Evaluating the population measles susceptibility in Tianjin,China |
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| Institution: | 1. Department of Expanded Program Immunization, Tianjin Center for Disease Control and Prevention, 6 Hua Yue Street, Hedong District, Tianjin 300011, China;2. Department of Viral Laboratory, Tianjin Center for Disease Control and Prevention, 6 Hua Yue Street, Hedong District, Tianjin 300011, China;3. NHC Key Laboratory of Medical Virology and Viral Diseases and WHO WPRO Regional Reference Measles/Rubella Laboratory, National Institute for Viral Disease Control and Prevention, Chinese Center for Diseases Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, China;4. National Institute for Viral Disease Control and Prevention, Chinese Center for Diseases Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, China;5. Institute for Infectious Diseases Control and Prevention, Tianjin Center for Disease Control and Prevention, 6 Hua Yue Street, Hedong District, Tianjin 300011, China;1. Office of the WHO Representative, People’s Republic of China, Beijing, China;2. Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China;3. Office of the WHO Western Pacific Region, Manila, Philippines;1. Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain;2. Agència de Salut Pública de Catalunya, Barcelona, Spain;3. Institut de Recerca Sant Joan de Déu, Sant Joan de Déu University Hospital, Barcelona, Spain;4. Departamento de Medicina, Universitat Internacional de Catalunya, Barcelona, Spain;5. Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain;6. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain;7. Servicio de Epidemiología y Prevención, Dirección General de Salud Pública, Servicio Canario de la Salud, Spain;8. Sección de Epidemiología, Consejería de Sanidad, Trabajo y Servicios Sociales, Cantabria, Spain;9. Servicio de Epidemiología, Consejería de Sanidad, Sonia Humanes, Servicio de Epidemiología, Consejería de Sanidad, Castilla-La Mancha, Spain;10. Subdirecció General de Vigilància i Resposta a Emergències en Salut Pública, Agència de Salut Pública, CIBERESP, Cataluña, Spain;11. Servicio de Vigilancia y Control Epidemiológico, Consellería de Sanidad Universal y Salud Pública, Comunidad Valenciana, Spain;12. Servicio de Vigilancia y Control Epidemiológico, Consellería de Sanidad Universal y Salud Pública, Comunidad Valenciana, Spain;13. Servicio de Epidemiología, Dirección General de Salud Pública, Madrid, Spain;14. Servicio de Epidemiología, Sección Vigilancia Epidemiológica, Consejería de Salud, Murcia, Spain;15. Sección de Vigilancia de Enfermedades Transmisibles del Instituto de Salud Pública, CIBERESP, Navarra, Spain;p. Unidad de Vigilancia Epidemiológica, Subdirección de Salud Pública de Álava, País Vasco, Spain;q. Unidad de Vigilancia Epidemiológica de Bizkaia, País Vasco, Spain;r. Servicio de Epidemiología y Prevención Sanitaria, Dirección General de Salud Pública y Consumo, La Rioja, Spain;s. Servicio de Epidemiología y Prevención Sanitaria, Dirección General de Salud Pública y Consumo, La Rioja, Spain;t. Sección de Vigilancia Epidemiológica, Consejería de Sanidad y Bienestar Social, Ceuta, Spain;u. Servicio de Epidemiología, Dirección General de Sanidad y Consumo, Consejería de Presidencia y Salud Pública, Melilla, Spain;v. Centro Nacional de Epidemiología, Instituto de Salud Carlos III, CIBERESP, Centro Nacional de Epidemiología, Melilla, Spain;w. Centro Nacional de Epidemiología, Instituto de Salud Carlos III, CIBERESP, Spain;1. Dirección General de Salud Pública y Ordenación Farmacéutica, Consejería de Salud, Andalucía, Spain;6. Servicio de Epidemiología y Prevención, Dirección General de Salud Pública, Servicio Canario de la Salud, Canarias, Spain;2. Servicio de Vigilancia y Salud, Consejería de Salud, Andalucía, Spain;3. Dirección General de Salud Pública, Aragón, Spain;4. Servicio de Vigilancia Epidemiológica, Dirección General de Salud Pública, Consejería de Sanidad, Asturias, Spain;5. Servicio de Epidemiología, Dirección General de Salud Pública y Participación, Baleares, Spain;1. World Health Organization Consultant, C/Juan de Austria, 