Rubella in Poland in 1999

In Poland in 1999 rubella was characterized by an epidemiological stability. A total of 30 958 rubella cases (including one case of Congenital Rubella Syndrome) were registered. The incidence rate was 80.1 per 100,000 and was 28% lower than in 1998. Of all reported cases, children aged 14 and less accounted for 94.6% cases. The highest incidence rate was among children aged 7 years (752.8 per 100,000). Comparing with the eighties, the last decade was characterized by a decline of the mean incidence rate in the population under 30 years of age, which was probably the consequence of mandatory vaccinations of 13 year old schoolgirls. Also, a decline of incidence rate among 2-5-year old children was observed, which was probably due to recommended vaccinations with MMR-II vaccine. The incidence rate among children aged 6-9 years was higher in 1999, as compared with previous years. Of all rubella cases, 0.5% were hospitalized. No deaths from rubella were reported.     

上海市1990-2006年风疹流行病学特征分析

目的了解1990—2006年上海市风疹流行病学特征。方法用描述流行病学方法分析1990—2006年上海市传染病报告疫情数据库，数据采用Excel整理与分析。结果1990—2006年上海市风疹报告发病率为0．15110万～451．57／10万；1993年上海市发生风疹大流行，是风疹发病最高的年份，共报告风疹病例58104例，1998年是风疹发病的最低年份，共报告19例；1990—1994年（疫苗使用前）年平均报告发病率为93．00/10万，在疫苗使用前，风疹发病有明显的季节性特征，每年发病高峰集中在3—6月；风疹病例主要集中在儿童和青少年人群，即以5～9岁和10～14岁年龄组为主。1995年开始在上海市大规模使用风疹联合疫苗（MMR）后，全市MMR接种率达85％以上。风疹发病率呈逐渐下降趋势，每年报告风疹发病数除1995年外均〈100例，风疹的发病得到有效控制。但疫苗使用后，风疹发病的年龄构成有所改变，0～4岁发病年龄构成增加，占总发病数的21．00％，且发病年龄有逐年后移趋势，20岁以上年龄组发病占总发病数的31．62％，1995—2006年25～29岁年龄组和30～34岁年龄组风疹发病率均高于疫苗使用前（除1993年）相同年龄组的发病率。结论上海市风疹发病年龄后移。     

Rubella in Poland in 2003

In Poland, 10,588 cases of rubella were registered in 2003 (incidence 27.7 per 100,000 population). No cases of congenital rubella syndrome were reported. A 74% decrease in incidence was noted, compared to 2002. Across voivodeships, the incidence ranged from 113.1 per 100,000 in warmińsko-mazurskie to 6.2 per 100,000 in lódzkie. As in 2002 rubella incidence among residents of urban areas was lower, compared to residents of rural areas (26.4 and 29.8, respectively). The incidence in men (32.3) was 38% higher than in women (23.4) and this difference appears to systematically increase with routine vaccination of 13-year old girls. The highest incidence was observed in children aged 7 (242.0 per 100,000) and 8 years (209.3). Approximately 0.5% of cases required hospital admission. No rubella deaths were registered.     

Hepatitis B in Poland in 1999

A total of 3,508 of hepatitis B cases (including 152 cases of mixed HBV and HCV infections) were reported in Poland in 1999. For the first time since 1979, when registration has began, the incidence decreased below 10.0 and was 9.1 per 100,000. The program of eradication of hepatitis B in Poland has been introduced in 1993 and since then the fourfold decrease in number of hepatitis B cases has been noticed. During the past 7 years there has been a steady decline in hepatitis B incidence. In 1997 the incidence decreased 23% as compared to 1996, followed by 16.8% decrease in 1998 and 13.9% in 1999; the marked differences in incidence in particular voivodeships have been observed. The overall rate of hospitalized hepatitis B cases in Poland reached 98.1%. A total of 25 cases of hepatitis B (rate 1.2 per 100,000) occurred among children under 4 years of age, who should be vaccinated. Among children aged 5-9 years, of which many could not be vaccinated, the incidence rate was 6 times higher, ranging from 4.9 per 100,000 in girls to 9.8 per 100,000 in boys. The increase of incidence from 5.3 to 9.2 was observed in young people (14-24 years old). Data from the study of serological markers of hepatitis B, conducted among 4,500 health care workers during 1998-2000, have indicated that about 22% of health care workers have been infected with HBV (in 21% of persons anti-HBc and in 1% anti-HBc together with HBsAg were detected).     

