Lemos Daniele Rocha Queiroz, Franco Aidée Ramirez, de Sá Roriz Maria Lúcia Feitosa, Carneiro Ana Karine Borges, de Oliveira Garcia Márcio Henrique, de Souza Fábia Lidiana, Duron Andino Regina, de Góes Cavalcanti Luciano Pamplona
Secretaria da Saúde do Estado do Ceará, Fortaleza, Ceará, Brazil; Programa de pós-graduação em Saúde Coletiva da Universidade Estadual do Ceará, Fortaleza, Ceará, Brazil; Centro Universitário Christus, Fortaleza, Ceará, Brazil.
Organização Panamericana da Saúde, Washington, DC, United States.
Vaccine. 2017 Mar 23;35(13):1721-1728. doi: 10.1016/j.vaccine.2017.02.023. Epub 2017 Feb 27.
The measles virus circulation was halted in Brazil in 2001 and the country has a routine vaccination coverage against measles, mumps and rubella higher than 95%. In Ceará, the last confirmed case was in 1999. This article describes the strategies adopted and the effectiveness of surveillance and control measures implemented during a measles epidemic in the post-elimination period. The epidemic started in December 2013 and lasted 20 months, reaching 38 cities and 1,052 confirmed cases. The D8 genotype was identified. More than 50,000 samples were tested for measles and 86.4% of the confirmed cases had a laboratory diagnosis. The beginning of an campaign vaccination was delayed in part by the availability of vaccine. The classic control measures were not enough to control the epidemic. The creation of a committee of experts, the agreement signed between managers of the three spheres of government, the conducting of an institutional active search of suspected cases, vaccination door to door at alternative times, the use of micro planning, a broad advertising campaign at local media and technical operative support contributed to containing the epidemic. It is important to recognize the possibility of epidemics at this stage of post-elimination and prepare a sensitive surveillance system for timely response.
2001年，巴西阻断了麻疹病毒传播，该国针对麻疹、腮腺炎和风疹的常规疫苗接种覆盖率超过95%。在塞阿拉州，最后一例确诊病例出现在1999年。本文描述了在消除麻疹后时期的一次麻疹疫情期间所采取的策略以及实施的监测和控制措施的成效。此次疫情始于2013年12月，持续了20个月，波及38个城市，有1052例确诊病例。鉴定出了D8基因型。对50000多个样本进行了麻疹检测，86.4%的确诊病例通过实验室诊断确诊。疫苗供应问题在一定程度上导致了疫苗接种运动启动延迟。传统的控制措施不足以控制疫情。成立专家委员会、三级政府管理人员签署协议、开展机构性主动搜索疑似病例、在非传统时间挨家挨户进行疫苗接种、采用微观规划、在当地媒体上广泛开展宣传活动以及提供技术操作支持，这些措施有助于控制疫情。认识到在消除麻疹后这一阶段出现疫情的可能性并建立一个敏感的监测系统以便及时做出应对，这一点很重要。
