Objective.In the Russian Federation on the background of the sporadic incidence of measles, the trend is not highly uniform distribution of morbidity on territories of the country with the formation of local outbreaks, including the result of nosocomial infection. Find out the causes of the outbreak, for example the territory, for 15 years keeping and epidemic well-being in relation to measles, high vaccination coverage in children and adults, to assess the capacity of health care organizations and epidemiology to prevent the spread of measles and the elimination of flash was the goal of this research.Material and methods. A retrospective epidemiological analysis was held: the incidence of measles for the period 2001–2016 in the Sverdlovskiy region ; 76 «Cards epidemiological case investigation suspected measles», was from October to December 2016; the analysis of the extraordinary and final reports of the measles outbreak, reports on the activities carried out in the outbreak of measles. Laboratory verification of cases suspected were examined the ELISA method in the Perm regional centre, on the basis of detection of specific IgM and/or IgG increase. Molecular genetic research of 15 clinical specimens were performed at the Scientific- methodical centre on supervision of measles and rubella (Gabrichevsky Research Institute by Epidemiology & Microbiology», Moscow).Results.During the period c from 40 to 51 week of 2016 measles ill 76 people, mostly (66 persons) residents of the city of Yekaterinburg. Prevailed among the infected children was 67% (51 persons), usually not vaccinated against this infection – 90% (46) of children had a measles vaccination. All cases were laboratory confirmed. Expected sources or place of infection was established in 90.8% of cases. Among cases and 72.4% (55 persons) amounted to unvaccinated against measles, 11.8 per cent(9 people) were vaccinated once, of 15.8% (12) had a two-fold vaccination. In 8 hospitals was 8 foci of measles, 6 of which had spread. Among the cases of measles identified in health facilities, 35 children and 19 adults, including 5 health workers and 3 medical students. The formation of foci of nosocomial infection contributed to missed cases of measles, late diagnosis, significantly reduce the effectiveness of anti-epidemic measures. The results of molecular genetic studies of 15 clinical samples of patients selected at 42–44, and 47–49 weeks possible to establish the circulating strains of measles virus genotype D8. Epidemiological investigations and the common genetic variant circulating genotypes, selected at different stages of measles spread from different foci made it possible to combine all cases in one outbreak. Analysis of clinical manifestations of measles have testified to the fact that measles is proceeded typically in 92.2% of cases. Eleven drifts infection in educational institutions of Ekaterinburg was not accompanied by the secondary spread, indicating good collective immunity.Conclusion.Thus, a retrospective epidemiological analysis of outbreaks of measles showed that in conditions of sporadic measles in doctors reduced vigilance against measles. Late diagnosis of measles and as a consequence of its failure to carry out anti- epidemic measures led to the spread of infection, as well as skid measles in other medicine organization, which consisted of nosocomial foci. The present outbreak showed that measles requires constant attention, especially during her long absence in the region. It is only possible to prevent sustained secondary transmission if measles vaccination coverage is high for the entire population.
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Open Access
Nov 14, 2018
Fabio Magurano + 5