Rubella in Poland in 2002

In Poland, 40,518 cases of rubella were registered in 2002 (incidence 106 per 100,000 population), including 2 cases of congenital rubella syndrome (incidence 0.57 per 100,000 live births). A 52% decrease in incidence was noted with respect to the epidemic year 2001. Across the voivodeships the incidence ranged from 227.7 per 100,000 in wielkopolskie to 21.4 per 100,000 in warminsko-mazurskie. As in 2001 urban areas registered slightly lower incidence than the rural areas (104.2 and 108.9 respectively). The incidence in men (120.2) was 24% higher than in women (91.9) and this difference appears to increase with routine vaccination of 13-year old girls. The highest incidence was observed in children aged 7 (1,023.2 per 100,000), 8 (930.7) and 9 years (859.6). Approximately 0.4% of cases required hospital admission. No rubella deaths were registered.     

The epidemiology of rubella and congenital rubella in Australia, 1992 to 1997.

Selective rubella vaccination of schoolgirls commenced in 1971 and was followed by a significant reduction in congenital rubella. Infant vaccination with MMR was introduced in 1989 to interrupt circulation of the virus in young children, and in 1994/95 the adolescent school based rubella vaccination program was changed to MMR for both boys and girls. This report reviews the epidemiology of rubella and congenital rubella between 1992 and 1997 using reports to the National Notifiable Diseases Surveillance System (NNDSS) and the Australian Paediatric Surveillance Unit (APSU). Notification rates for rubella exceeded 20 per 100,000 in 1992, 1993 and 1995 and declined to 7.2 per 100,000 in 1997. Sixty-one per cent of notifications occurred between September and December and 68% occurred in males. The incidence rate in males aged 15-22 years peaked at 152.6 per 100,000 in 1995 reflecting the lack of immunisation in this cohort. From 1993 to 1997, 19 children were reported with congenital rubella syndrome, representing 1 in 67,000 live births. Of these, 17 had multiple defects (4 died) and 2 had deafness only. There were also 5 infants with congenital rubella infection but no defects. Australia's rate of congenital rubella syndrome exceeded that of the United Kingdom and the United States of America but this may be partly attributable to differences in reporting practices. The impact of changing the second dose of MMR vaccine to 4 years of age in 1998 will require careful monitoring.     

Relationship between occurrence of Guillain-Barre syndrome and mass campaign of measles and rubella immunization in Iranian 5-14 years old children

BACKGROUND: Case reports and epidemiologic studies have reported a relation between different vaccines including measles, rubella, mumps and Guillain-Barre syndrome (GBS). In this study we investigated relation between receiving measles and/or rubella vaccines and occurrence of GBS after national immunization campaign in 2003 in Iran. MATERIALS AND METHODS: We used the national surveillance system for acute flaccid paralysis from the beginning of 2002 to the end of 2004 and studied the incidence of GBS disease among 5-14-year-old children. The 3-year time span of the study was divided into fifteen 10 weeks intervals and the number of reported and confirmed GBS case reports in each time period was analyzed supposing their distribution was according to Poisson distribution. RESULTS: From 2002 through 2004 there were 370 patients confirmed GBS case reports among persons 5-14 years of age. The annual incidence in this age group remained relatively constant over the 3-year period and ranged from 0.65 per 100,000 population in 2004 to 0.76 in 2003. The estimated average annual incidence of GBS in persons <15 years of age was 1/100,000 (CI 95%: 0.88-1.13), and 0.7/100,000 in persons 5-14 years of age (CI 95%: 0.58-0.83). No obvious seasonal pattern in GBS occurrence was observed. The mean number of GBS patients during each 10 week study interval was 23.8. Twenty-five patients with GBS were reported in the time period which coincided with national immunization campaign. The probability of occurring >/=25 cases of GBS in that time period according to Poison distribution with expected case numbers of 23-8 is equal to 0.43 (p=0.43). CONCLUSION: The yearly incidence rate of GBS in this study was similar to other studies. According to our results, there was no increase in GBS Incidence in the 4 weeks national Immunization campaign and 6 weeks after it in comparison to other 10 weeks periods before or after this time period.     

