Characteristics of the Epidemiological Situation of Measles in the Period of its Elimination in Republic of Moldova

Abstract

Relevance Measles continues to be one of the priorities of health care worldwide, due to it high contagiosity, still widespread, severity of the disease and complications. A high degree of population migration contributes to the spread of infection, i.e. global measles virus circulation, clinical change and late diagnosis, inadequate immunization coverage. Aim. Analysis of measles incidence in the Republic of Moldova in 2000–2018. and features of the epidemic process. Materials and Methods. Statistics on measles incidence and immunization coverage in 2000–2018 were used. 340 cases of measles registered in the country in 2018 were subjected to a detailed analysis Results There is a decrease in measles vaccination coverage, in 2017–87.1%. In the same year, the coverage with the first revaccination at 6–7 years was 92.4% and the second at 14–15 years is 94.9%, which is not enough to maintain epidemiological well-being. There are territorial differences in vaccination coverage. In 2018, imported cases of measles were in 62.5% from Ukraine, 25.0% from Russia and 12.5% from Romania. There have been isolated measles cases (14), and epidemic foci or outbreaks (7), with from 2 to 252 cases of measles. The largest measles outbreak in 2018 was registered among those who rest in a religious camp unvaccinated against measles. The average age of the diseased is 14 years, and in outbreaks with a significant number of cases (9 and more) within 7.9–14.9 years. In the age structure of the diseased, children from 1 to 10 years old prevail (66.1%), children under one year old make up 8,2%, teenagers 17,5% and adults 8.2%. Only 11.0% received one dose of measles vaccine, and 3.6% of the relevant age groups received two doses of vaccine. The reason is the refusal of vaccination for religious motive. In 196 (57.6%) cases, the diagnosis was confirmed by laboratory methods, and in the remaining 144 (42.4%) by clinical and epidemiological data. Conclusions Measles remains a childhood infection, but cases of the disease occur among adolescents (17.5%) and adults (8.2%). The uneven of vaccination coverage throughout the country, the low level of responsibility of the population, the increased incidence of measles in neighboring countries, the high level of population migration are risk factors for the importation and spread of measles.