in the fight against measles through vaccination at the beginning of the twentyfirst century allowed WHO to declare the goal of eliminating this infection by 2010. However, ten years later, the problem of the growing incidence of measles has become relevant again for all countries of the world. The pandemic of the new coronavirus infection (COVID-19) has affected all spheres of human life and has exacerbated the situation in the fight against other infections, including those managed with the help of specific prophylaxis. Since the measles contagiosity index and mortality rate are significantly higher than similar characteristics of COVID-19, the risk of increasing the incidence of this infection in the coming years is difficult to overestimate.Aim of the study: to assess the epidemic situation of measles in the context of the COVID-19 pandemic, as well as the prospects for its development; to propose preventive measures.Materials and methods. The article analyzes the statistical materials available on the official websites of the WHO (WHO). https://www.who.int/data/), the CDC US (https://www. cdc.gov) and the Federal Service of Rospotrebnadzor (https://www.rospotrebnadzor.ru/) on vaccination coverage and measles incidence in 13 countries in the WHO European Region and the United States. The epidemic situation on measles, as well as the level of population coverage with vaccination against its pathogen in the Russian Federation, were assessed according to the Federal State Statistical Observation forms 2010 – 2020: Form 2 «Information on infectious and parasitic diseases» and Form 6 «Information on the populations of children and adults vaccinated against infectious diseases».Results. It has been established that the increase in the measles incidence occurred in 2017–2019 worldwide, including European countries with a population coverage of two vaccine doses at the 97% level between 2010 and 2019. The prevalence of measles cases in children under the age of 10 is shown, as well as the wide range (from 56.9% to 10.9%) in the proportion of vaccinated persons among them. The results obtained indicate the existence of problems in the organization of modern vaccine prevention. The introduction of widespread restrictive and quarantine measures against the COVID-19 pandemic, on the one hand, has reduced the incidence of measles and, on the other hand, has exacerbated the difficulties in implementing measles prevention. Thus, the results indicate a possible increase in measles incidence in the population after the end of the COVID-19 pandemic.Conclusion. It is necessary to immediately develop an action plan to catch up on the coverage and increase the rate of routine vaccination, to improve the statistical record of persons subject to the introduction of the vaccine and vaccinated, as well as to overcome anti-vaccination attitude among the population.

Epidemiology of Measles in West Arsi Zone, Oromia Region, Ethiopia: 2011-2015

Background Measles is a leading vaccine-preventable childhood disease, which has been designated for elimination. Despite the success of measles control, measles is still responsible for 145,700 deaths worldwide each year, with many of the outbreaks in developing countries including Ethiopia. We analyzed to characterize the epidemiology of measles and recommend better prevention and control strategies in West Arsi Zone, Ethiopia. Methods Data from 2011–2015 from the Public Health Emergency and Management Unit of the West Arsi Zone Health Department database were obtained using a semi-standard checklist. We analyzed and described the data by person, place, and time. Results We identified 1735 cases of measles between 2011–2015. The annual average measles incidence rate during 2011–2014 was 3.4/100,000 while the incidence rate in 2015 was 14/100,000. During 2011–2015, most of the cases occurred in children age less than 15 years old (87%), and 33 % were under five. Measles cases were reported every month, and March had the highest number of cases (24%). The districts with the highest incidence rates of measles had high routine measles vaccination coverage’s. The proportion of districts with an annual detection rate for non-measles febrile rash was 67% both in 2014 and 2015 which was below the national target (> 80%). Conclusions Measles outbreaks in children in 2015 in an area with high routine vaccination coverage were identified. We recommended improving vaccine management and supplementary vaccination for children less than 15 years. It needs further study to identify contributing factors for measles outbreaks and evaluating the effectiveness of measles control and prevention strategies.