Last cases of rubella and congenital rubella syndrome in Spain, 1997–2016: The success of a vaccination program

With a highly immunized population, rubella infection in Spain is so low that the WHO has declared the elimination of rubella. Rubella in pregnant women is also very rare. The objective of this study is to describe the last cases of congenital rubella syndrome reported and recommend actions to maintain the status of the disease as eliminated.The CRS cases reported to the Spanish National Epidemiological Surveillance Network between 1997 and 2016 were studied, and the epidemiological, clinical, diagnostic and maternal characteristics of newborns with CRS described. The incidence of CRS was calculated using Birth Statistics from the Spanish National Statistics Agency (INE).Twenty-three cases of CRS were reported, 70% of which were associated with rubella outbreaks. The most common clinical conditions were heart disease (52.2%), deafness (39.1%) and cataracts (30.4%); 91.3% of cases were confirmed by laboratory testing. 70.0% were born from a non-vaccinated foreign mother, resident in Spain (cumulative rate incidence (CR): 1.1/100,000 births), with mothers coming from Africa (36.0%), Latin America (29.0%), Eastern Europe (21.0%) and Asia (14.0%). Six were born to Spanish mothers (CR: 0.08/ 100,000 births), the last of which were in 2005.The majority of CRS cases were born to unvaccinated immigrant women infected in Spain during rubella outbreaks. Universal vaccination in childhood is the most efficient strategy to prevent rubella. The limited circulation of the virus will, however, quickly lead to a loss of awareness about rubella among clinicians and epidemiologists. It is necessary to maintain protocols capable of identifying signs consistent with rubella in pregnant women and signs suggestive of congenital rubella in newborns.     

The impact of additional pertussis vaccine doses on disease incidence in children and infants

Background

Pertussis remains a cause of considerable morbidity in children worldwide. Due to the resurgence of the disease, two vaccine doses for schoolchildren were added to the routine Israeli schedule. In 2005 a 5th dose was introduced for second-graders (aged 7-8), and in 2008 an additional catch-up dose in the eighth grade (13-14 year-olds).

Methods

Population-based epidemiologic study of pertussis in the Jerusalem district.

Results

1736 pertussis cases were reported from 1990 to 2009. The pertussis incidence rates increased sharply from 2.6/100,000 in 1990, to 10/100,000 in 2000, peaking at 28.8/100,000 in 2006, then declining to 22/100,000 in 2008 and to 15.7 in 2009 (2006 vs. 2009, p = 0.0001). Most cases (74.4%, 1134/1524 during 1998-2009) were under 20 years. Infants under one year had the highest average incidence rate (72.3/100,000; 12.5% of cases); specifically those under 6 months (84.3% of cases under one year). The case distribution among 1-4, 5-9, 10-14, and 15-19 year-olds was: 11%, 18%, 24.1%, and 8.9%. The vaccination status (age-appropriate) was: unvaccinated - 19.2%, partially vaccinated - 7.6%, and fully vaccinated - 73.2%. The overall hospitalization rate was 5.4%; infants - 33.5%. Household transmission occurred in 16.1% of cases.The two age groups showing significant decline were children aged 5-9 (61.5% reduction) and 10-14 years (73.9% reduction); there is as yet no significant decline in other age groups.

Conclusions

The recent marked decline in pertussis incidence among the 5-14 year-olds is encouraging. Young infants still constitute a significant disease burden, and the incidence in this age group should be followed closely.     

Rubella in Poland in 2001

In 2001 in Poland we observed a subsequent peak of rubella epidemic (the previous peak was observed in 1997). As compared to 2000, an 82.8% increase in the number of rubella cases was noted. A total of 84,419 cases were registered, including 3 cases of congenital rubella. Incidence on the country level was 218.5 per 100,000 population. In particular voivodeships it ranged from 50.1 to 655.2. For the first time since rubella became reportable, the incidence in rural areas (220.1) was higher than in urban areas (217.4) Incidence among women (193.6) was 21% lower than among men (244.8). This disproportion is gradually increasing. One of the probable reasons of this difference is the intensive immunisation of 13-year old girls, which has been in place for several years now. Among all registered rubella cases 91.7% were children under 15 years of age. The highest incidence was noted among 7-year old (2,235.8), 8-year old (1,964.7) and 6-year old (1,954.5) children. About 0.3% of rubella cases were hospitalised. No rubella deaths were noted if to exclude one death due to congenital rubella.     

