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Measles — controlled infection! Some epidemiological paradigm of measles in Zaporizhzhia region

SOVREMENNAYA PEDIATRIYA.2019.1(97):13-18; doi 10.15574/SP.2019.97.13

Usachova O. V., Silina Ye. A., Pakholchuk T. N., Konakova O. V., Dralova O. A., Puhir V. P., Firyulina O. M., Zelenukhina E. V.
Zaporizhzhia State Medical University, Ukraine
KU «Regional Infectious Clinical Hospital of Zaporizhzhia Regional State Administration», Ukraine
SI «Zaporizhzhia Regional Laboratory center of the Ministry of Health of Ukraine»

The aim: to conduct a comparative analysis of the coverage of measles vaccination, the status of specific immunity of population and measles morbidity in the Zaporizhzhia region in 2009–2018.

Material and methods. We carried out retrospective epidemiological analysis with statistical processing of data obtained from reporting forms for vaccination for the period of 2009–2018. It was done assessment of the state of collective immunity in children to the measles virus for 2008–2017. The analysis of 1494 blood serum samples of children under the age of 18 years and pregnant women, residents of Zaporizhzhia region, and 1157 — of city Zaporizhzhya. The state of herb immunity to the measles virus for 10 years was analyzed. Additionally, the level of Ig G in blood serum was estimated by the IFA method from 2011. Statistics were carried out with using the methods accepted in medicine.

Results. In 2017 a significant increase in the incidence of measles was noted. Cases of measles in 2017 were reported in both children (102 cases) and adults (100 cases). 88% of children older than one year with measles were not vaccinated (the incidence rate — 35.4 per 100.000). In 2010, 2013, 2016 and 2017 the coverage of the first measles vaccination at the age of one year was 50%, whereas in 2011, 2014, 2015 and 2018 — 70–80 %. Coverage of the second measles vaccination at the age of 6 year over the past ten years was 50%, but in 2010 and 2016 — 20%). Among the residents of Zaporizhzhya city, the vast majority of pregnant women during the last decade are protected against measles; children 1–2 years of age — who were supposed to receive the first dose of the vaccine, were protected from measles worst of all in 2008–2012 and in 2016 (less than 50% had antibodies to measles virus). A similar tendency has been observed in a group of children aged 7 and 15 years. The anti-measles virus antibody titers among inhabitants of Zaporizhzhia region in all age groups were lower than those in Zaporozhzhya city (only less than 60% of the pregnant women in 2008, 2014, 2015, 2016 and 2017 had sufficient antibody titers).

Conclusions. In 2017–2018, there was a rise in measles morbidity due to unsatisfactory coverage of the measles vaccine in 2009–2016. The epidemic situation continue to be tense because a large number of unvaccinated children (88% of children >12 months of age who were hospitalized with measles were not vaccinated.

Key words: measles, coverage of vaccination, morbidity, herb immunity against measles, children.

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Article received: Oct 18, 2018. Accepted for publication: Feb 11, 2019.