13, 28010 Madrid, Spain;2. National Center for Communicable Diseases, Ministry of Health, Nam Yan Ju Street 1, Ulaanbaatar, Mongolia;3. Ministry of Health, Olympic Street 2, Government Building VIII, Ulaanbaatar, Mongolia;4. National Statistics Office, Baga Toiruu 44, Government Building III, Ulaanbaatar, Mongolia;5. Mongolian Academy of Medical Sciences, Prime Minister Amar Street, Ulaanbaatar, Mongolia;6. Global Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, United States;7. Expanded Programme on Immunization, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland;8. Expanded Programme on Immunization, World Health Organization Regional Office of the Western Pacific, P.O. Box 2932, 1000 Manila, Philippines;1. Xiang Ya Nursing School of Central South University, No. 172, Tongzipo Road, Changsha, Hunan province, China;2. Room 712, Chinese Center for Disease Control and Prevention, No. 27, Nanwei Road, Xicheng District, Beijing, China;3. Ningxia Provincial Center for Disease Control and Prevention, No. 470, Shengli Road, Xingqing District, Yinchuan, Ningxia province, China;4. Hubei Provincial Center for Disease Control and Prevention, No. 6, Zhuodaoquanbei Road, Hongshan District, Wuhan, Hubei province, China;1. Department of Pediatrics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China;2. Pediatric Intensive Care Unit, Beijing Children''s Hospital, Capital Medical University, National Center for Children''s Health, Beijing, PR China;3. Department of Pediatrics, the First People’s Hospital of Foshan, Foshan, PR China;4. Department of Clinical Laboratory, Nanhai Hospital Affiliated to Southern Medical University, Foshan, PR China;1. Provincial Health Office, North Sumatera, Indonesia;2. Grandmed Hospital, Deliserdang, North Sumatera, Indonesia;3. Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia;4. Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia;5. Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia |
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| Abstract: | BackgroundMeasles is a highly infectious illness requiring herd immunity of 95% to interrupt transmission. China has not reached elimination goals despite high vaccination coverage. We estimated the population susceptibility against measles in Tianjin, China and to tailor awareness raising activities in the measles elimination plan.MethodsAge-specific measles seroprevalence was evaluated by Enzyme-Linked Immunosorbent Assay (ELISA) on 12,164 individual aged 0–44 years in 2009–2018. Measles IgG avidity testing was performed to confirm the relationship of the waning immunity after vaccination and secondary vaccination failures (SVF) on 324 confirmed measles cases in 2013–2018.Results11,108 samples (91.32%) tested positive for measles IgG, 239 (1.96%) tested as equivocal and 817 (6.72%) were negative. The age distribution of measles cases in Tianjin followed a U-shaped curve and was highest for those at <8 months and again at 20–39 years which correlated closely with the age distribution of measles susceptibility based on measles IgG antibody status (r = 0.72, P < 0.001). The seropositivity rate and antibody geometric mean concentration (GMC) for the 2018 study population were significantly lower (χ2 = 7.45, P = 0.006 and t = 12.01, P < 0.001) compared to 2009. The multivariate stepwise logistic regression analysis showed that age and region were the risk factors for both measles seropositivity rate and GMC after vaccination. The proportion of high avidity cases increased with age, being significantly higher in 75.31% of cases in patients aged 30–34 years (χ2 = 18.04, P = 0.003).ConclusionsHigh immunization coverage in children alone will not be adequate to realizing sufficient levels of population herd immunity, particularly given that the potential susceptibility window in adult. Implementation of supplemental immunization activity (SIA) targeted to appropriate group aged 30–34 years is recommended. |
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| Keywords: | Measles China Seroprevalence IgG avidity Secondary vaccination failures |
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