中国2004～2006年风疹流行病学特征初步分析

目的了解中国(未包括香港、澳门特别行政区和台湾地区,下同)2004~2006年风疹流行病学特征,为控制风疹提供依据。方法对法定传染病报告系统及突发公共卫生事件报告信息管理系统报告的风疹发病资料进行描述流行病学分析。结果全国2004~2006年风疹报告发病率分别为1.85/10万、1.95/10万、2.84/10万,各省(自治区、直辖市)均有病例报告,<15岁儿童风疹病例数分别占2004~2006年总病例数的78.70%、75.34%、66.66%,15~35岁人群风疹病例构成比从2004年的19.08%增加到2006年的31.34%。结论应尽快制定切实可行的全国控制风疹策略,合理使用风疹减毒活疫苗,预防控制风疹爆发,减少先天性风疹综合征的发生。     

2010-2019年广东省中山市风疹流行特征分析

目的了解广东省中山市风疹病例和暴发疫情流行病学特征,为防控工作提供依据。方法对2010-2019年期间报告的中山市风疹病例及暴发疫情进行整理和分析。结果 2010-2019年共报告风疹病例757例,其中1例为先天性风疹综合征(CRS);暴发疫情15起;无死亡病例报告。风疹病例年均发病率为2.40/10万,发病高峰在3～6月,男性发病率高于女性,发病年龄以15～29岁为主(478例,占63.14%),以工人为高发人群(262例,占34.61%),育龄妇女占总病例数的34.08%(258/757)。病例中的适龄儿童含风疹成分疫苗(RCV)接种率为70.37%(38/54),首针及时率为50.00%(19/38)。风疹暴发疫情集中在3～5月,总罹患率为0.62%(324/52 586),主要发生在工厂,疫情发现时间与疫情持续时间呈正相关(r=0.541,P=0.037)。结论风疹发病高峰在3～6月,应提高适龄儿童RCV接种率和首针及时率,并加强育龄妇女、工人等重点人群的补充免疫工作。     

Hepatitis B in 1998

In 1998 in Poland 4074 new cases of viral hepatitis B were noted (including 149 mixed infections with HBV and HCV). Incidence was 10.5 per 100,000 and it was 2.2 lower than year ago. In 1997 the infection with HBV was observed in 4896 persons, including 66 mixed infections (incidence rate 12.7/100,000). Constant decrease in number of new cases and incidence was observed in both sexes gender and all age groups after introduction of the intensive program of prevention and control of hepatitis B in 1993. It lead to almost 4 fold decrease of the number of new cases. There are still significant differences in incidence between particular voivodeships. For example between voivodeships Lodz and Warsaw the difference is twofold (20.6 and 10.2). The incidence of hepatitis B is still higher in cities (11.8) then in rural areas (8.6). It is dependent on gender and age. The lowest incidence is among children 0-4 years old 2.8/100,000 (61 cases). Twofold increase of incidence (from 4.6 to 9.8) is observed between ages 14 and 24; it is mainly due to higher incidence among young men especially those living in cities.     

Mumps and rubella morbidity

This paper studies all cases affected by 5 parotiditis from January to September 1986 (1767 cases) and 1987 (124 cases), as well as all patients with rubella reported in the same period in 1986 (584 cases) and 1987 (5 cases) in the province of Pinar del Río. The rise in the incidence of the two diseases with an annual basis per 100,000 population during 1986 in the different municipalities is emphasized. The overtly downward trend of these two diseases in 1987 after the administration of the triple viral vaccine--93% for mumps and 99.15% for rubella--is discussed. It was found that these two diseases affected more often school children (5-14 years). It was found that these two diseases are not frequent under the first year of life (76.4 and 120.1 cases per 100,000 population respectively). The percentage of vaccine effectiveness was documented--97.4% for parotiditis and 100% for rubella.     

