MacIntyre C R, Karki S, Sheikh M, Zwar N, Heywood A E
School of Public Health & Community Medicine, University of New South Wales, UNSW Australia, Sydney, Australia.
School of Public Health & Community Medicine, University of New South Wales, UNSW Australia, Sydney, Australia.
Vaccine. 2016 Aug 17;34(37):4386-91. doi: 10.1016/j.vaccine.2016.07.023. Epub 2016 Jul 19.
Many developed countries, like Australia, maintain a high population level immunity against measles, however, there remains a risk of acquisition of measles in non-immune travellers and subsequent importation into Australia leading to localised outbreaks. In this study, we estimate the incidence of measles and describe characteristics including immunisation and pre-travel health seeking behaviour of notified cases of measles in New South Wales and Victoria, Australia between February 2013 and January 2014. Cases were followed up by telephone interview using a questionnaire to collect information of demographic and travel characteristics. In NSW, the incidence was highest in age group 0-9years (20/million population) whereas in Victoria the highest incidence was observed in 10-19 (23/million population) years group. Out of 44 cases interviewed, 25 (56.8%) had history of travel outside of Australia during or immediately prior to the onset of measles. Holiday (60%) was the main reason for travel with 44% (11/25) reporting visiting friends and relatives (VFR) during the trip. The major reason described for not seeking prior medical advice before travel were "no perceived risk of diseases" (41%) and "previous overseas travel without any problem" (41%). Of the 25 measles cases with recent overseas travel during the incubation period, one reported a measles vaccine prior to their recent trip. Four cases were children of parents who refused vaccination. Twenty out of 25 (80.0%) had attended mass gathering events. Young adults and VFR travellers should be a high priority for preventive strategies in order to maintain measles elimination status.
许多发达国家，如澳大利亚，维持着针对麻疹的较高人群免疫力水平，然而，非免疫旅行者仍有感染麻疹的风险，随后将麻疹输入澳大利亚会导致局部疫情爆发。在本研究中，我们估计了2013年2月至2014年1月期间澳大利亚新南威尔士州和维多利亚州麻疹的发病率，并描述了麻疹确诊病例的特征，包括免疫接种情况和旅行前寻求医疗保健的行为。通过电话访谈对病例进行随访，使用问卷收集人口统计学和旅行特征信息。在新南威尔士州，0至9岁年龄组的发病率最高（每百万人口20例），而在维多利亚州，10至19岁年龄组的发病率最高（每百万人口23例）。在接受访谈的44例病例中，25例（56.8%）在麻疹发病期间或发病前立即有过澳大利亚境外旅行史。度假（60%）是旅行的主要原因，44%（11/25）的人报告在旅行期间探亲访友。未在旅行前寻求医疗建议的主要原因是“未察觉到疾病风险”（41%）和“以前的海外旅行没有任何问题”（41%）。在25例潜伏期内近期有海外旅行史的麻疹病例中，1例报告在近期旅行前接种过麻疹疫苗。4例是父母拒绝接种疫苗的儿童。25例中有20例（80.0%）参加过大型集会活动。为维持麻疹消除状态应将青年人和探亲访友旅行者作为预防策略的高度优先对象。
