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Wang W, O'Driscoll M, Wang Q, Zhao S, Salje H, Yu H. Dynamics of measles immunity from birth and following vaccination. Nat Microbiol 2024:10.1038/s41564-024-01694-x. [PMID: 38740931 DOI: 10.1038/s41564-024-01694-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/03/2024] [Indexed: 05/16/2024]
Abstract
Measles remains a major threat to human health despite widespread vaccination. While we know that maternal antibodies can impair vaccine-induced immunity, the relative contributions of pre-existing immunity levels, maternal and infant characteristics on vaccine responses remain unclear, hampering evidence-based vaccination policy development. Here we combine serological data from 1,505 individuals (aged 0-12 years) in a mother-infant cohort and in a child cohort with empirical models to reconstruct antibody trajectories from birth. We show that while highly heterogeneous across a population, measles antibody evolution is strongly predictive from birth at the individual level, including following vaccination. Further, we find that caesarean section births were linked with 2.56 (95% confidence interval: 1.06-6.37) increased odds of primary vaccine failure, highlighting the long-term immunological consequences of birth route. Finally, we use our new understanding of antibody evolution to critically assess the population-level consequences of different vaccination schedules, the results of which will allow country-level evaluations of vaccine policy.
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Affiliation(s)
- Wei Wang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | | | - Qianli Wang
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Sihong Zhao
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Henrik Salje
- Department of Genetics, University of Cambridge, Cambridge, UK.
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China.
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
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Deng LL, Han YJ, Li ZW, Wang DY, Chen T, Ren X, He GX. Epidemiological characteristics of seven notifiable respiratory infectious diseases in the mainland of China: an analysis of national surveillance data from 2017 to 2021. Infect Dis Poverty 2023; 12:99. [PMID: 37953290 PMCID: PMC10642048 DOI: 10.1186/s40249-023-01147-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/11/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Respiratory infectious diseases (RIDs) remain a pressing public health concern, posing a significant threat to the well-being and lives of individuals. This study delves into the incidence of seven primary RIDs during the period 2017-2021, aiming to gain deeper insights into their epidemiological characteristics for the purpose of enhancing control and prevention strategies. METHODS Data pertaining to seven notifiable RIDs, namely, seasonal influenza, pulmonary tuberculosis (PTB), mumps, scarlet fever, pertussis, rubella and measles, in the mainland of China between 2017 and 2021 were obtained from the National Notifiable Disease Reporting System (NNDRS). Joinpoint regression software was utilized to analyze temporal trends, while SaTScan software with a Poisson probability model was used to assess seasonal and spatial patterns. RESULTS A total of 11,963,886 cases of the seven RIDs were reported during 2017-2021, and yielding a five-year average incidence rate of 170.73 per 100,000 individuals. Among these RIDs, seasonal influenza exhibited the highest average incidence rate (94.14 per 100,000), followed by PTB (55.52 per 100,000), mumps (15.16 per 100,000), scarlet fever (4.02 per 100,000), pertussis (1.10 per 100,000), rubella (0.59 per 100,000), and measles (0.21 per 100,000). Males experienced higher incidence rates across all seven RIDs. PTB incidence was notably elevated among farmers and individuals aged over 65, whereas the other RIDs primarily affected children and students under 15 years of age. The incidences of PTB and measles exhibited a declining trend from 2017 to 2021 (APC = -7.53%, P = 0.009; APC = -40.87%, P = 0.02), while the other five RIDs peaked in 2019. Concerning seasonal and spatial distribution, the seven RIDs displayed distinct characteristics, with variations observed for the same RIDs across different regions. The proportion of laboratory-confirmed cases fluctuated among the seven RIDs from 2017 to 2021, with measles and rubella exhibiting higher proportions and mumps and scarlet fever showing lower proportions. CONCLUSIONS The incidence of PTB and measles demonstrated a decrease in the mainland of China between 2017 and 2021, while the remaining five RIDs reached a peak in 2019. Overall, RIDs continue to pose a significant public health challenge. Urgent action is required to bolster capacity-building efforts and enhance control and prevention strategies for RIDs, taking into account regional disparities and epidemiological nuances. With the rapid advancement of high-tech solutions, the development and effective implementation of a digital/intelligent RIDs control and prevention system are imperative to facilitate precise surveillance, early warnings, and swift responses.
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Affiliation(s)
- Le-le Deng
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Ya-Jun Han
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Zhuo-Wei Li
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Da-Yan Wang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Tao Chen
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
| | - Xiang Ren
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning On Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
| | - Guang-Xue He
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
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Choi S, Chung JW, Chang YJ, Lim EJ, Moon SH, Do HH, Lee JH, Cho SM, Kwon BS, Chung YS, Park SY. A Lesson from a Measles Outbreak among Healthcare Workers in a Single Hospital in South Korea: The Importance of Knowing the Prevalence of Susceptibility. Vaccines (Basel) 2023; 11:1505. [PMID: 37766181 PMCID: PMC10535736 DOI: 10.3390/vaccines11091505] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Despite the high vaccination coverage rate, in-hospital transmission of measles continues to occur in South Korea. We present a measles outbreak in which two healthcare workers (HCWs) with presumptive evidence of measles immunity were infected by a patient with typical measles at a single hospital in South Korea. This facilitated the evaluation of measles seroprevalence in all HCWs. METHODS In 2018, suspected patients and contacts exposed during a measles outbreak were investigated based on their medical histories and vaccination status. Cases were confirmed by the detection of measles-specific immunoglobulin M or RNA. After the measles outbreak in 2018, measles IgG testing was conducted on a total of 972 HCWs for point-prevalence, including those exposed to the measles. In addition, we have routinely performed measles IgG tests on newly employed HCWs within one week of their hire date since 2019. The measles vaccine was administered to HCWs who tested negative or equivocally negative for IgG antibodies. RESULTS An index patient who returned from China with fever and rash was diagnosed with measles at a hospital in Korea. Two additional HCWs were revealed as measles cases: one was vaccinated with the two-dose measles-mumps-rubella (MMR) vaccine, and the other, who was born in 1967, was presumed to have immunity from natural infection in South Korea. All three patients harbored the same D8 genotype. No additional measles cases were identified among the 964 contacts of secondary patients. A total of 2310 HCWs, including those tested during the 2018 outbreak, underwent measles IgG tests. The average age at the time of the test was 32.6 years, and 74.3% were female. The overall seropositivity of measles was 88.9% (95% confidence interval, 87.5-90.1). Although the birth cohorts between 1985 and 1994 were presumed to have received the measles-rubella (MR) catch-up vaccination in 2001, 175 (89.3%) HCWs were born after 1985 among the 195 seronegative cases. CONCLUSION Despite high population immunity, imported measles transmission occurred among HCWs with presumed immunity. This report underscores the importance of understanding the prevalence of measles susceptibility among newly employed HCWs. This is important for policymaking regarding hospital-wide vaccinations to prevent the spread of vaccine-preventable diseases.
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Affiliation(s)
- Sungim Choi
- Department of Infectious Diseases, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea;
- Department of Infection Control, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
| | - Jae-Woo Chung
- Department of Infection Control, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
- Department of Laboratory Medicine, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
| | - Yun Jung Chang
- Department of Infection Control, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
| | - Eun Jung Lim
- Department of Infection Control, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
| | - Sun Hee Moon
- Department of Infection Control, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
| | - Han Ho Do
- Department of Emergency Medicine, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
| | - Jeong Hun Lee
- Department of Emergency Medicine, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
| | - Sung-Min Cho
- Department of Pediatrics, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
| | - Bum Sun Kwon
- Department of Rehabilitation Medicine, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
| | - Yoon-Seok Chung
- Division of Infectious Disease Diagnosis Control, Honam Regional Center for Disease Control and Prevention, Korea Disease Control and Prevention Agency, Gwangju 61947, Gyeonggi-do, Republic of Korea
| | - Seong Yeon Park
- Department of Infectious Diseases, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea;
- Department of Infection Control, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
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Chen J, Zhang W, Wang Y, Yang W. Determinants of measles persistence in Beijing, China: A modelling study. Epidemiol Infect 2023; 151:e144. [PMID: 37605994 PMCID: PMC10540187 DOI: 10.1017/s0950268823001322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/10/2023] [Accepted: 08/15/2023] [Indexed: 08/23/2023] Open
Abstract
In Beijing, the capital of China, routine measles mass vaccination has been in place for decades with high coverage; and since the 2000s, catch-up vaccination programmes have been implemented for migrant workers coming to the city. However, measles epidemics in Beijing persisted. Here, we explored the contributing factors of persistent measles transmission in Beijing using an epidemic model in conjunction with a particle filter. Model inputs included data on birth, death, migration, and vaccination. We formulated a series of hypotheses covering the impact of migrant influx, early waning of maternal immunity, and increased mixing among infants; we compared the plausibility of the hypotheses based on model fit to age-grouped, weekly measles incidence data from January 2005 to December 2014, and out-of-fit prediction during 2015-2019. Our best models showed close agreement with the data, and the out-of-fit prediction generally captured the trend of measles incidence from 2015 to 2019. We found that large influx of migrants with considerably higher susceptibility likely contributed to the persistent measles transmission in Beijing. Our findings suggest that stronger catch-up vaccination programmes for migrants may help eliminate measles transmission in Beijing.
