Aix-Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France; Aix-Marseille Université, APHM, Hôpital Nord, Réanimation des Détresses Respiratoires et Infections Sévères, Marseille, France.
Santé publique France, the French Public Health agency, Regions division, Regional office (PACA-Corse), Saint-Maurice, France.
Int J Infect Dis. 2018 Nov;76:97-101. doi: 10.1016/j.ijid.2018.08.023. Epub 2018 Sep 7.
To analyse a measles outbreak in a Roma community.
We describe a community-wide outbreak of genotype D8 measles that took place in southeastern France, between May and July 2017, along with the control measures adopted.
We identified a total of eighteen cases, between six months and 24 years old. All cases were unvaccinated or incompletely vaccinated and belonged to a sedentary French Roma community. Most of them (67%) were hospitalised, with three cases (17%) of severe measles including one death of a 16-year-old girl who had previously received oral corticosteroids. The latter was the only lethal case notified in France during the year 2017. Control measures included intensification of surveillance, isolation of cases, and a large vaccination campaign in this Roma community. During the outbreak period, there was no case of healthcare-associated measles transmission. A broad adherence to vaccination through the mediating role of both the chief of the community and the pastor allowed reaching completed vaccination coverage of 90%.
Efforts should be concentrated to enhance access to health services for minorities such as the Roma community characterized by low vaccination coverage. A trustful relationship with leaders of the community is essential to ensure adherence to vaccination. In France, attributable mortality to measles is low and concerns mainly unvaccinated and immunodepressed patients.
分析一个罗姆人社区的麻疹暴发情况。
我们描述了 2017 年 5 月至 7 月在法国东南部发生的基因型 D8 麻疹的全社区暴发情况,以及所采取的控制措施。
共发现 18 例病例,年龄在 6 个月至 24 岁之间。所有病例均未接种或未完全接种疫苗,且均属于定居的法国罗姆人社区。他们大多数(67%)住院,其中 3 例(17%)为重症麻疹,包括一名 16 岁女孩死亡,该女孩之前曾接受过口服皮质类固醇治疗。后者是 2017 年法国唯一报告的死亡病例。控制措施包括加强监测、隔离病例以及在该罗姆人社区开展大规模疫苗接种运动。在暴发期间,没有发生与医疗保健相关的麻疹传播病例。通过社区首领和牧师的调解作用,广泛接受疫苗接种,使完全接种疫苗的覆盖率达到 90%。
应集中精力为罗姆人等少数民族提供获得卫生服务的机会,这些少数民族的疫苗接种率较低。与社区领袖建立信任关系对于确保疫苗接种的依从性至关重要。在法国,麻疹的归因死亡率较低,主要涉及未接种疫苗和免疫抑制的患者。