Bianchi S, Faccini M, Lamberti A, Senatore S, Ciceri G, Frati E R, Colzani D, Gori M, Cereda D, Gramegna M, Auxilia F, Tanzi E, Amendola A
Department of Biomedical Sciences for Health, University of Milan, Italy.
Health Protection Agency, Metropolitan Area of Milan, Italy.
J Prev Med Hyg. 2019 Dec 20;60(4):E286-E292. doi: 10.15167/2421-4248/jpmh2019.60.4.1269. eCollection 2019 Dec.
In Italy, the transmission of measles is still endemic, and 7,919 cases were reported to the National Surveillance System between January 2017 and December 2018. Aim of this study is to report the results of the measles surveillance activities in the Metropolitan City of Milan from March 2017 to December 2018, and to evaluate the surveillance performance WHO indicators.
The Local Health Units (LHUs) carried out case investigations and collected specimens to send to the EpiSoMI Lab (Subnational Reference Laboratory, SRL) of the University of Milan for cases/outbreaks confirmation and genotyping performed according to the WHO Guidelines.
Overall, 610 suspected measles cases were reported by the surveillance system of the Metropolitan City of Milan. A total of 439 out of 540 cases with adequate specimens were laboratory-confirmed by molecular and/or serological assays. Two-hundred and thirty-six cases were notified as sporadic and 203 as related to 94 outbreaks. The most confirmed cases were aged 15-39 years, almost all not vaccinated. Overall, 282 cases were genotype D8 and 118 genotype B3.The evaluation of a set of indicators to monitor the quality of surveillance activities demonstrated the proficiency of the EpiSoMI Lab.
A well-done investigation of cases and outbreaks by the surveillance local system, in a timely manner, in order to notify and investigate suspected cases and to laboratory confirm or discard cases is fundamental to reduce morbidity, to prevent further virus transmission and to achieve measles elimination.
在意大利，麻疹传播仍呈地方性流行，2017年1月至2018年12月期间，国家监测系统共报告了7919例病例。本研究旨在报告2017年3月至2018年12月米兰市辖区麻疹监测活动的结果，并评估监测绩效的世界卫生组织指标。
地方卫生单位开展病例调查并采集样本，送至米兰大学的EpiSoMI实验室（地区参考实验室，SRL），按照世界卫生组织指南进行病例/疫情确认和基因分型。
总体而言，米兰市辖区监测系统报告了610例疑似麻疹病例。在540例有充足样本的病例中，共有439例通过分子和/或血清学检测得到实验室确诊。236例被通报为散发病例，203例与94起疫情有关。确诊病例中多数年龄在15 - 39岁，几乎都未接种疫苗。总体而言，282例为D8基因型，118例为B3基因型。对一组监测活动质量指标的评估表明EpiSoMI实验室具备专业水平。
地方监测系统及时对病例和疫情进行充分调查，以便通报和调查疑似病例，并通过实验室确诊或排除病例，对于降低发病率、防止病毒进一步传播以及实现消除麻疹至关重要。