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Affiliation(s)
- Jianjiu Chen
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Yong Wang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Wan Yang
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA
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5
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Jia Y, Xu Q, Zhu Y, Li C, Qi C, She K, Liu T, Zhang Y, Li X. Estimation of the relationship between meteorological factors and measles using spatiotemporal Bayesian model in Shandong Province, China. BMC Public Health 2023; 23:1422. [PMID: 37491220 PMCID: PMC10369697 DOI: 10.1186/s12889-023-16350-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/19/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Measles-containing vaccine (MCV) has been effective in controlling the spread of measles. Some countries have declared measles elimination. But recently years, the number of cases worldwide has increased, posing a challenge to the global goal of measles eradication. This study estimated the relationship between meteorological factors and measles using spatiotemporal Bayesian model, aiming to provide scientific evidence for public health policy to eliminate measles. METHODS Descriptive statistical analysis was performed on monthly data of measles and meteorological variables in 136 counties of Shandong Province from 2009 to 2017. Spatiotemporal Bayesian model was used to estimate the effects of meteorological factors on measles, and to evaluate measles risk areas at county level. Case population was divided into multiple subgroups according to gender, age and occupation. The effects of meteorological factors on measles in subgroups were compared. RESULTS Specific meteorological conditions increased the risk of measles, including lower relative humidity, temperature, and atmospheric pressure; higher wind velocity, sunshine duration, and diurnal temperature variation. Taking lowest value (Q1) as reference, RR (95%CI) for higher temperatures (Q2-Q4) were 0.79 (0.69-0.91), 0.54 (0.44-0.65), and 0.48 (0.38-0.61), respectively; RR (95%CI) for higher relative humidity (Q2-Q4) were 0.76 (0.66-0.88), 0.56 (0.47-0.67), and 0.49 (0.38-0.63), respectively; RR (95%CI) for higher wind velocity (Q2-Q4) were 1.43 (1.25-1.64), 1.85 (1.57-2.18), 2.00 (1.59-2.52), respectively. 22 medium-to-high risk counties were identified, mainly in northwestern, southwestern and central Shandong Province. The trend was basically same in the effects of meteorological factors on measles in subgroups, but the magnitude of the effects was different. CONCLUSIONS Meteorological factors have an important impact on measles. It is crucial to integrate these factors into public health policies for measles prevention and control in China.
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Affiliation(s)
- Yan Jia
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Qing Xu
- Institute of Immunization and Preventive Management, Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Yuchen Zhu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Chunyu Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Chang Qi
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Kaili She
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Tingxuan Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Ying Zhang
- Faculty of Medicine and Health, School of Public Health, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Xiujun Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
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Zhao L, Wang Y, Chen X, Yang L, Cai M, Zhang Z, Zhang Y, Ma Y. Clinical characteristics of adult inpatients with Measles in Beijing from 2010 to 2021: a retrospective analysis. BMC Infect Dis 2023; 23:312. [PMID: 37161385 PMCID: PMC10169103 DOI: 10.1186/s12879-023-08256-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/15/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND With the measles vaccine coverage rate gradually increasing, adult patients' epidemiological and clinical characteristics have changed. AIMS To analyze the clinical characteristics of adult measles patients in Beijing Youan Hospital. METHODS We retrospectively reviewed the electronic medical records of 818 patients diagnosed with measles at Beijing Youan Hospital between June 2010 and October 2021. We divided all hospitalized patients into two demographics groups, using 14 years of age as the cut-off. RESULTS Of the adult inpatients, 110 (74.83%) were aged 20-40. There was an overall peak incidence in 2014, and yearly peaks came in April. Fever, cough, erythema, and Koplik's spots were present in 79.59%, 82.1%, 99.3%, and 59.8% of the adult group, respectively, compared to 75.26%, 92.0%, 99.9%, and 39.0% of the pediatric group. Decreased lymphocytes and hepatic impairment were common in adults. The adult group's median level of C-reactive protein was higher than that of the pediatric group (p < 0.05). The positive rate of measles antibody (IgM) detection was 64.6% in the adults and 78.8% in the pediatric group (p < 0.05). Of the adults, 46.9%, 8.8%, and 66% had pneumonia, gastroenteritis, and antibiotic use, compared to 89.6%, 2.7%, and 83.2% of the pediatric patients. The duration of symptoms before admission and the average length of hospital stay was approximately six days in both groups. CONCLUSIONS Koplik's spots are more likely to be detected by clinicians in adult patients admitted to the hospital. Active surveillance is helpful for adults who are negative for IgM on admission. Although the proportion of adult measles patients with liver injury is high, the disease is generally mild. Measles significantly impacts peripheral blood lymphocytes in adults, but adults are at lower risk of concurrent pneumonia than the pediatric group. Clinicians need to pay attention to the appropriate use of antibiotics. Expanding the coverage of the measles vaccination in high-risk areas is beneficial for preventing measles in adults.
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Affiliation(s)
- Lixue Zhao
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
- Department of Respiratory and Critical Care Medicine, Beijing LiangXiang Hospital, Capital Medical University, Beijing, 102401, China
| | - Yu Wang
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Xue Chen
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Liu Yang
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Miaotian Cai
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Zhili Zhang
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Yulin Zhang
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
| | - Yingmin Ma
- Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
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Wang Q, Wang W, Winter AK, Zhan Z, Ajelli M, Trentini F, Wang L, Li F, Yang J, Xiang X, Liao Q, Zhou J, Guo J, Yan X, Liu N, Metcalf CJE, Grenfell BT, Yu H. Long-term measles antibody profiles following different vaccine schedules in China, a longitudinal study. Nat Commun 2023; 14:1746. [PMID: 36990986 PMCID: PMC10054217 DOI: 10.1038/s41467-023-37407-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 03/13/2023] [Indexed: 03/31/2023] Open
Abstract
Characterizing the long-term kinetics of maternally derived and vaccine-induced measles immunity is critical for informing measles immunization strategies moving forward. Based on two prospective cohorts of children in China, we estimate that maternally derived immunity against measles persists for 2.4 months. Following two-dose series of measles-containing vaccine (MCV) at 8 and 18 months of age, the immune protection against measles is not lifelong, and antibody concentrations are extrapolated to fall below the protective threshold of 200 mIU/ml at 14.3 years. A catch-up MCV dose in addition to the routine doses between 8 months and 5 years reduce the cumulative incidence of seroreversion by 79.3-88.7% by the age of 6 years. Our findings also support a good immune response after the first MCV vaccination at 8 months. These findings, coupled with the effectiveness of a catch-up dose in addition to the routine doses, could be instrumental to relevant stakeholders when planning routine immunization schedules and supplemental immunization activities.
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Affiliation(s)
- Qianli Wang
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
| | - Wei Wang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Amy K Winter
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA
| | - Zhifei Zhan
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Marco Ajelli
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Filippo Trentini
- Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy
| | - Lili Wang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Fangcai Li
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Juan Yang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Xingyu Xiang
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Qiaohong Liao
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jiaxin Zhou
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Jinxin Guo
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Xuemei Yan
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Nuolan Liu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - C Jessica E Metcalf
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
- Princeton School of Public and International Affairs, Princeton University, Princeton, NJ, USA
| | - Bryan T Grenfell
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
- Princeton School of Public and International Affairs, Princeton University, Princeton, NJ, USA
| | - Hongjie Yu
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China.
