Sharma Munesh K, Bhatia Vikas, Swami H M
Department of Community Medicine, Govt. Medical College, College Building, Sector 32-A, Chandigarh-160 030, India.
Indian J Med Sci. 2004 Feb;58(2):47-53.
An outbreak of measles was reported from a slum, UT, Chandigarh in April 2003. Similar outbreak was also reported in less than three years from the same and adjoining areas. The present study was conducted to investigate and assess various epidemiological features associated with measles outbreak.
Three cases of measles were admitted in Dept. of Paediatrics, Govt. Medical College & Hospital, Chandigarh and were reported to the Dept. of Community Medicine for an outbreak investigation. A trained team investigated the slum having a population of 25,000 and studied various features associated with epidemic between the period of April 22 to May 10, 2003.
The study covered 484 houses having 1130 children. Among the children who developed measles 32.76% were vaccinated ones. In them attack rate was 3%. Attack rate in vaccinated children went on increasing as age increased. An overall attack rate of 5.13% (Peak incidence 6% in 1-4 years age group) was recorded. Among measles cases, one-fifth had post measles complications. As much as 32.76% children with measles had received measles vaccination in the past. Therefore something more than immunization by single dose of vaccine is required. Measles was reported to be higher amongst the children without Vitamin A supplementation (P < 0.001).
There is need to store vaccine properly and to strengthen routine immunization coverage, Vitamin A supplementation and health infrastructure in underprivileged population. Serological studies among vaccinated children against measles should be undertaken to explore the possibility of second dose of measles in older children.
2003年4月,印度旁遮普邦昌迪加尔联合属地的一个贫民窟报告了麻疹疫情。在不到三年的时间里,同一地区及周边地区也报告了类似疫情。本研究旨在调查和评估与麻疹疫情相关的各种流行病学特征。
昌迪加尔政府医学院及医院儿科收治了3例麻疹病例,并报告给社区医学部进行疫情调查。一个经过培训的团队对一个有25000人口的贫民窟进行了调查,并研究了2003年4月22日至5月10日期间与疫情相关的各种特征。
该研究覆盖了484户家庭,共有1130名儿童。在患麻疹的儿童中,32.76%接种过疫苗。其中发病率为3%。接种疫苗儿童的发病率随年龄增长而上升。总体发病率为5.13%(1-4岁年龄组发病率最高,为6%)。在麻疹病例中,五分之一有麻疹后并发症。多达32.76%患麻疹的儿童过去接种过麻疹疫苗。因此,需要采取单剂量疫苗免疫之外的更多措施。据报告,未补充维生素A的儿童中麻疹发病率更高(P<0.001)。
需要妥善储存疫苗,加强弱势群体的常规免疫接种覆盖率、维生素A补充和卫生基础设施。应对接种疫苗儿童进行麻疹血清学研究,以探讨大龄儿童接种第二剂麻疹疫苗的可能性。