Rodrigo Silvia Guiral, Calatrava Rosana Guaita, Vicenta Rigo Medrano M, Vidal Miquel Amat, Martín-Sierra Balibrea Miguel, Zarco Isabel Huertas, Ramón Jorge Roda, Cifre Antonio Salazar, Morán Francisco González
Dirección General de Salud Pública de la Comunidad Valenciana, Servicio de Vigilancia y Control Epidemiológico.
Sección de Epidemiología, Centro de Salud Pública de Valencia, Valencia, España.
Enferm Infecc Microbiol Clin. 2014 Feb;32 Suppl 1:43-50. doi: 10.1016/S0213-005X(14)70149-1.
Measles incidence declined until becomes a sporadic reporting and infrequent notification in the last decade. The reemergence of the disease reached 744 cases in 2012, a rate of 14.50×10(5) inhabitants. A classic design in Public Health Surveillance was performed: retrospective analysis of cumulative incidence and characteristics of the affected subjects. Those dates were in record linkage with Valencia Microbiology Network (RedMIVA). Finally, 976 cases of measles were confirmed in 2011-2012 epidemic period. Time-line distribution shows three waves with amplitude length on 12-15 weeks. Proportion of unvaccinated or unknown subjects came up to 85% of cases. 25 outbreaks were reported, 499 cases associated. In 7 of the 10 community outbreaks early cases were from Roma population unvaccinated. In the city of Valencia was applied post-exposure prophylaxis in 32 schools and was observed low coverage: between 63% and 77% in 8 schools and less than 50% in 4. Serum negative rate was 12.4% and we highlight the rate under 16 months: 44.8%. Cohorts of 20-59 years had negative rates between 13.5 to 5.9%. The origin of the epidemic was the importation of cases to a territory with inadequate immune protection against measles. Its impact and development was conditioned by previous immunization coverage, the social and ethnic pattern of different areas or quarters and the extensive application of post-exposure prophylaxis at school and family contacts of cases.
麻疹发病率持续下降，直至在过去十年中变为零星报告且鲜有通报。2012年该疾病再度出现，病例达744例，发病率为14.50×10⁵/居民。开展了公共卫生监测中的经典设计：对累积发病率及受影响对象特征进行回顾性分析。这些数据与巴伦西亚微生物网络（RedMIVA）进行了记录关联。最终，在2011 - 2012年流行期间确诊976例麻疹病例。时间线分布显示出三波，波幅时长为12 - 15周。未接种疫苗或情况不明的对象占病例的85%。报告了25起疫情，涉及499例病例。在10起社区疫情中的7起，早期病例来自未接种疫苗的罗姆人群体。在巴伦西亚市对32所学校实施了暴露后预防措施，观察到覆盖率较低：8所学校在63%至77%之间，4所学校低于50%。血清阴性率为12.4%，我们着重指出16个月以下儿童的血清阴性率为44.8%。20 - 59岁人群的血清阴性率在13.5%至5.9%之间。疫情起源于病例输入到对麻疹免疫防护不足的地区。其影响和发展受到既往免疫接种覆盖率、不同地区或街区的社会和种族模式以及在病例的学校和家庭接触者中广泛实施暴露后预防措施的制约。