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
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Wang Z, Yan X, Zhao M, Zhang S, Jia Z. Spatial and temporal distribution of emerging airborne viral infectious diseases outbreaks on a global scale. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-11. [PMID: 36852013 PMCID: PMC9947442 DOI: 10.1007/s10389-023-01850-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023]
Abstract
Aim This study aimed to explore the spatial and temporal characteristics of emerging airborne viral infectious diseases outbreaks worldwide. Subject and methods We conducted a systematic literature review on outbreaks of emerging airborne viral infectious diseases and calculated outbreak number and intensity at the country level. Fisher's exact test was used to compare the viral infectious diseases outbreaks in different income-level regions. To identify the major airborne viral infectious diseases outbreaks, we ranked and extracted the leading viral infectious diseases in outbreak number and intensity in each country by year. Results A total of 2505 outbreaks were reported from 1873 to 2021 across 2010 studies. There were 47 countries (47/130, 36.15%) with more frequent emerging airborne viral infectious disease outbreaks (more than nine outbreaks), and these countries mainly distributed in high-income regions (22/47 countries, 46.81%, p < 0.05), especially in Western Europe (14/47 countries, 29.79%, p < 0.05). The number of overall outbreaks was more in the United States and China than in other countries in different years. Outbreaks of measles and influenza are always frequent and intense. Highly pathogenic human coronaviruses infection caused short-term pandemics during which their outbreak number and intensity exceeded other viruses. Rift valley fever outbreaks in the human population are spreading outside of Africa through the flow of goods and travelers. Conclusion Countries in high-income regions reported more emerging airborne viral infectious diseases outbreaks, especially in the Western European region, the United States, and China. It is urgent to strengthen collaborative surveillance of emerging airborne viruses, cross-border flow of goods and travelers, and ecological environment to avoid the spread of viral infectious diseases outbreaks worldwide. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-023-01850-3.
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Affiliation(s)
- Zekun Wang
- School of Public Health, Peking University, 38 Xueyuan Rd, Beijing, 100191 Haidian District China
| | - Xiangyu Yan
- School of Public Health, Peking University, 38 Xueyuan Rd, Beijing, 100191 Haidian District China
| | - Mingchen Zhao
- School of Public Health, Peking University, 38 Xueyuan Rd, Beijing, 100191 Haidian District China
| | - Shan Zhang
- School of Public Health, Peking University, 38 Xueyuan Rd, Beijing, 100191 Haidian District China
| | - Zhongwei Jia
- School of Public Health, Peking University, 38 Xueyuan Rd, Beijing, 100191 Haidian District China
- Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, 100191 China
- Center for Drug Abuse Control and Prevention, National Institute of Health Data Science, Peking University, Beijing, 100191 China
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Deng L, Han Y, Wang J, Liu H, Li G, Wang D, He G. Epidemiological Characteristics of Notifiable Respiratory Infectious Diseases in Mainland China from 2010 to 2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3946. [PMID: 36900957 PMCID: PMC10002032 DOI: 10.3390/ijerph20053946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
Respiratory infectious diseases (RIDs) pose threats to people's health, some of which are serious public health problems. The aim of our study was to explore epidemic situations regarding notifiable RIDs and the epidemiological characteristics of the six most common RIDs in mainland China. We first collected the surveillance data of all 12 statutory notifiable RIDs for 31 provinces in mainland China that reported between 2010 and 2018, and then the six most prevalent RIDs were selected to analyze their temporal, seasonal, spatiotemporal and population distribution characteristics. From 2010 to 2018, there were 13,985,040 notifiable cases and 25,548 deaths from RIDs in mainland China. The incidence rate of RIDs increased from 109.85/100,000 in 2010 to 140.85/100,000 in 2018. The mortality from RIDs ranged from 0.18/100,000 to 0.24/100,000. The most common RIDs in class B were pulmonary tuberculosis (PTB), pertussis, and measles, while those in class C were seasonal influenza, mumps and rubella. From 2010 to 2018, the incidence rate of PTB and rubella decreased; however, pertussis and seasonal influenza increased, with irregular changes in measles and mumps. The mortality from PTB increased from 2015 to 2018, and the mortality from seasonal influenza changed irregularly. PTB was mainly prevalent among people over 15 years old, while the other five common RIDs mostly occurred among people younger than 15 years old. The incidence of the six common RIDs mostly occurred in winter and spring, and they were spatiotemporally clustered in different areas and periods. In conclusion, PTB, seasonal influenza and mumps remain as public health problems in China, suggesting that continuous government input, more precise interventions, and a high-tech digital/intelligent surveillance and warning system are required to rapidly identify emerging events and timely response.
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Affiliation(s)
- Lele Deng
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Yajun Han
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Jinlong Wang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Haican Liu
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Guilian Li
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Dayan Wang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Guangxue He
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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10
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Wang H, Zhu Z, Duan X, Song J, Mao N, Cui A, Wang C, Du H, Wang Y, Li F, Zhou S, Feng D, Li C, Gao H, He J, Li L, Lei Y, Zheng H, Gong T, Hu Y, Xu C, Zhao H, Sun Z, Chen Y, Tang X, Chen M, Deng L, Wang S, Tian X, Zhang T, Si Y, Yuan F, Fan L, Mahemutijiang K, Chen Z, Chen H, Xu W, Zhang Y. Transmission Pattern of Measles Virus Circulating in China During 1993-2021: Genotyping Evidence Supports That China Is Approaching Measles Elimination. Clin Infect Dis 2023; 76:e1140-e1149. [PMID: 36037029 DOI: 10.1093/cid/ciac674] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/04/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To provide useful insights into measles elimination progress in China, measles surveillance data were reviewed, and the transmission patterns of measles viruses circulating in China during 1993-2021 were analyzed. METHODS Measles incidence data from the National Notifiable Disease Reporting System of the China Center for Disease Control and Prevention were analyzed. A total of 17 570 strains were obtained from 30 of 31 provinces in mainland China during 1993-2021. The recommended genotyping window was amplified. Genotyping analysis was conducted for comparison with the reference strains. Phylogenetic analyses were performed to identify genetic relationships among different lineages within the genotypes. RESULTS With high coverage of routine immunization and intensive supplementary immunization activities, measles incidence has shown a downward trend since 1993, despite 2 resurgences, reaching a historic low level in 2020-2021 (average 0.5 per million). During 1993-2021, 9 genotypes including domestic genotype H1; imported genotypes B3, D4, D8, D9, D11, G3, and H2; and vaccine-associated genotype A were identified. Among them, the genotype H1 strain circulated endemically in China for more than 25 years; the last strain was detected in Yunnan Province in September 2019. Multiple imported genotypes have been identified since 2009 showing different transmission patterns. Since April 2020, no imported strains have been detected, while vaccine-associated genotype A continues to be detected. CONCLUSIONS The evidence of low incidence during 2020-2021 and virological surveillance data in this study confirm that China is currently approaching measles elimination.