Risk of Absence of Measles Antibody in Healthcare Personnel and Efficacy of Booster Vaccination

We aimed to identify the presence of the measles IgG antibody (mIgG-Ab) in healthcare personnel and finding out who needs the measles vaccination. The history of measles vaccination was obtained from the national vaccine registry. A baseline mIgG-Ab test was performed, and the measles vaccine was administered to participants who tested negative or equivocal for mIgG-Abs. During the study, 2885 (87.3%) of the 3303 employees were tested for measles serostatus. The baseline seropositivity rate for mIgG-Abs was 91.9%. Among the 234 seronegative cases, 82.9% were born after 1985. The seroprevalence rate was lower in those who received the measles–mumps–rubella (MMR) vaccine >10 years before the testing time, especially if they were born after 1985 and if there was only one previous record of vaccination. Among the 234 seronegative cases, MMR vaccination was administered in 174 cases, of which serostatus was evaluated in 146 cases. After the first dose, positive seroconversion was achieved in 126 participants (86.3%). After a second dose, 15 achieved (75.0%) positive seroconversion. In healthcare personnel born after the period when measles incidence significantly decreased, it may be necessary to reassess their immune status for measles if more than 10 years have elapsed since the last vaccination.

Socioeconomic deprivation is inversely associated with measles incidence: a longitudinal small-area analysis, Germany, 2001 to 2017

Background Although measles is endemic throughout the World Health Organization European Region, few studies have analysed socioeconomic inequalities and spatiotemporal variations in the disease’s incidence. Aim To study the association between socioeconomic deprivation and measles incidence in Germany, while considering relevant demographic, spatial and temporal factors. Methods We conducted a longitudinal small-area analysis using nationally representative linked data in 401 districts (2001–2017). We used spatiotemporal Bayesian regression models to assess the potential effect of area deprivation on measles incidence, adjusted for demographic and geographical factors, as well as spatial and temporal effects. We estimated risk ratios (RR) for deprivation quintiles (Q1–Q5), and district-specific adjusted relative risks (ARR) to assess the area-level risk profile of measles in Germany. Results The risk of measles incidence in areas with lowest deprivation quintile (Q1) was 1.58 times higher (95% credible interval (CrI): 1.32–2.00) than in those with highest deprivation (Q5). Areas with medium-low (Q2), medium (Q3) and medium-high deprivation (Q4) had higher adjusted risks of measles relative to areas with highest deprivation (Q5) (RR: 1.23, 95%CrI: 0.99–1.51; 1.05, 95%CrI: 0.87–1.26 and 1.23, 95%CrI: 1.05–1.43, respectively). We identified 54 districts at medium-high risk for measles (ARR > 2) in Germany, of which 22 were at high risk (ARR > 3). Conclusion Socioeconomic deprivation in Germany, one of Europe’s most populated countries, is inversely associated with measles incidence. This association persists after demographic and spatiotemporal factors are considered. The social, spatial and temporal patterns of elevated risk require targeted public health action and policy to address the complexity underlying measles epidemiology.

To the question of the reasons for the activation of the epidemic process of Мeasles at the stage of elimination of infection and the forecast of the situation in the near and long term

Introduction. Measles infection in recent years has become particularly relevant in connection with the registration of outbreaks of this disease in various territoriesof the Russian Federation and abroad.The aim of the study is to characterize the epidemic process of measles in a large industrial city in the near and long term with the use of modern mathematical modeling technologies for making new management decisions on infection control at the elimination stage.Materials and methods. The research materials were data from statistical reports of measles incidence in Yekaterinburg from 1950 to 2019 (70 years of follow-up), medical documentation of measles cases, population vaccination data (form No. 6 for 2000—2018 and outpatient maps of children under two years of age vaccinated against measles), results of screening for measles IgG ofmedical organizations, data of planned serological monitoringof population immunity to measles in «indicator» groups in the period from 2013 to 2017 and the results of mathematical modeling of measles incidence in different scenarios of its prevention.Results. Under the influence of vaccination, the epidemic process of measles in Yekaterinburg — a city with a population of 1.5million inhabitants-has undergone significant changes. During the observation period, the incidence decreased to sporadic levels, there was no indigenous measles, drifts from endemic areas had no consequences, the epidemic process was under control. However, outbreaks of 72 cases in 2016 and 90 cases in 2019 have changed our view of measles as a eradicated infection.Of the factors that led to the spread of infection in the foci, the most significant were the presence of measles-susceptible children and adults, including those previously vaccinated, mainly in the periods remote from vaccination and revaccination, defects in the clinical diagnosis of measlesin the first and subsequent cases, and violations in the organization and conduct of anti-epidemic measures. Conclusion. Based on the data of mathematical modeling of the epidemic process of measles with different combinations of its determinants, for the elimination of infection, it is necessary to ensure vaccination against measles at the age of 1 year and 6 years in 95—97.5%. In vulnerable groups for infection to discuss the introduction of routine revaccination among people up to 50 years of age with an interval of 10 years.

