Gao Jie, Shen Bing, Xiong JianJing, Lu Yihan, Jiang Qingwu
The Key Laboratory of Public Health Safety of Minister of Education-School of Public Health, Fudan University, Shanghai,China.
Jing'an District Center for Disease Control and Prevention, Shanghai, China.
PLoS One. 2017 Jun 22;12(6):e0179470. doi: 10.1371/journal.pone.0179470. eCollection 2017.
Measles vaccination over the past 50 years has greatly reduced the incidence of measles. However, measles among migrants and the resulting changes in epidemiological characteristics have brought new challenges to the elimination of measles. We aim to describe the measles epidemic trend over the past 30 years in a central district in Shanghai, China.
The present study was conducted in the Jing'an District, which is located in the center of Shanghai. Based on historical surveillance data of measles, we calculated the incidence of measles among local residents and migrants separately. Next, we classified all of the cases of the measles among local residents between 1984 and 2015 into 8 age groups and 5 birth cohorts. Finally, we calculated the measles incidence in each time period by the different age groups and birth cohorts, to understand the measles epidemic trend over past 30 years in the Jing'an District.
A total of 103 cases of measles were reported from the Jing'an District, Shanghai, from 1984 to 2015. For infants less than 1 year of age and adults over 30 years of age, the incidence of measles continued to rise over the past 30 years. For a specific birth cohort, the incidence of measles after measles vaccination declined initially, and was then followed by a rebound.
The incidence of measles in older adults and infants increased in some developed regions, which slows the process of measles elimination. This suggested that the population immunity against measles after measles vaccination would gradually reduce with time. We recommend supplemental immunization against measles in adults in order to reduce the immunity decline, especially for migrants.
过去50年里,麻疹疫苗接种极大地降低了麻疹发病率。然而,移民中的麻疹以及由此导致的流行病学特征变化给消除麻疹带来了新挑战。我们旨在描述中国上海某中心城区过去30年的麻疹流行趋势。
本研究在位于上海市中心的静安区开展。基于麻疹历史监测数据,我们分别计算了本地居民和移民中的麻疹发病率。接下来,我们将1984年至2015年间本地居民中的所有麻疹病例分为8个年龄组和5个出生队列。最后,我们计算了不同年龄组和出生队列在各时间段的麻疹发病率,以了解静安区过去30年的麻疹流行趋势。
1984年至2015年,上海静安区共报告103例麻疹病例。在过去30年里,1岁以下婴儿和30岁以上成年人的麻疹发病率持续上升。对于特定出生队列,麻疹疫苗接种后的麻疹发病率最初下降,随后出现反弹。
在一些发达地区,老年人和婴儿的麻疹发病率上升,这减缓了麻疹消除进程。这表明麻疹疫苗接种后的人群麻疹免疫力会随时间逐渐下降。我们建议对成年人进行麻疹补充免疫,以减少免疫力下降,尤其是对移民而言。