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Affiliation(s)
- Huiling Wang
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhen Zhu
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaojian Duan
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinhua Song
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Naiying Mao
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Aili Cui
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Changyin Wang
- Provincial Measles/Rubella Laboratory, Shandong Provincial Center for Disease Control and Prevention, Jinan, China
| | - Hui Du
- Provincial Measles/Rubella Laboratory, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang, China
| | - Yan Wang
- Provincial Measles/Rubella Laboratory, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, China
| | - Fangcai Li
- Provincial Measles/Rubella Laboratory, Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Shujie Zhou
- Provincial Measles/Rubella Laboratory, Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Daxing Feng
- Provincial Measles/Rubella Laboratory, Henan Provincial Center for Disease Control and Prevention, Zhengzhou, China
| | - Chongshan Li
- Provincial Measles/Rubella Laboratory, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Hui Gao
- Provincial Measles/Rubella Laboratory, Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, China
| | - Jilan He
- Provincial Measles/Rubella Laboratory, Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
| | - Liqun Li
- Provincial Measles/Rubella Laboratory, Yunnan Provincial Center for Disease Control and Prevention, Kunming, China
| | - Yue Lei
- Provincial Measles/Rubella Laboratory, Tianjin Municipal Center for Disease Control and Prevention, Tianjin, China
| | - Huanying Zheng
- Provincial Measles/Rubella Laboratory, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Tian Gong
- Provincial Measles/Rubella Laboratory, Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, China
| | - Ying Hu
- Provincial Measles/Rubella Laboratory, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Changping Xu
- Provincial Measles/Rubella Laboratory, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Hua Zhao
- Provincial Measles/Rubella Laboratory, Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Zhaodan Sun
- Provincial Measles/Rubella Laboratory, Heilongjiang Provincial Center for Disease Control and Prevention, Ha'erbin, China
| | - Ying Chen
- Provincial Measles/Rubella Laboratory, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Xiaomin Tang
- Provincial Measles/Rubella Laboratory, Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
| | - Meng Chen
- Provincial Measles/Rubella Laboratory, Beijing Municipal Center for Disease Control and Prevention, Beijing, China
| | - Lili Deng
- Provincial Measles/Rubella Laboratory, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Shuang Wang
- Provincial Measles/Rubella Laboratory, Jilin Provincial Center for Disease Control and Prevention, Changchun, China
| | - Xiaoling Tian
- Provincial Measles/Rubella Laboratory, Neimenggu Center for Disease Control and Prevention, Huhehaote, China
| | - Ting Zhang
- Provincial Measles/Rubella Laboratory, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Yuan Si
- Provincial Measles/Rubella Laboratory, Shaanxi Provincial Center for Disease Control and Prevention, Xian, China
| | - Fang Yuan
- Provincial Measles/Rubella Laboratory, Ningxia Center for Disease Control and Prevention, Yinchuan, China
| | - Lixia Fan
- Provincial Measles/Rubella Laboratory, Qinghai Provincial Center for Disease Control and Prevention, Xining, China
| | - Kuerban Mahemutijiang
- Provincial Measles/Rubella Laboratory, Xinjiang Center for Disease Control and Prevention, Wulumuqi, China
| | - Zhifei Chen
- Provincial Measles/Rubella Laboratory, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Haiyun Chen
- Provincial Measles/Rubella Laboratory, Hainan Provincial Center for Disease Control and Prevention, Haikou, China
| | - Wenbo Xu
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yan Zhang
- World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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11
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He Q, Fan S, Xue Z, Yuan J, Wang Y, Yang Z, Zhou Z, Zhang Z. Waning of maternal antibody against measles virus in Shufu, China. Hum Vaccin Immunother 2022; 18:2045854. [PMID: 36399713 DOI: 10.1080/21645515.2022.2045854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND As measles vaccination coverage has increased, measles infection has shifted to the population of infants. We conducted a follow-up seroepidemiological study among mothers and their infants to evaluate measles seroprevalence and the persistence of maternal measles antibody in Shufu, Kashgar from 2018 to 2020. METHODS Maternal venous blood and cord blood was obtained among mothers and their infants at 0, 3, 5, 8, 9, and 12 months of age. An enzyme-linked immunosorbent assay was used for quantitative measurement of measles antibodies. We analyzed the correlation between maternal and neonatal measles antibodies, and antibodies persistence after infants were born. RESULTS The overall neonatal maternal ratio was 2.38 (95%CI: 2.05-2.71). The measles antibodies for mothers and newborns were 438.93 IU/mL (95%CI: 409.47-470.51 IU/mL) and 440.10 IU/mL (95%CI: 410.82-471.48 IU/mL), respectively. Neonatal measles antibodies were dropping after birth and then beginning to increase starting at 8 months of age. CONCLUSIONS Infant measles antibody levels progressively declined after birth regardless of maternal measles antibody levels. Efforts should be carried out to eliminate measles.
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Affiliation(s)
- Qing He
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Shujun Fan
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Zhenxiang Xue
- Emergency Management department, Shufu Center for Disease Control and Prevention, Kashgar, China
| | - Jun Yuan
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Yuzhong Wang
- Emergency Management department, Shufu Center for Disease Control and Prevention, Kashgar, China
| | - Zhicong Yang
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Ziyan Zhou
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Zhoubin Zhang
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, China
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12
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Donadel M, Scobie HM, Pastore R, Grabovac V, Batmunkh N, O’Connor S, Dahl BA, Murrill CS. Comprehensive Vaccine-Preventable Disease Surveillance in the Western Pacific Region: A Literature Review on Integration of Surveillance Functions, 2000-2021. GLOBAL HEALTH, SCIENCE AND PRACTICE 2022; 10:GHSP-D-22-00017. [PMID: 36316133 PMCID: PMC9622275 DOI: 10.9745/ghsp-d-22-00017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION A strategic framework for 2021-2030 developed by the World Health Organization (WHO) Regional Office for the Western Pacific emphasizes the need for high-quality and integrated vaccine-preventable disease (VPD) surveillance. We conducted a literature review to document the barriers, enabling factors, and innovations for integrating surveillance functions for VPDs and other communicable diseases in Western Pacific Region (WPR) countries. METHODS We searched published and gray literature on integrated VPD surveillance from 2000 to 2021. Articles in English, Spanish, or French were screened to identify those relating to VPD surveillance in a WPR country and not meeting defined exclusion criteria. We categorized articles using the 8 WHO surveillance support functions and abstracted data on the country; type of surveillance; and reported barriers, enabling factors, and best practices for integration. RESULTS Of the 3,137 references screened, 87 met the eligibility criteria. Of the 8 surveillance support functions, the proportion of references that reported integration related to the laboratory was 56%, followed by workforce capacity (54%), governance (51%), data management and use (47%), field logistics and communication (47%), coordination (15%), program management (13%), and supervision (9%). Several references noted fragmented systems and a lack of coordination between units as barriers to integration, highlighting the importance of engagement across public health units and between the public and private sectors. The literature also indicated a need for interoperable information systems and revealed the use of promising new technologies for data reporting and laboratory testing. In some WPR countries, workforce capacity was strengthened at all administrative levels by the implementation of integrated trainings on data monitoring and use and on laboratory techniques applicable to multiple VPDs. CONCLUSION This literature review supports integrating VPDs into broader communicable disease surveillance systems in WPR countries while ensuring that the minimal WHO-recommended standards for VPD surveillance are met.
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Affiliation(s)
- Morgane Donadel
- Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA.,Correspondence to Morgane Donadel ()
| | - Heather M. Scobie
- Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Roberta Pastore
- World Health Organization, Western Pacific Regional Office, Manila, the Philippines
| | - Varja Grabovac
- World Health Organization, Western Pacific Regional Office, Manila, the Philippines
| | - Nyambat Batmunkh
- World Health Organization, Western Pacific Regional Office, Manila, the Philippines
| | - Stephanie O’Connor
- Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Benjamin A. Dahl
- Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christopher S. Murrill
- Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
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13
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Shen M, Sun X, Xiao Y, Liu Y, Wang C, Wang Z, Rong L, Peng Z. The impact of supplementary immunization activities on measles transmission dynamics and implications for measles elimination goals: a mathematical modelling study. J Theor Biol 2022; 551-552:111242. [PMID: 35952756 DOI: 10.1016/j.jtbi.2022.111242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 08/04/2022] [Accepted: 08/04/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Measles has re-emerged globally due to the accumulation of susceptible individuals and immunity gap, which causes challenges in eliminating measles. Routine vaccination and supplementary immunization activities (SIAs) have greatly improved measles control, but the impact of SIAs on the measles transmission dynamics remains unclear as the vaccine-induced immunity wanes. METHODS We developed a comprehensive measles transmission dynamics model by taking into account population demographics, age-specific contact patterns, seasonality, routine vaccination, SIAs, and the waning vaccine-induced immunity. The model was calibrated by the monthly age-specific cases data from 2005 to 2018 in Jiangsu Province, China, and validated by the dynamic sero-prevalence data. We aimed to investigate the short-term and long-term impact of three-time SIAs during 2009-2012 (9.68 million and 4.25 million children aged 8 months-14 years in March 2009 and September 2010, respectively, and 140,000 children aged 8 months-6 years in March 2012) on the measles disease burden and explored whether additional SIAs could accelerate the measles elimination. RESULTS We estimated that the cumulative numbers of measles cases from March 2009 to December 2012 (in the short run) and to December 2018 (in the long run) after three-time SIAs (base case) were 6,699 (95% confidence interval [CI]: 2,928-10,469), and 22,411 (15,146-29,675), which averted 45.0% (42.9%-47.0%) and 34.3% (30.7%-37.9%) of 12,226 (4,916-19,537) and 34,274 (21,350-47,199) cases without SIAs, respectively. The fraction of susceptibles for children aged 8-23 months and 2-14 years decreased from 8.3% and 10.8% in March 2009 to 5.8% and 5.8% in April 2012, respectively. However, the fraction of susceptibles aged 15-49 years and above 50 years increased gradually to about 15% in 2018 irrespective of SIAs due to the waning immunity. The measles elimination goal would be reached in 2028, and administrating additional one-off SIAs in September 2022 to children aged 8-23 months, or young adolescents aged 15-19 years could accelerate the elimination one year earlier. CONCLUSIONS SIAs have greatly reduced the measles incidence and the fraction of susceptibles, but the benefit may wane over time. Under the current interventions, Jiangsu province would reach the measles elimination goal in 2028. Additional SIAs may accelerate the measles elimination one year earlier.
