4.Control measures and the outcome of the measles epidemic of 1999 in the Eastern Highlands Province
J. M. Mgone ; C. S, Mgone ; T. Duke ; D. Frank ; W. Yeka
Papua New Guinea medical journal 2000;43(1-2):91-97
In the Eastern Highlands Province (EHP) of Papua New Guinea (PNG) measles outbreaks have occurred regularly every 3 to 4 years since 1980. The latest was between September 1998 and March 2000. Between July 1999 and March 2000 314 children with measles were reviewed at Goroka Base Hospital. The majority of these children were very young: 55% were under 1 year and 27% under 6 months. The median age of the measles cases was 11 months (range 10 days to 13 years). 40% of the children had a verifiable history of having received at least one dose of measles vaccine. The majority were vaccinated during the epidemic and included many children who either were below 6 months of age or who developed measles within 2 weeks of vaccination. Measles complications occurred in 82% of the children, the most common being pneumonia. Serious complications, particularly severe pneumonia, were more common among the unvaccinated children than in those who had received at least a single dose of the measles vaccine. No deaths occurred among 82 children who had received measles vaccine more than 2 weeks before the onset of clinical measles, compared with 10 deaths in 206 children who had never been vaccinated against measles or were vaccinated in the 2 weeks before presentation (p=0.067). The overall case fatality was 4%: 14% among the hospital-acquired and 2.5% in community-acquired measles. Improvement in the measles vaccination coverage and supplementary vaccination campaigns are required to prevent measles outbreaks in PNG. Intensified measles vaccination campaigns, such as the one conducted in EHP in 1999, are recommended during epidemics to minimize deaths due to measles and to rapidly control outbreaks. The efficacy of measles vaccination can only be measured in total mortality, not in the prevention of clinical measles.
Adolescent
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Child, Preschool
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Disease Outbreaks
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Measles - epidemiology
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Measles - prevention &
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control
5.Epidemiological analysis of cases with rash and fever illness after measles vaccine inoculation during 1999 to 2002 in Shandong province, China.
Ai-qiang XU ; Qing XU ; Li-zhi SONG ; Zuo-kui XIAO ; Li ZHANG ; Chang-yin WANG ; Tong-zhan WANG ; Ren-peng LI ; Man-shi LI ; Zhen LI
Chinese Journal of Epidemiology 2004;25(5):417-420
OBJECTIVETo study the incidence of cases with rash and fever illness (RFIs) after measles vaccine (MV) inoculation.
METHODSDuring 1999 to 2002, 150 RFIs cases reported by the special measles surveillance system in Shandong province, China, were investigated and analyzed epidemiologically.
RESULTS7 674 690 ml MV were distributed during 1999 to 2002 and the annual average incidence of RFIs cases after MV inoculation was 0.20/10 000 ml (0.2 ml per dose). There was significant difference of incidences each year (chi(2) = 10.13, P < 0.05). All RFIs cases were sporadically distributed without epidemiological links. Clinical symptoms showed that 88.67% of the 150 RFIs cases having > 38.5 degrees C fever and 75.33% of all cases appeared typical rash after 4 to 11 days (the medium was 8 days) after MV inoculation. The order of rash onset among RFIs cases was consistent with that of regular measles cases caused by wild virus. 68.67% of the RFIs cases had first MV inoculation and 94.71% were 8 to 12 month-olds. IgM sera antibody test from RFIs cases were rubella negative and 45.65% positive for measles.
CONCLUSIONRFIs due to allergic reaction or measles vaccine virus infection might occur after MV inoculation. There seemed to be a correlation between RFIs incidence and the doses of MV. Measles virus genotype analysis needs to be carried out to confirm if the onset of some RFIs cases is aetiologically associated to MV vaccine virus infection.
Exanthema ; etiology ; virology ; Fever ; etiology ; virology ; Humans ; Measles ; prevention & control ; Measles Vaccine ; adverse effects ; Measles virus ; immunology ; Polymerase Chain Reaction ; Vaccination
6.Epidemiological Investigation of a Measles Outbreak in a Preschool in Incheon, Korea, 2006.
