DIFFICULTIES IN ELIMINATING MEASLES AND CONTROLLING RUBELLA AND MUMPS: A CROSS-SECTIONAL STUDY OF A FIRST MEASLES AND RUBELLA VACCINATION AND A SECOND MEASLES, MUMPS, AND RUBELLA VACCINATION

Monday, 12th of May 2014

[source]PLoS One[|source]

Despite the safe, free, and high uptake rate of the two doses of measles-containing vaccine (MCV) and rubella-containing vaccine (RCV) and one dose of mumps-containing vaccine (MuCV), measles, mumps, and rubella remain common diseases throughout Zhejiang province. Measles outbreaks continued in 2008, with 12,782 cases reported, which translated to 252.61 per million of the population. From 2009 to 2011, the incidence of measles remained high at 3.14–17.2 per million of the population. This trend of events clearly shows that measles and rubella elimination goals were threatened. Could serological surveillance be an additional surveillance method to inform strategies for measles and rubella elimination?

In this report, the authors determined the incidence, seroprevalence and vaccination history of MMR in Zhejiang Province in 2011 to clarify the population immunity characteristics and aid in the development of improved vaccination strategies. Detailed findings and recommendations are accessible at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930734/

 

ABSTRACT

 

BACKGROUND: The reported coverage of the measles–rubella (MR) or measles–mumps–rubella (MMR) vaccine is greater than 99.0% in Zhejiang province. However, the incidence of measles, mumps, and rubella remains high. In this study, we assessed MMR seropositivity and disease distribution by age on the basis of the current vaccination program, wherein the first dose of MR is administered at 8 months and the second dose of MMR is administered at 18–24 months.

METHODS: Cross-sectional serological surveys of MMR antibodies were conducted by collecting epidemiological data in Zhejiang province, China in 2011. In total, 1015 participants were randomly selected from two surveillance sites. Serum MMR-specific immunoglobulin G levels were tested by enzyme-linked immunosorbent assay. The geometric mean titres and seroprevalence with 95% confidence intervals (CIs) were calculated by age and gender. Proportions of different dose of vaccine by age by vaccine were also identified. Statistically significant differences between categories were assessed by the Chi-square test.

RESULTS: Over 95% seroprevalence rates of measles were seen in all age groups except <7 months infants. Children aged 5–9 years were shown lower seropositivity rates of mumps while elder adolescences and young adults were presented lower rubella seroprevalence. Especially, rubella seropositivity was significantly lower in female adults than in male. Nine measles cases were unvaccinated or unknown vaccination history. Among them, 66.67% (6/9) patients were aged 20–29 years while 33.33% (3/9) were infants aged 8–12 months. In addition, 57.75% (648/1122) patients with mumps were children aged 5–9 years, and 50.54% (94/186) rubella cases were aged 15–39 years.

CONCLUSIONS: A timely two-dose MMR vaccination schedule is recommended, with the first dose at 8 months and the second dose at 18–24 months. An MR vaccination speed-up campaign may be necessary for elder adolescents and young adults, particularly young females.