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Affiliation(s)
- Mingwang Shen
- China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, PR China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, PR China
| | - Xiang Sun
- Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, Jiangsu, 210009, PR China
| | - Yanni Xiao
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yuanbao Liu
- Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, Jiangsu, 210009, PR China
| | - Congyue Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Zhiguo Wang
- Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, Jiangsu, 210009, PR China
| | - Libin Rong
- Department of Mathematics, University of Florida, Gainesville, FL, USA
| | - Zhihang Peng
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, PR China.
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14
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Ang LW, Gao Q, Cui L, Farwin A, Toh MPHS, Boudville IC, Chen MIC, Chow A, Lin RTP, Lee VJM, Leo YS. Prevalence of measles antibodies among migrant workers in Singapore: a serological study to identify susceptible population subgroups. BMC Infect Dis 2022; 22:88. [PMID: 35078426 PMCID: PMC8787927 DOI: 10.1186/s12879-022-07066-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 01/13/2022] [Indexed: 11/20/2022] Open
Abstract
Background In 2019, two clusters of measles cases were reported in migrant worker dormitories in Singapore. We conducted a seroprevalence study to measure the level of susceptibility to measles among migrant workers in Singapore. Methods Our study involved residual sera of migrant workers from seven Asian countries (Bangladesh, China, India, Indonesia, Malaysia, Myanmar and the Philippines) who had participated in a survey between 2016 and 2019. Immunoglobulin G (IgG) antibody levels were first measured using a commercial enzyme-linked immunosorbent assay (ELISA) test kit. Those with equivocal or negative IgG results were further evaluated using plaque reduction neutralization test (PRNT). Results A total of 2234 migrant workers aged 20–49 years were included in the study. The overall prevalence of measles IgG antibodies among migrant workers from the seven Asian countries was 90.5% (95% confidence interval 89.2–91.6%). The country-specific seroprevalence ranged from 80.3 to 94.0%. The seroprevalence was significantly higher among migrant workers born in 1965–1989 than those born in 1990–1999 (95.3% vs. 86.6%, p < 0.0005), whereas there was no significant difference by gender (90.8% in men vs. 89.9% in women, p = 0.508). 195 out of 213 samples with equivocal or negative ELISA results were tested positive using PRNT. Conclusion The IgG seroprevalence in migrant workers was below the herd immunity threshold of 95% for measles. Sporadic outbreaks may occur in susceptible individuals due to high transmissibility of measles virus. Seroprevalence surveys can help identify susceptible subgroups for vaccination. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07066-2.
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Affiliation(s)
- Li Wei Ang
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore, 308442, Singapore. .,Public Health Group, Ministry of Health, Singapore, Singapore.
| | - Qi Gao
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore, 308442, Singapore
| | - Lin Cui
- National Public Health Laboratory, National Centre for Infectious Diseases, Singapore, Singapore
| | - Aysha Farwin
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore, 308442, Singapore
| | - Matthias Paul Han Sim Toh
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore, 308442, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Irving Charles Boudville
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore, 308442, Singapore
| | - Mark I-Cheng Chen
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore, 308442, Singapore.,Public Health Group, Ministry of Health, Singapore, Singapore
| | - Angela Chow
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore, 308442, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore, Singapore
| | - Raymond Tzer-Pin Lin
- National Public Health Laboratory, National Centre for Infectious Diseases, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Laboratory Medicine, National University Hospital, National University Health System, Singapore, Singapore
| | - Vernon Jian Ming Lee
- Public Health Group, Ministry of Health, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Yee Sin Leo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,National Centre for Infectious Diseases, Singapore, Singapore.,Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore
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15
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Altulayhi RI, Alqahtani RM, Alakeel RA, Khorshid FA, Alshammari RH, Alattas SG, Alshammari FAM, Bin-Jumah M, Abdel-Daim MM, Almohideb M. Correlation between measles immunization coverage and overall morbidity and mortality for COVID-19: an epidemiological study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:62266-62273. [PMID: 34184228 PMCID: PMC8238512 DOI: 10.1007/s11356-021-14980-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 06/14/2021] [Indexed: 06/13/2023]
Abstract
We conducted the current analysis to determine the potential role of measles vaccination in the context of the spread of COVID-19. Data were extracted from the World Health Organization's (WHO) Global Health Observatory data repository about the measles immunization coverage estimates and correlated to overall morbidity and mortality for COVID-19 among different countries. Data were statistically analyzed to calculate the Spearman rank correlation coefficient (rho). There was a significant positive correlation between the vaccine coverage (%) and new cases per one million populations (rho = 0.24; p-value = 0.025); however, this correlation was absent in deaths per one million populations (rho = 0.17; p-value = 0.124). On further analysis of the effect of first reported year of vaccination policy, there was no significant correlation with both of total cases per one million populations (rho = 0.11; p-value = 0.327) and deaths per one million populations (rho = -0.02; p-value = 0.829). Claims regarding the possible protective effect of measles vaccination seem to be doubtful.
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Affiliation(s)
| | - Rakan M. Alqahtani
- Department of Critical Care Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Reem Abdullah Alakeel
- Family Medicine Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Faten Abdulrahman Khorshid
- Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, 21589 Saudi Arabia
| | | | - Sana Ghazi Alattas
- Biological Sciences Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Fahad Abdullah M. Alshammari
- Department of Adult Emergency Medicine, Department of Emergency Medical Services, King Khalid Hospital, Hail, Saudi Arabia
| | - May Bin-Jumah
- Biology Department, College of Science, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Mohamed M. Abdel-Daim
- Department of Zoology, Science College, King Saud University, Riyadh, 11451 Saudi Arabia
- Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, 41522 Egypt
| | - Mohammad Almohideb
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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16
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Chen J, Jia H, Cai Z, Zhou Y, Ma S, Chen Y, Chen C, Pan W. Economic burden of measles and its influencing factors in Fujian, China. Hum Vaccin Immunother 2021; 17:5367-5371. [PMID: 34714722 DOI: 10.1080/21645515.2021.1989917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Measles is a highly-contagious, serious diseases that can lead to potentially fatal illness, disability and death . We conducted an investigation to calculate the economic burden of measles cases from 2018 to 2019 and to analyze factors that influenced the total costs of measles cases in Fujian Province, China. METHODS We investigated confirmed cases of measles by telephone interview, from 2018 to 2019, including demographic characteristics, therapeutic measures, self-treatment and nutritional supplement expenditure, transportation fees, and lost wages. Medical expenses in the hospitals were obtained from the hospital service charge system. RESULTS A total of 131 measles cases were investigated, the average direct cost, indirect cost, and total cost were $518, $284, and $802, respectively. The total cost was 15.5% of Annual Per Capita Disposable Income of Households ($5 162) in Fujian. Hospitalization (OR = 98.6, 95%CI: 21.1 ~ 460.6) and complication (OR = 8.7, 95%CI: 1.3 ~ 58.0) significantly influenced the total cost according to binary logistic regression, and an outbreak of measles may pose a significant threat to household finances in a short term. CONCLUSIONS The economic burden of measles was high when compared with Annual Per Capita Disposable Income of Households. The resurgence of measles and measles outbreaks increased economic burden of household finances.