Jae Sung SO ; Un Yeong GO ; Dong Han LEE ; Koang Suk PARK ; Jong Koo LEE
Journal of Preventive Medicine and Public Health 2008;41(3):153-158
OBJECTIVES: This study describes a plan that was designed to prevent a measles outbreak that showed a changed outbreak pattern. This study is based on the epidemiological investigation of a measles outbreak in a preschool in Incheon, Korea, 2006. METHODS: The subjects were 152 students at a preschool where a measles outbreak occurred. A questionnaire survey was conducted and serological testing for measlesspecific IgM was preformed. RESULTS: Of the fifteen confirmed, identified cases, eleven patients had been vaccinated with one dose, one patient had received two doses and three patients were unvaccinated. The three unvaccinated cases consisted of one 5-year-old child, one 3-year-old child and one 16-month-old infant. For the cases with one dose of the vaccination, there were 11 cases, which consisted of six 5-year-old children, two 4-year-old children, two 3-year-old children and one 2-year-old child. The case with two doses of the vaccination was one 4-year-old child. The attack rate of measles was 100% in the 0-dose group, 11.2% in the 1-dose group and 2.0% in the 2-dose group. The vaccine's efficacy was 88.8% in the 1-dose group and 98.0% in the 2-dose group. The vaccine effectiveness for the 2-dose group was higher than that of the 1-dose group. CONCLUSIONS: High coverage with a 2-dose vaccination should be maintained, and the vaccination should be given at the suitable time to prevent a measles outbreak with a changed outbreak pattern.
Child, Preschool
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*Disease Outbreaks/prevention & control
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Humans
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Immunization Programs
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Korea
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Measles/*epidemiology/immunology/*prevention & control/virology
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Measles Vaccine/*administration & dosage
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Preventive Medicine
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Questionnaires
7.Study on a high coverage of measles vaccine while high incidence of measles disease still appeared in Shaanxi province.
Ping LI ; Yuan SI ; Yi LIU ; Rong-hui GUAN
Chinese Journal of Epidemiology 2007;28(11):1096-1100
OBJECTIVETo analyze the affecting factors on the cause of measles and measles vaccine under the high coverage of measles vaccine in Shaanxi province.
METHODSAge distribution and vaccination history on measles cases were studied. Throat swabs were obtained from measles cases. Measles virus was isolated from collected specimens with phenol-chloroform extraction method. Amplification was performed by RT-PCR in order to amplify 450 bp fragment of the -COOH side of N gene,and then the sequences of PCR products were detected to confirm the gene type of measles virus. Sera were obtained from patients who were in acute phase of measles disease,and antibody titer against measles vaccine strain and wild strain were determined by small amounts neutralization test.
RESULTSMeasles cases with the history of measles vaccination were accounted for 38.97% of the total numbers. The geometrical mean titer (GMT) (56.18) against S191 attenuated strain was significant higher than that of wild strain (26.90) among these measles patients with history of having received measles vaccination. The GMT (25.40) against S191 attenuated strain was similar to that of wild strain (27.86) among these measles patients with non-history of measles vaccination. The antibody negative rate against wild strain was 19.15% to these sera from patients with the history of measles vaccination and antibody potency against S191 strain was less than 16.
CONCLUSIONThe appearance of higher measles incidence under the higher coverage of measles vaccine indicated that measles epidemic strain might degenerate as the result regarding the failure of the present measles vaccine in protecting the transmission of H1 wild strain.
Age Distribution ; Antibodies, Viral ; blood ; Base Sequence ; China ; epidemiology ; Disease Outbreaks ; prevention & control ; Humans ; Incidence ; Measles ; epidemiology ; prevention & control ; Measles Vaccine ; administration & dosage ; Measles virus ; genetics ; isolation & purification ; Molecular Sequence Data ; Neutralization Tests
8.Study on the epidemiological characteristics of measles in Henan province during 2004-2006.
Lin-Qi DIAO ; Kai KANG ; Yan-Yang ZHANG ; Ying YE
Chinese Journal of Epidemiology 2007;28(8):761-764
OBJECTIVETo understand the epidemiological characteristics of measles in Henan province during 2004-2006 and to evaluate the quality of measles special report system (MSS) in order to provide evidence for strategies and measures development for measles prevention and control.
METHODSData were collected from the National Notifiable Disease Report System (NNDRS) and MSS on epidemiological characteristics of measles in Henan province during 2004-2006.
RESULTSThe sensitivity of MSS was lower than that of NNDRS in Henan province during 2004-2006. The incidence of measles appeared to be 2.54/100 000 in 2004 increased to 8/100 000 during 2005-2006. The incidence of measles was higher in the central part of the province during the recent years with cases concentrated in March to May every year. The percentage of cases from age groups < 8 months and 8 months to 1 year olds increased yearly. All the cases with no or unclear vaccination record took up 77.13%, with 18.23% of the measles cases fell into the floating population.
CONCLUSIONImproving the 2 doses and timely coverage rate of the first dose of measles vaccine strategy was essential for measles control and prevention. In order to improve the quality of measles surveillance program, the advantage of MSS and NNDRS should be integrated.
Adolescent ; Child ; Child, Preschool ; China ; epidemiology ; Humans ; Incidence ; Infant ; Measles ; epidemiology ; prevention & control ; Population Surveillance
9.Analysis of measles immunity level in persistent populations in Beijing, 2012.
