Gabutti G, Rota M C, Salmaso S, Bruzzone B M, Bella A, Crovari P
Department of Health Sciences, Hygiene and Preventive Medicine Section, Faculty of Medicine, University of Genoa, Italy.
Epidemiol Infect. 2002 Dec;129(3):543-50. doi: 10.1017/s0950268802007677.
A serosurvey for measles, mumps and rubella was conducted in Italy; incidence based on statutory notifications over the last three decades was also calculated. In Italy the diseases followed an endemic-epidemic pattern, with an incidence peak every 2-4 years, and had a limited reduction of incidence attributable to childhood immunization. Lower notification rates were observed in the Southern regions. This is possibly related to greater under notification in the South and is confirmed by our seroprevalence data. Incidence of measles and rubella and proportion of cases among young adults increased significantly in the three decades considered, but not for mumps. Serological data confirmed that these infections are still very frequent in Italy, without significant geographic variation in the country. In the age groups 2-4 and 5-9 years the percentage of individuals still susceptible to each virus was higher than 30%. The proportion of susceptible subjects older than 15 years was similar for the three infections (6.1, 11.7 and 8.8% for measles, mumps and rubella, respectively). The low vaccine coverage for rubella and measles in Italy has so far only partially affected the occurrence of the diseases. No impact of mumps vaccination is visible. The average number of deaths, for each disease, has decreased during the three study periods. Today the priority in Italy is to halt the progressive increase of the mean age of acquisition of the three infections, to eliminate differences in coverage among regions and to conform to European standards. This will be achieved through a combination of increasing MMR vaccine coverage before 2 years of age, implementing vaccination campaigns for low seroprevalence age groups, and/or introducing a second dose of MMR, depending on the level of current MMR coverage.
在意大利开展了一项针对麻疹、腮腺炎和风疹的血清学调查；还计算了过去三十年基于法定通报的发病率。在意大利，这些疾病呈地方流行-流行模式，每2-4年出现一次发病高峰，且因儿童免疫接种导致的发病率下降有限。南部地区的通报率较低。这可能与南部地区漏报情况更严重有关，我们的血清流行率数据也证实了这一点。在所研究的三十年中，麻疹和风疹的发病率以及青年成人中的病例比例显著上升，但腮腺炎并非如此。血清学数据证实，这些感染在意大利仍然非常常见，在该国没有明显的地理差异。在2-4岁和5-9岁年龄组中，对每种病毒仍易感的个体比例高于30%。15岁以上易感人群在三种感染中的比例相似（麻疹、腮腺炎和风疹分别为6.1%、11.7%和8.8%）。意大利风疹和麻疹疫苗接种覆盖率较低，迄今为止仅对这些疾病的发生产生了部分影响。未发现腮腺炎疫苗接种有任何影响。在三个研究期间，每种疾病的平均死亡人数均有所下降。如今，意大利的首要任务是阻止这三种感染发病平均年龄的逐步上升，消除各地区之间的接种覆盖率差异，并符合欧洲标准。这将通过以下措施实现：在2岁前提高麻疹-腮腺炎-风疹（MMR）疫苗接种覆盖率，对血清流行率较低的年龄组开展疫苗接种运动，和/或根据当前MMR疫苗接种覆盖率水平引入第二剂MMR疫苗。