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Affiliation(s)
- Junlei Chen
- Department of Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Haimei Jia
- Department of Immunization Program, Fuzhou Center for Disease Control and Prevention, Fuzhou, China
| | - Zhikun Cai
- Department of Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Yong Zhou
- Department of Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
| | - Shanshan Ma
- Department of Immunization Program, Xiamen Center for Disease Control and Prevention, Xiamen, China
| | - Yahong Chen
- Department of Immunization Program, Quanzhou Center for Disease Control and Prevention, Quanzhou, China
| | - Changfu Chen
- Department of Immunization Program, City Center for Disease Control and Prevention, Ningde, China
| | - Weiyi Pan
- Department of Immunization Program, Fujian Provincial Center for Disease Control and Prevention, Fuzhou, China
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Wang Q, Cheng X, Liu D, Chen C, Yao K. One single-center serological survey on measles, rubella and mumps antibody levels of people in Youyang, China. Hum Vaccin Immunother 2021; 17:4203-4209. [PMID: 34623932 DOI: 10.1080/21645515.2021.1924522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Although measles, rubella and mumps elimination had achieved great progress in recent years, outbreaks were still reported worldwide. Serological surveillance on the remaining susceptibility in the population is essential to evaluate the preventive policy, estimate the current risk of infection, and predict evolutions in the future. In this study, we aimed to investigate the prevalence of seropositivity of antibodies against measles, rubella and mumps in a population of all ages in Youyang, southwest China. A cross-sectional hospital-based study was conducted among 657 cases who attended to Youyang Hospital from Sep 2018 to Aug 2019. Sero IgG antibodies were measured by ELISA. No difference in the seropositivity of antibodies against measles, rubella and mumps was found between neither urban vs. rural, nor male vs. female. The overall seropositivity of anti-measles, rubella, mumps IgG antibodies was 81.1% (95% CI: 78.0-83.9), 65.9% (95% CI: 62.2-69.4) and 63.2% (95% CI: 59.4-66.8), respectively. The IgG seropositivity varied with age significantly. In this study, the seropositivity of antibodies against measles, rubella and mumps among the participants was insufficient in the population, especially among infants, teenagers and productive women, who were suggested to booster the immunity. To better control and eliminate measles, mumps and rubella-related diseases, nation-wide active laboratory-supported surveillance, outbreak investigation and revaccination for vulnerable population are needed.
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Affiliation(s)
- Qing Wang
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xiaoping Cheng
- Clinical Laboratory, Youyang County People's Hospital, Chongqing, China
| | - Dandan Liu
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Changhui Chen
- Department of Pediatrics, Youyang County People's Hospital, Chongqing, China
| | - Kaihu Yao
- Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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Tang XY, Cheng M, Geater A, Deng QY, Zhong G, Lin YD, Chen N, Lan T, Jiang LY, Zhu MT, Li Q. Multi-level determinants of failure to receive timely and complete measles vaccinations in Southwest China: a mixed methods study. Infect Dis Poverty 2021; 10:102. [PMID: 34294157 PMCID: PMC8296749 DOI: 10.1186/s40249-021-00885-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/12/2021] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Measles outbreaks re-emerged in 2013-2014 in Guangxi Zhuang Autonomous Region of China, where measles immunisation coverage is high. The discrepancy between the vaccination coverage and outbreaks indicates that timeliness is crucial, yet there is limited knowledge on the health system barriers to timely vaccination. Using integrated evidence at the household, village clinic, and township hospital levels, this study aimed to identify the determinants of failure in receiving timely measles vaccinations among children in rural Guangxi. METHODS A multi-stage stratified cluster sampling survey with a nested qualitative study was conducted among children aged 18-54 months in Longan, Zhaoping, Wuxuan, and Longlin counties of Guangxi from June to August 2015. The status of timely vaccinations for the first dose of measles-containing vaccine (MCV1) and the second dose of measles-containing vaccine (MCV2) was verified via vaccination certificates. Data on household-level factors were collected using structured questionnaires, whereas data on village and township-level factors were obtained through in-depth interviews and focus group discussions. Determinants of untimely measles vaccinations were identified using multilevel logistic regression models. RESULTS A total of 1216 target children at the household level, 120 villages, and 20 township hospitals were sampled. Children were more likely to have untimely vaccination when their primary guardian had poor vaccination knowledge [MCV1, odds ratio (OR) = 1.72; MCV2, OR = 1.51], had weak confidence in vaccines (MCV1, OR = 1.28-4.58; MCV2, OR = 1.42-3.12), had few practices towards vaccination (MCV1, OR = 12.5; MCV2, OR = 3.70), or had low satisfaction with vaccination service (MCV1, OR = 2.04; MCV2, OR = 2.08). This trend was also observed in children whose village doctor was not involved in routine vaccination service (MCV1, OR = 1.85; MCV2, OR = 2.11) or whose township hospital did not provide vaccination notices (MCV1, OR = 1.64; MCV2, OR = 2.05), vaccination appointment services (MCV1, OR = 2.96; MCV2, OR = 2.74), sufficient and uniformly distributed sessions for routine vaccination (MCV1, OR = 1.28; MCV2, OR = 1.17; MCV1, OR = 2.08), or vaccination service on local market days (MCV1, OR = 2.48). CONCLUSIONS Guardians with poor knowledge, weak beliefs, and little practice towards vaccination; non-involvement of village doctors in routine vaccinations; and inconvenient vaccination services in township hospitals may affect timely measles vaccinations among children in rural China.
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Affiliation(s)
- Xian-Yan Tang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, China. No. 22nd, Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China.
| | - Man Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, China. No. 22nd, Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China
| | - Alan Geater
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Qiu-Yun Deng
- Institute of Vaccination, Guangxi Centre for Disease Control and Prevention, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Ge Zhong
- Institute of Vaccination, Guangxi Centre for Disease Control and Prevention, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Yue-Dong Lin
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, China. No. 22nd, Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China
| | - Ning Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, China. No. 22nd, Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China
| | - Tao Lan
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, China. No. 22nd, Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China
| | - Long-Yan Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, China. No. 22nd, Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China
| | - Man-Tong Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, China. No. 22nd, Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China
| | - Qiao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, China. No. 22nd, Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China.
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Liu Y, Xiong Y, Liang Y, Deng X, Hu Y, Hu R, Chen Q, Tang F, Wang Z, Sun X, Guo H, Zhang L, Zhu FC. Waning immunity and potential asymptomatic infection in 3-7 years old children who received one dose of measles-mumps-rubella vaccine: A 4-year prospective study. Vaccine 2021; 39:3509-3515. [PMID: 33994238 DOI: 10.1016/j.vaccine.2021.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 04/29/2021] [Accepted: 05/03/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND Mumps outbreaks in adolescents who received two doses of measles-mumps-rubella vaccine (MMR) during childhood have been reported worldwide. In China, one dose of MMR administered in children aged among 18-24 months has a limited effect on the mumps epidemic. There are limited prospective studies evaluating the mumps immunity profile of children aged 3-7 years who received one dose of MMR. This study aimed to describe mumps immunity profile over a span of 4-years in kindergarten and primary school children. METHODS An observational, prospective study on one-dose MMR in children aged 3-7 years who underwent blood sample collection in 2015, 2016, and 2018 was conducted from 2015 to 2018. The seropositivity and geometric mean concentration of mumps IgG antibodies over time were analyzed. RESULTS A total of 3346 eligible children aged 3-7 years who underwent three rounds of blood sample collection were included. The overall seropositivity (79.6%) in 2015 was significantly higher than those recorded in 2016 (73.1%) and 2018 (71.4%). Approximately 11.6-15.9% of the participants were seropositive for mumps in 2015, and converted to negative in 2016. Meanwhile, 11.1-14.6% of the participants were seropositive for mumps in 2016, and the results converted to negative in 2018. Over 6.1-7.4% of the participants had asymptomatic infection from 2015 to 2016, while 9.0-9.9% of the participants were infected without clinical symptoms from 2016 to 2018. CONCLUSIONS Kindergarten and primary school children who only received one dose of MMR were at higher risk of developing mumps. Waning immunity, seronegative conversion, and asymptomatic infection coexist in children who received one dose MMR. Determining the optimal age for administering the second dose of MMR in children should be prioritized to improve the control and prevention of mumps in China.
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Affiliation(s)
- Yuanbao Liu
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Yan Xiong
- Qinhuai District Center for Disease Control and Prevention, Nanjing 210029, China
| | - Yaqiong Liang
- Department of Expanded Programme on Immunization, Nanjing Center for Disease Control and Prevention, Nanjing 210009, China
| | - Xiuying Deng
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Ying Hu
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Ran Hu
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Qiang Chen
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Fenyang Tang
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Zhiguo Wang
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Xiang Sun
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Hongxiong Guo
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Lei Zhang
- Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
| | - Feng-Cai Zhu
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Department of Expanded Programme on Immunization, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China.
