Humans ; Measles ; prevention & control ; Measles Vaccine

China ; Humans ; Measles ; prevention & control ; Measles Vaccine ; Vaccination

child ; Human ; Infant ; Measles - immunology ; Measles - prevention & ; control ; Vaccination

Asian Continental Ancestry Group ; China ; Humans ; Laboratories ; organization & administration ; Measles ; prevention & control ; Measles Vaccine ; administration & dosage

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 ; Child, Preschool ; Disease Outbreaks ; Measles - epidemiology ; Measles - prevention & ; control

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

OBJECTIVETo evaluate the development and operation on measles surveillance system.

METHODSTo formulate surveillance program, and then establish surveillance system on measles in Hainan province before the case surveillance was conducted. Descriptive epidemiological method was used to analyze the measles cases reported through the notifiable diseases epidemic situation report system and measles surveillance system during 2004 - 2008 in Hainan province.

RESULTSFrom 2004 to 2008, through surveillance system, 3040 suspected measles cases were reported which was 96.00% higher than that from the notifiable diseases epidemic situation report system. When the measles surveillance system was first established in 2004, the number of cases reported by the surveillance system was less than that from the epidemic report system, however, the sensitivity of the surveillance system had been increasing since 2005. In 2008, the number of suspected cases reported by surveillance system was 19.12 times more than from the epidemic report system. The proportion of confirmed cases in the total suspected cases was decreasing annually, from 90.34% to 4.48%, along with the increase of the sample collection rate, from 22.73% to 99.12%. The proportion of laboratory confirmed cases in the total confirmed cases increased from 7.55% to 86.97%. With suspected cases, the IgM antibody positive rate on measles and rubella were 31.57% and 34.52%, respectively. In Hainan, the epidemic pattern of measles had been sporadic, except for 2006 as there occurred several outbreaks in that year. The of disease incidence had an obvious seasonal peaks, from March to June. Measles mainly attacked children under 15 years of age, accounted for 86.68% of the age group. Children with no immunity or unknown immune history accounted for 85.67%.

CONCLUSIONThe sensitivity of surveillance system had been increasing annually since it was developed and the incidence had been dropping to its lowest level. These achievements had built a solid foundation for the eventual elimination of measles.

China ; epidemiology ; Disease Outbreaks ; prevention & control ; Humans ; Incidence ; Measles ; epidemiology ; prevention & control ; Population Surveillance

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 ; *Disease Outbreaks/prevention & control ; Humans ; Immunization Programs ; Korea ; Measles/*epidemiology/immunology/*prevention & control/virology ; Measles Vaccine/*administration & dosage ; Preventive Medicine ; Questionnaires

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

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