Juan LI ; Li LU ; Meng CHEN ; Fang HUANG ; Yang ZENG ; Xiao-mei LI ; Rui MA ; Jing-bin PAN ; Mu SUN ; Hao SUN ; Zhong-zhan WANG ; Fang-ru GUO ; Yi-hua ZHANG ; Feng-shuang WANG ; Tao WU ; De-jun CUI ; Xing-hui PENG ; Jiang WU ; Xing-huo PANG
Chinese Journal of Preventive Medicine 2013;47(10):916-919
OBJECTIVETo analyze the measles immunity level of persistent population in Beijing.
METHODSA total of 2125 objects from 10 age groups, who had been living in Beijing for over 6 months, were selected from urban and rural areas in Beijing in 2012. Demographic characteristics, history of measles and vaccine immunization were investigated by questionnaire. 5 ml blood sample of each subject was collected, and the Measles IgG antibody was measured by ELISA assay.
RESULTSPositive rate of measles antibody was 84.71% (1800/2125) and standardized positive rate was 88.07% . Median of antibody was 960.46 IU/L. Positive rate and median of measles antibody were significantly different between population from different age groups (χ(2) = 341.60, P < 0.01; H = 216.27, P < 0.01). Antibody positive rate and median were lowest in the <1 year age group, which were separately 43.06% (90/209) and 185.80 IU/L; and highest in the 1-4 (97.31% (181/186) and 2448.81 IU/L) and 5-9 years age group (96.46% (218/226) and 1910.72 IU/L). The range of antibody positive rate and median in adults of ≥ 15 years were 81.98%-90.14% and 744.38-1474.84 IU/L. Antibody positive rate and median in persistent population, which were separately 82.45% (883/1071) and 899.82 IU/L, were lower than those in migrant population, which were 87.00% (917/1054) and 166.19 IU/L, respectively (χ(2) = 8.51, P < 0.01;U = 538 704.00, P < 0.01). Antibody positive rate and median in population with vaccination history, which were separately 91.95% (891/969) and 1443.11 IU/L, were higher than those population without vaccination history and people whose history unknown (32.95% (57/173) , 127.33 IU/L; 86.67% (852/983) , 923.73 IU/L). The difference showed statistical significance (χ(2) = 399.92, P < 0.01; H = 202.11, P < 0.01).
CONCLUSIONAmong the persistent population in China, measles antibody level among the children aging 1-9 years old was high enough to prevent outbreak and epidemic of measles. However, we should try our best to strengthen the measles antibody level among the babies younger than 1 year old and the migrant population aging between 15 and 40 years old.
Adolescent ; Adult ; Antibodies, Viral ; blood ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Male ; Measles ; epidemiology ; immunology ; prevention & control ; Measles virus ; Young Adult
10.Study on the risk factors of measles among the 8-month-olds and children≥15 years of age in Gansu province.
Ningjing ZHANG ; Xiaoshu ZHANG ; Hong FU ; Jing AN ; Ying CHEN ; Na JIN ; Bingling ZHANG ; Hui LI
Chinese Journal of Epidemiology 2014;35(10):1095-1098
OBJECTIVETo understand the risk factors of measles among babies under 8-months-old and people ≥15 years old, in Gansu province.
METHODSLaboratory-confirmed measles cases were divided into two groups among children below 8-months-old and those ≥15 year olds. Descriptive epidemiology and 1:3 case control study were conducted to find out those related risk factors as:hospital exposure, contact with measles cases, vaccination, history of measles etc. so as to determine the risk factors and appropriate control measures.
RESULTSHistories of hospital exposure, contact with measles cases and travelling to other cities were risk factors for measles among babies younger than 8-months and people ≥15 year olds. Vaccination appeared a protective factor for people ≥15 years of age. From 42 cases and 126 controls, through multivariate analysis, results showed that hospital exposure was the only significant factor ( OR = 29.23, 95%CI:2.82-302.89)for those babies younger than 8-months. Factors as hospital exposure and travelling among cities for 7-21 days before being infected, were with significant importance ( OR = 5.15, 95% CI:2.28-11.63; OR = 5.48, 95%CI:1.38-21.69)for people ≥15 years of age, according to the observation from 74 cases and 222 controls.
CONCLUSIONIn order to reduce the incidence of measles among babies under 8-month-old and people ≥15 years old, efforts on control of nosocomial infection should be strengthened, while the routine immunization coverage need to be increased for the children at higher risks, to reduce the source of infection.
Adolescent ; Case-Control Studies ; China ; epidemiology ; Cross Infection ; Humans ; Incidence ; Infant ; Measles ; diagnosis ; epidemiology ; prevention & control ; Measles Vaccine ; administration & dosage ; Risk Factors ; Vaccination ; utilization