| Measles is one of the acute respiratory infectious diseases, which do great harm to children’s health. It is easily to arouse outbreaks. Measles is prevalent all over the world. Either in developed countries or in developing countries, measles is an important issue of public health. To implement immunization program is the main strategy of controlling and even eradicating vaccine preventable diseases. Measles is on the WHO’s list as the next infectious disease which intends to be eliminated. Elimination of Measles is practicable both by theory and by technology. The influence on measles morbidity by large scale immunization of measles vaccine has been fully validated. From the international perspective, in order to achieve the objective of controlling and eliminating measles, countries all over the world launched a series of supplementary immunization activities besides the strengthening of routine immunization. All of these measures have greatly reduced the morbidity of measles. The strategies of eliminating measles in China are much the same as those of other countries around the world, which are comprehensive measles elimination strategies. The core is immunization. To form the immunization barrier which cover all populations by routine immunization and measles vaccine supplementary immunization activities at regular intervals. The comprehensive strategies also includes developing disease surveillance, strengthening the epidemic control, controlling rubella, controlling nosocomial infection, and enhancing health promotion. etc. The study includes two parts as follows:Part One Study on the epidemiological characteristics of measles in Anhui province during the year of1997-2010Objective To describe the epidemiological characteristics of measles in Anhui province since1997when the acceleration of the measures to control measles began. Also analyze the influence of measles control and elimination measurement on the epidemiology of measles.Methods Analyzing epidemiological characteristics of measles in Anhui province with descriptive epidemiology.Results Since1997when the acceleration of the measures to control measles began, the reported measles incidence of1997to1999had greatly decreased. In the year of2000, measles local outbreaks in Anhui province increased, the epidemic of measles rebounded. After2000, the peak of measles epidemic lowered, and the cycle of measles prevalence prolonged. It present as a "platform" small peak. From1997to2010, there was a measles cases report each year in Anhui province. The morbidity of measles had obvious seasonal characteristics. Measles cases occurred mainly in Spring or in Winter, mostly appearing in the period from March to June every year. The number of measles cases began to rise at the time of March. It reached the peak in May, and then fell down from June. Most of measles cases appeared between March and June from2004to2008in Anhui province. Between March and June of2004, the peak of measles morbidity is not clear. But it emerged since December of the same year, which significantly higher than the same time of other years. The number of reported measles cases showed an increasing trend since December of2004. In2005, the epidemic of measles continued for a long time; the morbidity of measles rose to a larger extent; the incidence was11.14/100000. In2008, measles morbidity continued to rise in Anhui province until August when it showed a decline trend. After the measles vaccine supplementary immunization activity for the children aged from8months to14years within the whole province, the peak of measles cases didn’t appear until April. What’s more, it dropped remarkably. The incidence of2010fell to 0.72/100000, which was the lowest one since2005. Measles morbidity in Anhui province had the characteristics of coexistence of high sporadic and local outbreak. From1997to2010, each region in Anhui province had reported measles cases. Most of measles cases were found among the children aged0-14years old during1997-2010in Anhui province. And most of measles cases are preschool children and pupils. The proportions of measles cases in each age group had changed obviously since2005. Firstly, the proportion of measles cases aged<1year rose significantly, which went up year by year since2005, from about5%of2005to33.49%of2010. Secondly, from1997to2010, the number of measles cases of≥15years old had increased. The measles incidences of<1year old children during year of2005-2010ranked the first place among all age groups. Among the population of≥15years old, the measles incidence of the people of20-29had a small peak. The students in school and0-14years old children are the high-risk populations of measles in Anhui province. From1997to2010, the total proportion of the measles cases who are kindergarten children, scattered children and students ranked first in the occupation distribution of measles cases. In the year of2008,2009,2010respectively, the proportions of measles cases without explicit measles vaccine immunization, aging0-14years old, are77.91%,53.88%45.12%.Conclusions The key to reduce the incidence of measles and even to eliminate measles is high rate of immunization coverage and high quality of disease surveillance. Improving the rate of measles vaccine inoculation in order to maintain a high level of crowd immunity is the fundamental measure in the blocking of measles spread. The schedule of measles vaccine immunization should be strictly obeyed. The timely coverage rate of measles vaccine among the children of8months old and1.5years old should be improved.Part two Study on the effect of the supplementary immunization activity in2009in Anhui provinceObjective To evaluate the effect of measles vaccine supplementary immunization activity in Anhui province in2009. and to provide the basis for the elimination of measles.Methods Collecting measles epidemiology data before and after the supplementary immunization activity of2009. Analyze the data with descriptive epidemiology.Results The supplementary immunization activity was implemented between October10th and October20th in2009. The target population of the supplementary immunization activity is the children aged from8months to14years. The total population inoculated was10619433, and the rate of coverage was97.96%. Totally, there were41cases of adverse event following immunization reported which were relevant to the supplementary immunization activity of2009. There was no serious rare vaccine reaction or adverse event following immunization cluster. In2010, both the number of measles cases and the measles incidence dropped to the lowest level since2004, which were439cases and0.72/100000respectively. According to the seventeen regions of Anhui province, the number of measles cases and the measles incidence of2010were also dramatically lower than those of2009. After the supplementary immunization activity of2009. the seasonal measles cases peak was smoothed. The measles incidence of each age group among the children of0-14years old in2010dropped a lot, which was up to above95%, comparing with that of2009. In2010, comparing with that of2009, the proportion of measles cases who were kindergarten children or students changed greatly.Conclusions Carrying out high quality of supplementary immunization activity at suitable time can reduce the susceptible population, control the epidemic of measles quickly, and decrease measles morbidity. Being a supplementary method for routine immunization, supplementary immunization activity is one of the important strategies to eliminate measles. |
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