Measles in Zaporizhzhia: in the footsteps of the last epidemic

In 2017–2019 in Ukraine, including the Zaporizhzhia region, a strong rise in the incidence of measles was recorded. A retrospective analysis of the incidence in the Zaporizhzhia region during this outbreak allows us to identify the main problems in the system of epidemiological surveillance to predict future possible consequences. The aim of the work is to perform a comparative analysis of measles incidence in the Zaporizhzhia region with the data obtained in the period from 2015 to 2020 according to the epidemiological criteria. Materials and methods. The annual reports of 2015–2020 provided by the Department of Epidemiological Research of the Zaporizhzhia Regional Laboratory Center of the Ministry of Health of Ukraine were used as materials for the retrospective epidemiological analysis of measles incidence in Zaporizhzhia region. Statistical analysis of the data was carried out according to epidemiological characteristics: age distribution, the residence of patients in urban or rural areas. Commonly used statistical methods used in medicine were used to evaluate the obtained results. Results. It is concluded that in the Zaporizhzhia region during 2015 only 2 cases of measles were detected for children, and in 2016 no measles were registered in the region at all. In 2017–2019 1.433 measles patients were identified in the Zaporizhzhia region, of which 68 % were adults and 32 % were children. The lowest detection rate of measles was registered among rural residents. Insufficient vaccination coverage of the population has become a significant reason for the spread of measles among residents of the Zaporizhzhia region. In 2020 no cases of measles have been registered in the Zaporizhzhia region. Conclusions. The prevalence of incidence rate among adults attests to the fact that today measles can not be considered only a childhood disease. The deficiency of an immune layer, both among adults and children, contributed to the rapid spread of the disease. Mandatory vaccination of children and the introduction of additional vaccination of adults, optimizing the system of epidemiological surveillance for measles, including continuous monitoring of vaccination, is the main mechanism for combating this disease.

Modern features of the epidemic process of viral infections with aerosol transmission in Sumy oblast

Viral infections with aerosol transmission are one of the most common infectious diseases in the world. Their relevance is due to the wide distribution and socio-medical consequences. To study the dynamics of the incidence of viral infections with aerosol transmission in Sumy Oblast, to determine the level of influence of social and natural factors on the intensity of the epidemic process. Data from the sectoral statistical reporting of the Ministry of Health of Ukraine, Sumy Regional Laboratory Center, the Main Department of Statistics in Sumy Oblast, Sumy Regional Center of Hydrometeorology were used. Epidemiological and statistical research methods were used. It was established that in Sumy Oblast the epidemic process of aerosol viral infections was characterized by a pronounced tendency to reduced incidence of influenza (Rinc.aver.= -6.2 %) and rubella (Rinc.aver.= -22.7 %), moderate reduction tendency ‒ to mumps (Rinc.aver = -2.4 %); high intensity with no reduction in incidence ‒ for other acute respiratory diseases (Rinc.aver = 0.2 %); a sharp increase in the incidence of measles (Rinc.aver.= 23.1 %). Coronavirus infection caused by SARS-CoV-2 was found in 3% of the population. The average long-term rates of measles, rubella, and mumps vaccinations with MPR-1 and MPR-2 vaccines were 70.9 % and 61.2 %, respectively. An inverse correlation was established between air humidity, population, coefficients of natural and migratory movement and measles incidence (p<0.05). The system of epidemiological surveillance of infections of viral etiology with aerosol transmission requires new approaches to the development of preventive measures.