Esteghamati Abdoulreza, Gouya Mohammad Mehdi, Zahraei Seyed Mohsen, Dadras Mohammad Nasr, Rashidi Armin, Mahoney Frank
Ministry of Health and Medical Education, Tehran, Iran.
Pediatr Infect Dis J. 2007 Dec;26(12):1137-41. doi: 10.1097/INF.0b013e3181462090.
Measles is a leading cause of death worldwide because of vaccine preventable diseases. Prevention and control of measles and rubella is a high priority for the Islamic Republic of Iran. In 2002, the Ministry of Health and Medical Education in Iran developed a comprehensive strategy to eliminate measles and rubella. This strategy included recommendations for a mass immunization campaign for all persons between the ages of 5-25 years with measles-rubella (MR) vaccine. This report reviews the results of this campaign and progress in the elimination of measles and rubella in Iran.
Measles vaccination coverage, supplemental immunization activities, surveillance data, and results from a nationwide serosurvey were reviewed.
Between 1980 and 2005, vaccination coverage ranged from 38%-99% with sustained high coverage (> or =94-99%) for the past decade. Despite high coverage with the first dose of measles vaccine (MCV1) and the introduction of a second dose of measles in 1984, case counts remained high between 1980 and 2005 with a median case count of 4414. In December 2003, a nationwide immunization campaign was conducted targeting 33,579,082 people between the ages of 5 and 25 years with a combined measles and rubella vaccine; 98% of the target population was vaccinated. A postcampaign serosurvey conducted in 2004 revealed >97.4% of the population aged between 5 and 40 years had immunity to measles and rubella. Case-based surveillance for measles identified 3 children with laboratory confirmed disease in 2004, 35 in 2005, and 42 children in 2006. Most confirmed disease occurred in immigrant communities or communities with migrant populations from neighboring counties with ongoing measles outbreaks. Surveillance for rubella was established after the campaign and identified 37 patients with confirmed disease in the follow-up period.
Implementation of a comprehensive strategy for measles elimination in Iran has remarkably reduced the incidence of measles and rubella to <1 case per 1,000,000. Sporadic transmission continues to occur, particularly in areas with immigrant and nomadic populations.
在全球范围内，麻疹是疫苗可预防疾病导致死亡的主要原因之一。麻疹和风疹的预防与控制是伊朗伊斯兰共和国的高度优先事项。2002年，伊朗卫生和医学教育部制定了一项消除麻疹和风疹的综合战略。该战略包括针对所有5至25岁人群开展麻疹-风疹（MR）疫苗大规模免疫运动的建议。本报告回顾了此次运动的结果以及伊朗在消除麻疹和风疹方面取得的进展。
审查了麻疹疫苗接种覆盖率、补充免疫活动、监测数据以及全国血清学调查结果。
1980年至2005年期间，疫苗接种覆盖率在38%至99%之间，在过去十年中保持着较高的覆盖率（≥94%至99%）。尽管麻疹疫苗第一剂（MCV1）的接种覆盖率较高，且1984年引入了第二剂麻疹疫苗，但1980年至2005年期间病例数仍然居高不下，病例数中位数为4414例。2003年12月，针对33579082名5至25岁人群开展了全国性免疫运动，使用联合麻疹风疹疫苗；目标人群的98%接种了疫苗。2004年开展的运动后血清学调查显示，5至40岁人群中>97.4%对麻疹和风疹具有免疫力。基于病例的麻疹监测在2004年发现3例实验室确诊病例，2005年发现35例，2006年发现42例。大多数确诊病例发生在移民社区或有来自邻国持续发生麻疹疫情的流动人口的社区。运动后建立了风疹监测，在随访期间发现37例确诊病例。
伊朗实施的消除麻疹综合战略已将麻疹和风疹发病率显著降低至每100万人<1例。散发病例仍在继续出现，特别是在有移民和游牧人口的地区。
