MMWR Morb Mortal Wkly Rep. 2005 Nov 4;54(43):1100-4.
Measles continues to be a leading cause of childhood morbidity and mortality in developing countries and an outbreak threat in the majority of countries. In 2000, measles was considered the fifth leading cause of childhood mortality, and the World Health Organization (WHO) estimated that approximately 777,000 measles-associated deaths occurred worldwide. In 2001, WHO and the United Nations Children's Fund (UNICEF) developed a 5-year strategic plan, endorsed by the World Health Assembly in 2003, to reduce measles mortality by 50% by 2005 (relative to 1999 estimates) and to achieve and maintain interruption of indigenous measles transmission in large geographic areas with established measles elimination goals. This plan included strengthening routine vaccination coverage, providing a second opportunity for measles immunization to children, improving measles case management, and improving surveillance with laboratory confirmation of suspected measles cases. To date, four of six WHO regions have established measles elimination targets: the Americas Region (AMR) by 2000, the European Region (EUR) by 2010, the Eastern Mediterranean Region (EMR) by 2010, and the Western Pacific Region (WPR) by 2012. The remaining two WHO regions, the African (AFR) and South East Asian (SEAR) regions, are continuing work toward the measles mortality reduction goal. Likewise, to reduce the burden of disease from congenital rubella syndrome (CRS), currently estimated at 100,000 cases per year worldwide, several countries have developed or continue to develop rubella control programs, and AMR and EUR have established regional rubella elimination and CRS reduction goals, respectively. Because improved global surveillance is essential for monitoring progress toward mortality reduction and elimination of these diseases, WHO established the Measles and Rubella Laboratory Network (LabNet) in 2003 to promote case identification and confirmation. This report provides an update on the development of LabNet during January 2004-June 2005 and describes the geographic distribution of measles and rubella virus genotypes as of June 2005.
在发展中国家,麻疹仍然是导致儿童发病和死亡的主要原因,并且在大多数国家构成疫情爆发威胁。2000年,麻疹被认为是儿童死亡的第五大主要原因,世界卫生组织(WHO)估计全球约有77.7万例与麻疹相关的死亡。2001年,WHO和联合国儿童基金会(UNICEF)制定了一项为期5年的战略计划,该计划于2003年得到世界卫生大会的认可,目标是到2005年将麻疹死亡率降低50%(相对于1999年的估计数),并在已确立麻疹消除目标的大片地理区域实现并维持本土麻疹传播的阻断。该计划包括加强常规疫苗接种覆盖率,为儿童提供第二次麻疹免疫机会,改善麻疹病例管理,以及通过实验室确诊疑似麻疹病例来加强监测。迄今为止,WHO的六个区域中有四个已确立麻疹消除目标:美洲区域(AMR)于2000年实现,欧洲区域(EUR)于2010年实现,东地中海区域(EMR)于2010年实现,西太平洋区域(WPR)于2012年实现。WHO其余两个区域,即非洲(AFR)和东南亚(SEAR)区域,仍在继续努力实现降低麻疹死亡率的目标。同样,为减轻目前全球每年估计达10万例的先天性风疹综合征(CRS)疾病负担,一些国家已制定或继续制定风疹控制计划,AMR和EUR分别确立了区域风疹消除和CRS减少目标。由于加强全球监测对于监测降低死亡率和消除这些疾病的进展至关重要,WHO于2003年建立了麻疹和风疹实验室网络(LabNet)以促进病例识别和确诊。本报告提供了2004年1月至2005年6月期间LabNet的发展情况更新,并描述了截至2005年6月麻疹和风疹病毒基因型的地理分布。