MEASLES: MANIFESTATIONS AT THE STAGE OF ELIMINATION OF INFECTION AND DIRECTIONS FOR EFFECTIVE MANAGEMENT OF THE EPIDEMIC PROCESS

Abstract

Controlling measles is still important despite the significant progress achieved through routine immunization. Aim: to identify the weak points of the infection control system and to determine the directions for effective management of the epidemic process using the example of the local epidemic situation. Material and methods: The materials for the study were data from the official registration of the incidence of measles among residents of a large industrial city in 1988-2016 and the results of serological screening for anti-measles IgG of health care workers during the outbreak of measles in 2016. The epidemiological, clinical, serological and statistical research methods have been used. Results: In conditions of a high level of vaccination against measles in the metropolitan population, significant quantitative and qualitative changes occurred in the epidemic process of this infection. Between 2001 and 2015, on the territory of the city, local cases of measles were not recorded, and its single penetration from endemic territories did not cause the spread of the infection. However, in 2016, a measles outbreak was registered, due to the spread of infection mainly in medical settings among patients and staff. Serological immunity tests for measles conducted among health care workers showed that up to 80% of those who underwent the tests had a protective level of anti-measles antibodies, with the highest proportion of people with seroprotection being detected in the age group over 50 years old. Up to 40% of workers with an interval of 10 years and more after the last vaccination were included in the cohort of persons with anti-measles IgG below 0.18 IU / ml, i.е. below protective level. Conclusions: Measles remains an important infection, which has a possibility to spread among children and adults who are not protected against it. To effectively control the epidemic situation for measles during the elimination stage of the infection, it is necessary to implement a system of continuous monitoring of the intensity of measles immunity in the indicator groups and to perform routine immunization against measles once every 10 years up to 50 years of age. In the outbreaks where the first patient was not previously vaccinated, it is necessary to carry out booster immunization with live measles vaccine for contact people without preliminary screening.