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20
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Timeliness, completeness, and timeliness-and-completeness of serial routine vaccinations among rural children in Southwest China: A multi-stage stratified cluster sampling survey. Vaccine 2021; 39:3236-3249. [PMID: 33966907 DOI: 10.1016/j.vaccine.2021.04.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 03/31/2021] [Accepted: 04/23/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Vaccination coverage is widely used as metric of vaccination programme performance. However, VPDs outbreaks were reported in areas with high vaccination coverage. Timeliness and completeness have been considered more important assessment indicators of routine vaccination than overall vaccination coverage, but little is known in rural China. This study aimed to assess the timeliness and completeness of serial routine vaccinations among children in rural Southwest China. METHODS A multi-stage stratified cluster survey was conducted among 1062 children aged 18-48 months in rural Guangxi. Vaccination status was obtained from child's vaccination certificate. We calculated timely vaccination coverage, complete vaccination coverage, timely-and-complete vaccination coverage and 95% CI for routine vaccination through weighted estimation analysis. Weighted Kaplan-Meier analyses were applied to estimate the median delay periods for each dose of serial routine vaccines, including one-dose BCG, three-dose HepB, three-dose OPV, four-dose DTP, two-dose MCV, two-dose JEV and two-dose MPV-A. Complete coverage, and timely-and-complete coverage for combined 5-vaccine series were calculated. RESULTS For each dose of routine vaccines, overall vaccination coverages were over 90%, but timely vaccination coverage ranged from the lowest of 44.4% for JEV1 to the highest of 92.5% for MPV-A1. For multi-dose routine vaccines, complete vaccination coverages varied from the lowest of 92.9% for MCV to the highest of 100% for HepB, and timely-and-complete vaccination coverages were lower than 80%, ranging from the lowest of 30% for JEV to the highest of 77.2% for MPV-A. For combined 5-vaccine series, complete coverage was 77%, while timely-and-complete coverage was 12.1%. MPV-A1 had the longest median delay of 176 days, but BCG and HepB1 had the shortest of 1 day. CONCLUSIONS The overall coverages of serial routine vaccinations were high, but the timeliness and completeness were poor. Relevant agencies of vaccination service should address timeliness-and-completeness into the assessment indicators of routine vaccination service quality.
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21
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Ashford JW, Gold JE, Huenergardt MA, Katz RBA, Strand SE, Bolanos J, Wheeler CJ, Perry G, Smith CJ, Steinman L, Chen MY, Wang JC, Ashford CB, Roth WT, Cheng JJ, Chao S, Jennings J, Sipple D, Yamamoto V, Kateb B, Earnest DL. MMR Vaccination: A Potential Strategy to Reduce Severity and Mortality of COVID-19 Illness. Am J Med 2021; 134:153-155. [PMID: 33198951 PMCID: PMC7583585 DOI: 10.1016/j.amjmed.2020.10.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/01/2020] [Accepted: 10/01/2020] [Indexed: 01/06/2023]
Affiliation(s)
- J Wesson Ashford
- War Related Illness & Injury Study Center, VA Palo Alto Health Care System, Calif; Department of Psychiatry & Behavioral Sciences, Stanford University, Palo Alto, Calif.
| | | | | | - Ronit B A Katz
- Stanford University School of Medicine, Palo Alto, Calif
| | - Susanne E Strand
- Society for Brain Mapping & Therapeutics (SBMT), Brain Mapping Foundation, Pacific Palisades, Calif
| | - Joe Bolanos
- Society for Brain Mapping & Therapeutics (SBMT), Brain Mapping Foundation, Pacific Palisades, Calif
| | - Christopher J Wheeler
- Society for Brain Mapping & Therapeutics, Los Angeles, CA; T-Neuro Pharma, Albuquerque, NM & Aptos, Calif
| | - George Perry
- Semmes Distinguished University Chair in Neurobiology, Department of Biology and Chemistry, University of Texas at San Antonio
| | - Carr J Smith
- Society for Brain Mapping & Therapeutics, Mobile, Ala
| | - Lawrence Steinman
- Zimmermann Professor of Neurology & Neurological Sciences, and Department of Pediatrics, Beckman Center for Molecular Medicine, Stanford University, Palo Alto, Calif
| | - Mike Y Chen
- Division of Neurosurgery, City of Hope National Medical Center, Duarte, Calif
| | - Jeffrey C Wang
- Orthopaedic Surgery and Neurosurgery, University of Southern California, Los Angeles
| | | | - Walton T Roth
- Department of Psychiatry & Behavioral Sciences, Stanford University, Palo Alto, Calif
| | - Jauhtai Joseph Cheng
- VA Palo Alto Health Care System, Palo Alto, Calif; Department of Neurology, Stanford University, Palo Alto, Calif
| | - Steven Chao
- VA Palo Alto Health Care System, Palo Alto, Calif; Department of Neurology, Stanford University, Palo Alto, Calif
| | | | - Daniel Sipple
- Society for Brain Mapping & Therapeutics, Los Angeles, CA
| | | | - Babak Kateb
- Society for Brain Mapping & Therapeutics, Los Angeles, CA
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Chong KC, Jia KM. Accelerate the elimination of rubella through supplementary immunisation activities in China. THE LANCET. INFECTIOUS DISEASES 2021; 21:899-900. [PMID: 33515509 DOI: 10.1016/s1473-3099(20)30715-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 08/24/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Ka Chun Chong
- Centre for Health Systems and Policy Research, School of Public Health and Primary Care and Clinical Trials and Biostatistics Laboratory, Shenzhen Research Institute, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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Assessing the burden of congenital rubella syndrome in China and evaluating mitigation strategies: a metapopulation modelling study. THE LANCET. INFECTIOUS DISEASES 2021; 21:1004-1013. [PMID: 33515508 DOI: 10.1016/s1473-3099(20)30475-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 05/22/2020] [Accepted: 05/27/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND A rubella vaccine was licensed in China in 1993 and added to the Expanded Programme on Immunization in 2008, but a national cross-sectional serological survey during 2014 indicates that many adolescents remain susceptible. Maternal infections during the first trimester often cause miscarriages, stillbirths, and, among livebirths, congenital rubella syndrome. We aimed to evaluate possible supplemental immunisation activities (SIAs) to accelerate elimination of rubella and congenital rubella syndrome. METHODS We analysed residual samples from the national serological survey done in 2014, data from monthly rubella surveillance reports from 2005 and 2016, and additional publications through a systematic review. Using an age-structured population model with provincial strata, we calculated the reproduction numbers and evaluated the gradient of the metapopulation effective reproduction number with respect to potential supplemental immunisation rates. We corroborated these analytical results and estimated times-to-elimination by simulating SIAs among adolescents (ages 10-19 years) and young adults (ages 20-29 years) using a model with regional strata. We estimated the incidence of rubella and burden of congenital rubella syndrome by simulating transmission in a relatively small population lacking only spatial structure. FINDINGS By 2014, childhood immunisation had reduced rubella's reproduction number from 7·6 to 1·2 and SIAs among adolescents were the optimal elimination strategy. We found that less than 10% of rubella infections were reported; that although some women with symptomatic first-trimester infections might have elected to terminate their pregnancies, 700 children could have been born with congenital rubella syndrome during 2014; and that timely SIAs would avert outbreaks that, as susceptible adolescents reached reproductive age, could greatly increase the burden of this syndrome. INTERPRETATION Our findings suggest that SIAs among adolescents would most effectively reduce congenital rubella syndrome as well as eliminate rubella, owing both to fewer infections in the immunised population and absence of infections that those immunised would otherwise have caused. Metapopulation models with realistic mixing are uniquely capable of assessing such indirect effects. FUNDING WHO and National Science Foundation.
