Giambi C, Rota M C, Bella A, Filia A, Gabutti G, Guido M, De Donno A, Ciofi degli Atti M L
Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Roma, Italia.
Ann Ig. 2007 Mar-Apr;19(2):93-102.
In November 2003 the National Plan for the elimination of measles and congenital rubella was approved, with the aim of reducing and maintaining the incidence of congenital rubella syndrome (CRS) at less than 1 case per 100,000 live births by 2007. In order to describe the epidemiology of rubella in Italy, we conducted a serosurvey and evaluated incidence and vaccination coverage data available for the period 1998-2004. In the years considered, national mean coverage of measles-mumps-rubella vaccination within the second year of life, even though still below the 95% threshold, has progressively increased reaching 87%. In addition, previously existing differences in coverage among regions have diminished. In the same period the incidence of rubella has decreased, with a historic minimum of 461 cases notified in 2004. The cyclic pattern typical of rubella persists, but with a prolongation of the interepidemic period and an increased mean age of acquisition of the infection. Although the proportion of immune individuals has increased, the percentage of women of childbearing age susceptible to rubella remains high (11% in the 15-19 year age group and 8% in the 20-39 year age group) and CRS cases continue to occur. Despite the clear results achieved through the implementation of vaccination strategies in children within the second year of life, a continued strong public health commitment is required to increase the proportion of vaccinated individuals and absolute priority must be given to immunising women of childbearing age.
2003年11月,消除麻疹和先天性风疹国家计划获得批准,目标是到2007年将先天性风疹综合征(CRS)的发病率降低并维持在每10万例活产儿少于1例的水平。为了描述意大利风疹的流行病学情况,我们开展了一项血清学调查,并评估了1998 - 2004年期间可获得的发病率和疫苗接种覆盖率数据。在所研究的年份中,一岁内麻疹 - 腮腺炎 - 风疹疫苗接种的全国平均覆盖率虽仍低于95%的阈值,但已逐步上升至87%。此外,此前各地区在覆盖率上存在的差异已有所缩小。同一时期,风疹发病率有所下降,2004年报告的病例数创历史最低,为461例。风疹典型的周期性模式依然存在,但流行间期延长,感染的平均发病年龄增加。尽管免疫个体的比例有所上升,但育龄期易感风疹的女性比例仍然很高(15 - 19岁年龄组为11%,20 - 39岁年龄组为8%),CRS病例仍有发生。尽管在一岁内儿童中实施疫苗接种策略已取得明显成效,但仍需要持续有力的公共卫生投入,以提高接种个体的比例,并且必须绝对优先为育龄期妇女接种疫苗。