University Clinic of Infectious Diseases and Febrile Conditions, Clinical Centre, Medical Faculty, Skopje, R. Macedonia.
PLoS One. 2013 Sep 10;8(9):e74754. doi: 10.1371/journal.pone.0074754. eCollection 2013.
Despite a 92-99% national vaccination coverage since 2000, the former Yugoslav Republic of Macedonia experienced a large measles outbreak between 2010 and 2011. Here we investigate the characteristics of patients hospitalized during this outbreak at the Clinic of Infectious Diseases in Skopje.
Epidemiological, clinical and laboratory data of 284 measles patients, including 251 from Skopje (43.80% of the 573 reported cases) and 33 from elsewhere in Macedonia were collected.
The most affected age groups were children up to 4 years of age and adolescents/adults of 15 years and older. Most patients were unvaccinated (n=263, 92.61%) and many had non-Macedonian nationalities (n=156, 54.93%) or belonged to the Roma ethnicity (n=73, 25.70%). Bronchopneumonia and diarrhea were the most common complications. Eighty-two out of 86 tested patients (95.35%) had measles-specific IgM antibodies. The outbreak was caused by the measles variant D4-Hamburg.
The epidemic identified pockets of susceptibles in Skopje and indicated that additional vaccination opportunities in particular for people with non-Macedonian nationality and traveler communities are warranted to ensure efficient measles control in Macedonia. The high attack rate among children of less than 1 year suggests that vaccination before 12 months of age should be considered in high risk settings.
尽管自 2000 年以来全国疫苗接种覆盖率达到 92%-99%，但前南斯拉夫的马其顿共和国在 2010 年至 2011 年期间仍经历了大规模麻疹疫情。在此，我们研究了斯科普里传染病诊所在此期间住院的患者的特征。
我们收集了 284 例麻疹患者的流行病学、临床和实验室数据，其中 251 例来自斯科普里（报告的 573 例病例的 43.80%），33 例来自马其顿其他地区。
受影响最严重的年龄组是 4 岁以下的儿童和 15 岁及以上的青少年/成年人。大多数患者未接种疫苗（n=263，92.61%），许多人具有非马其顿国籍（n=156，54.93%）或属于罗姆族裔（n=73，25.70%）。支气管肺炎和腹泻是最常见的并发症。86 例接受检测的患者中有 82 例（95.35%）具有麻疹特异性 IgM 抗体。此次疫情由麻疹变体 D4-汉堡引起。
该疫情在斯科普里发现了易感人群，表明特别需要为具有非马其顿国籍和旅行者群体的人群提供额外的疫苗接种机会，以确保马其顿麻疹的有效控制。1 岁以下儿童的高发病率表明在高风险环境中应考虑在 12 个月之前接种疫苗。
