a Molecular Epidemiology and Public Health Laboratory (mEpiLab), Infectious Disease Research Centre (IDReC), Hopkirk Research Institute , Massey University , Palmerston North , New Zealand.
Hum Vaccin Immunother. 2019;15(1):28-33. doi: 10.1080/21645515.2018.1517074. Epub 2018 Sep 19.
Increased measles immunization has led to a significant decline in measles incidence and mortality. During 2016 it is estimated that fewer than 100,000 died from measles for the first time in recorded history. In highly immunized countries measles epidemiology has changed. Threats to national elimination goals and public health include aging cohorts of naïve people that exist from imperfect vaccination rates during the early years of immunization programs. This may be complemented by some loss of immunity in vaccinated populations. While childhood immunization must remain a focus for control efforts, due to higher mortality in the very young, these naïve adolescents and adults also accumulate as they age and add to the pool of susceptible people, perhaps beyond the view of those that are focused on childhood immunization. Here, features of measles epidemiology and control in highly immunized populations are reviewed, providing global data where necessary, to highlight why countries with high immunization coverage are still threatened by measles outbreaks and how changing dynamics may alter disease control.
麻疹免疫接种率的提高显著降低了麻疹的发病率和死亡率。据估计，2016 年有记录以来首次死于麻疹的人数不到 10 万。在高免疫接种率的国家，麻疹的流行病学发生了变化。对国家消除目标和公共卫生的威胁包括在免疫规划早期由于疫苗接种率不高而存在的未感染人群的年龄增长。这可能与接种人群的一些免疫丧失有关。虽然儿童免疫接种仍然是控制工作的重点，但由于非常年幼的儿童死亡率较高，这些未感染的青少年和成年人随着年龄的增长而积累，增加了易感人群的数量，这可能超出了关注儿童免疫接种的人的视野。在这里，审查了高免疫人群中麻疹流行病学和控制的特征，必要时提供了全球数据，以强调为什么高免疫覆盖率的国家仍受到麻疹暴发的威胁，以及动态变化如何改变疾病控制。