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Zhang H, Chen C, Tang A, Wu B, Liu L, Wu M, Wang H. Epidemiological Investigation and Virus Tracing of a Measles Outbreak in Zhoushan Islands, China, 2019. Front Public Health 2020; 8:600196. [PMID: 33335880 PMCID: PMC7736039 DOI: 10.3389/fpubh.2020.600196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 11/06/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Measles transmissions due to case importations challenge public health systems globally and herd immunities in all countries. In 2019, an imported measles case and its subsequently outbreak was found in the Zhoushan Islands. Here, the process of epidemiological investigation and virus tracing were summarized to provide references for the prevention and control of measles in the future. Materials and methods: The data on the demographic, epidemiological, and clinical manifestation of measles cases in this outbreak were collected. The 450 bp fragments of the measles virus (MeV) N gene were amplified and sequenced. The genome of the first imported case was further isolated. Then, the maximum-likelihood and time-scaled phylogenetic analysis was conducted. Results: A total of 28 measles cases were confirmed. Their onsets were between March 13 and May 18, 2019. The first patient was from the Ukraine. He was confirmed at the Fever Clinic in Zhoushan hospital on March 15, 2019 and at the same time, another patient had visited the hospital due to another illness and 10 days later, this second case had onset (March 25, 2019). The epidemic curve shows sustained community transmission. The majority of the following cases (19/26) were clustered on the Donggang street which was close to where the second case worked. The 22 measles virus strains successfully isolated from this outbreak all belonged to the D8.2a sub-cluster and clustered with the KY120864/MVs/GirSomnath.IND/42.16/[D8] which was the predominant genotype in the Ukraine during 2018-2019. The analysis of the complete D8 genotype genome pointed to the fact that this prevailing strain originated from India in 2015 and its substitution rate was estimated as 6.91 × 10-4 (5.64-7.98 × 10-4) nucleotide substitutions/site/year. Conclusion: This outbreak was caused by an imported case from the Ukraine. There was a possible nosocomial infection between the first case and the second case. Then, the second case played an important role in the spread of virus due to her occupation. The molecular phylogenetic analysis could help to track the origin of the virus. Increasing and maintaining the high level of vaccination coverage (≥95%) and an efficient response to imported cases are essential to prevent and control the recurrence and outbreak of measles virus.
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Affiliation(s)
- Hui Zhang
- Zhoushan Center for Disease Control and Prevention, Zhoushan, China
| | - Can Chen
- Zhoushan Center for Disease Control and Prevention, Zhoushan, China
| | - An Tang
- Zhoushan Center for Disease Control and Prevention, Zhoushan, China
| | - Bing Wu
- Zhoushan Center for Disease Control and Prevention, Zhoushan, China
| | - Leijie Liu
- Putuo Center for Disease Control and Prevention, Zhoushan, China
| | - Mingyu Wu
- Zhoushan Center for Disease Control and Prevention, Zhoushan, China
| | - Hongling Wang
- Zhoushan Center for Disease Control and Prevention, Zhoushan, China
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Patel MK, Goodson JL, Alexander JP, Kretsinger K, Sodha SV, Steulet C, Gacic-Dobo M, Rota PA, McFarland J, Menning L, Mulders MN, Crowcroft NS. Progress Toward Regional Measles Elimination - Worldwide, 2000-2019. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2020; 69:1700-1705. [PMID: 33180759 PMCID: PMC7660667 DOI: 10.15585/mmwr.mm6945a6] [Citation(s) in RCA: 127] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Zhou R, Li L, Yuan S, Yin J, Li Q, Guo L, Li M, Zhao Z, Song Z. Health and economic costs of an import-initiated measles outbreak in an international border area of Yunnan Province. Hum Vaccin Immunother 2020; 17:1347-1352. [PMID: 32991225 DOI: 10.1080/21645515.2020.1815488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Measles outbreaks often require labor- and resource-intense response. A border-area measles outbreak occurred in Yunnan province that required outbreak response immunization for its containment. We report results of our investigation into the outbreak and the health sector costs of the response activities, with the goal of providing evidence for policy makers when considering the full value of vaccines and of measles elimination. METHODS We conducted case investigations to determine sources of infection and routes of transmission. Costs of outbreak response activities incurred by health sector were determined through retrospective interviews and record reviews of staff. RESULTS In total, 67 measles cases were confirmed, including 4 cases imported from Myanmar. Among the 33 cases aged between 8 months and 14 y old, 22 (66∙7%) had received 2 doses of MCV; 2 (6∙0%) had received 1 dose of MCV; 9 (27∙3%) had not received MCV. The first 4 cases had been infected in Myanmar, and we identified 8 transmission clusters with a total of 62 cases. Transmission among Yunnan province residents occurred in schools, family settings, and at gatherings. The overall cost to control the outbreak was $214,774, for a per-case cost of $3,206. The outbreak response vaccination campaign accounted for 64% of the total outbreak costs. CONCLUSIONS Despite high population immunity among Yunnan province children and adolescents, an import-related measles outbreak occurred among individuals who were not vaccinated or had vaccine failure in the across-border area. The economic cost of the outbreak was substantial. Investment in a sensitive measles surveillance system to detect outbreaks in a timely manner, maintaining high population immunity to measles, and reinforcing cross-border collaboration with neighboring countries support achieving and sustaining measles elimination in the border areas of China.
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Affiliation(s)
- Rongrong Zhou
- Expanded Program on Immunization Department, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan Province, China
| | - Liqun Li
- Expanded Program on Immunization Department, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan Province, China
| | - Shuyi Yuan
- Lincang Center for Disease Control and Prevention, Lincang City, Yunnan Province, China
| | - Jie Yin
- Expanded Program on Immunization Department, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan Province, China
| | - Qiongfen Li
- Expanded Program on Immunization Department, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan Province, China
| | - Licun Guo
- Lincang Center for Disease Control and Prevention, Lincang City, Yunnan Province, China
| | - Mengtian Li
- Gengma Center for Disease Control and Prevention, Lincang City, Yunnan Province, China
| | - Zhixian Zhao
- Expanded Program on Immunization Department, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan Province, China
| | - Zhizhong Song
- Expanded Program on Immunization Department, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan Province, China
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Cui A, Zhang Y, Zhu Z, Wang H, Mao N, Song J, Xu W. Classification of measles cases from 2014 to 2018: Implications for progress towards measles elimination in China. Vaccine 2020; 38:3832-3838. [PMID: 32280040 DOI: 10.1016/j.vaccine.2020.03.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 02/17/2020] [Accepted: 03/27/2020] [Indexed: 02/04/2023]
Abstract
Measles incidence has decreased dramatically in China due to the implement of measles-containing vaccine (MCV). However, a measles epidemic caused resurgence recently, even among vaccinated individuals. To evaluate the effectiveness of current immunization programs and discuss initiatives for the next step in measles elimination in mainland China, the characteristics of 121,969 laboratory-confirmed measles cases reported in the measles surveillance system (MSS) during 2014-2018 were analyzed according to the vaccination status of the cases in this study. Children under 2 years of age without MCV vaccination (44,424, 36.42% of all cases) and adults over 20 years of age with an unknown vaccination history (37,564, 30.80% of all cases) accounted for the majority of measles cases from 2014 to 2018. 42,425 (34.78%) of the 77,384 cases with available vaccination information were categorized as programmatically preventable. 38,840 (91.55%) of the 42,425 cases were aged ≥8 months without the MCV vaccination history. 34,959 (28.66%) cases were categorized as programmatically non-preventable, of whom 22,611 (64.68%) were too young to receive their first MCV dose, 6857 (19.61%) received their first dose and were too young to receive their second dose, 5491 (15.71%) received at least two doses of MCV. 15,933 (13.06%) of the 121,969 cases had a history of MCV vaccination. Measles virus infection in cases with an MCV vaccination history mainly occurred within the first month after MCV vaccination, especially in those who received a one-dose measles vaccination. MCV vaccination could reduce the frequencies of clinical symptoms and complications of measles cases. Our study confirmed that the current measles immunization programs used in mainland China is effective in reducing the measles incidence in China. Unvaccinated infants/children aged 8-23 months and high risk susceptible adults over 20 years of age with unknown vaccination histories should be the focus groups of measles immunization activities in China in the future.
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Affiliation(s)
- Aili Cui
- WHO WPRO Regional Reference Laboratory of Measles/Rubella and NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.155, Changbai Road, Changping District, Beijing 102206, People's Republic of China
| | - Yan Zhang
- WHO WPRO Regional Reference Laboratory of Measles/Rubella and NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.155, Changbai Road, Changping District, Beijing 102206, People's Republic of China.
| | - Zhen Zhu
- WHO WPRO Regional Reference Laboratory of Measles/Rubella and NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.155, Changbai Road, Changping District, Beijing 102206, People's Republic of China
| | - Huiling Wang
- WHO WPRO Regional Reference Laboratory of Measles/Rubella and NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.155, Changbai Road, Changping District, Beijing 102206, People's Republic of China
| | - Naiying Mao
- WHO WPRO Regional Reference Laboratory of Measles/Rubella and NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.155, Changbai Road, Changping District, Beijing 102206, People's Republic of China
| | - Jinhua Song
- WHO WPRO Regional Reference Laboratory of Measles/Rubella and NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.155, Changbai Road, Changping District, Beijing 102206, People's Republic of China
| | - Wenbo Xu
- WHO WPRO Regional Reference Laboratory of Measles/Rubella and NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.155, Changbai Road, Changping District, Beijing 102206, People's Republic of China.
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