World Health Organization Western Pacific Regional Office Regional Reference Laboratory of Measles and Rubella, National Health Commission Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Provincial Measles/Rubella Laboratory, Shandong Provincial Center for Disease Control and Prevention, Jinan, China.
Clin Infect Dis. 2023 Feb 8;76(3):e1140-e1149. doi: 10.1093/cid/ciac674.
To provide useful insights into measles elimination progress in China, measles surveillance data were reviewed, and the transmission patterns of measles viruses circulating in China during 1993-2021 were analyzed.
Measles incidence data from the National Notifiable Disease Reporting System of the China Center for Disease Control and Prevention were analyzed. A total of 17 570 strains were obtained from 30 of 31 provinces in mainland China during 1993-2021. The recommended genotyping window was amplified. Genotyping analysis was conducted for comparison with the reference strains. Phylogenetic analyses were performed to identify genetic relationships among different lineages within the genotypes.
With high coverage of routine immunization and intensive supplementary immunization activities, measles incidence has shown a downward trend since 1993, despite 2 resurgences, reaching a historic low level in 2020-2021 (average 0.5 per million). During 1993-2021, 9 genotypes including domestic genotype H1; imported genotypes B3, D4, D8, D9, D11, G3, and H2; and vaccine-associated genotype A were identified. Among them, the genotype H1 strain circulated endemically in China for more than 25 years; the last strain was detected in Yunnan Province in September 2019. Multiple imported genotypes have been identified since 2009 showing different transmission patterns. Since April 2020, no imported strains have been detected, while vaccine-associated genotype A continues to be detected.
The evidence of low incidence during 2020-2021 and virological surveillance data in this study confirm that China is currently approaching measles elimination.
为了深入了解中国消除麻疹的进展，我们对麻疹监测数据进行了回顾，并分析了 1993-2021 年期间在中国流行的麻疹病毒的传播模式。
对中国疾病预防控制中心国家法定传染病报告系统的麻疹发病率数据进行了分析。共从中国大陆 31 个省份中的 30 个省份获得了 1993-2021 年的 17570 株麻疹病毒，扩增了推荐的基因分型窗口，对其进行基因分型分析，并与参考株进行比较。对不同基因型内的遗传关系进行了系统进化分析。
由于常规免疫接种覆盖率高，强化免疫活动密集，麻疹发病率自 1993 年以来呈下降趋势，尽管出现了 2 次反弹，在 2020-2021 年达到历史最低水平（平均每百万人口 0.5 例）。1993-2021 年，共发现 9 种基因型，包括本土基因型 H1；输入基因型 B3、D4、D8、D9、D11、G3 和 H2；以及疫苗相关基因型 A。其中，基因型 H1 株在中国流行超过 25 年；最后一个病例是 2019 年 9 月在云南省发现的。自 2009 年以来，已经发现了多种输入基因型，显示出不同的传播模式。自 2020 年 4 月以来，未检测到输入株，而疫苗相关基因型 A 仍在继续检测到。
2020-2021 年低发病率的证据和本研究的病毒学监测数据证实，中国目前正在接近消除麻疹。