松阳县2004年风疹流行病学分析

目的了解松阳县2004年风疹流行情况,指导风疹预防控制工作。方法对松阳县2004年报告的风疹病例进行流行病学分析。结果松阳县2004年共报告风疹195例,报告发病率为84．42／10万。病例中学生180例,占92．31％。1-6月均有发病,发病高峰为4月,占64．10％。共发生12起农村学校风疹爆发,181例爆发病例中,无风疹减毒活疫苗（Rubella Attenuated Live Vaccine,RubV）免疫史者占48．07％,免疫史不详者占51．93％。农村风疹爆发学校学生RubV接种率（20％）明显低于城区学校学生（92％）。结论松阳县2004年风疹发病率高的主要原因,与农村学校学生RubV接种率低及生活住宿条件差有关。采取RubV应急接种为主的综合措施可有效控制风疹爆发。     

Hospital admissions for pertussis in Spain, 1995-1998

This epidemiological survey was undertaken to estimate the annual burden of hospitalizations for pertussis in Spain during a four-year period 1995–1998. Data were obtained from the national surveillance system for hospital data. All hospital discharges for pertussis (ICD-9- CM 033) were analyzed. The annual incidence of hospitalization for pertussis was 1.7 per 100,000 population. Eighty-nine percent of the cases were <1 year of age (incidence of 78 per 100,000) and 95% were ≤5 years of age (incidence of 28 per 100,000). During the study period, 14 deaths were reported among patients hospitalized by pertussis. Despite of the high inmunization rates, many pertussis cases occur each year, mostly of them among very young children.     

天津市流行性腮腺炎疫苗纳入免疫规划效果评价

目的 麻疹、流行性腮腺炎和风疹联合疫苗纳入天津市免疫规划后,对流行性腮腺炎的控制效果进行评价。 方法 利用全国传染病报告管理系统和天津市流行性腮腺炎专报平台数据分析疾病流行特征和免疫状况,开展血清学监测评价人群抗体水平。 结果 2007-2014年天津市流行性腮腺炎发病率从40.34/10万下降到11.14/10万,0~4岁组病例比例从9.50%增加到32.50%,10~14岁组从33.20%降低到12.93%,5~9岁和10-14岁组发病率降幅分别为70.41%和81.05%。2013-2014年共调查<10岁组流行性腮腺炎病例2 195例,个案调查率分别是83.45%和96.78%,病例中87.19%有至少1剂次免疫史。其中18月龄~2岁85.85%有1剂次疫苗免疫史,在3~4岁组中达到91.33%,5-9岁组有73.81%的病例有≥2剂次免疫史。2007-2014年天津市开展了4次健康人群流行性腮腺炎IgG抗体监测,抗体阳性率分别是2007年73.52%、2011年74.09%、2013年74.04%和2014年79.85%,经χ2检验,各年份抗体阳性率无统计学差异(χ2=6.51,P=0.09)。不同年龄组中,18月龄~2岁、3~4岁和5~9岁组抗体阳性率近年来逐渐升高,其中2014年3~4岁和5~9岁组抗体阳性率分别达到91.53%和98.33%。 结论 加强流行性腮腺炎监测和实现消除目标,应提高病例实验室检测率和开展2剂次MMR疫苗接种。     

Rubella in Poland in 2000

In 2000, as compared with 1999, a 49% increase in the number of rubella cases was noted. It corresponded to the development a new compensatory epidemic (the peak of the last epidemic was observed in 1997). A total of 49,181 cases were registered, including 1 case of congenital rubella. Incidence on the country level was 119.5 per 100,000 population. In particular voivodeships it ranged from 24.0 to 314.8. Incidence in urban areas was 35% higher than in rural areas. Incidence among women (109.0) was 16% lower than among men (130.6). One of the probable reasons of this difference was intensive immunization of 13-year old girls, which have been providing for several years. Among all registered rubella cases 94.2% were children under 15 years of age. The highest incidence was noted among 7-year old (1,216.0) and 6-year old (1,148.9) children. About 0.3% of rubella cases were hospitalized. No rubella deaths were noted.     

Evaluation of the measles,mumps and rubella immunisation programme in Spain by using a sero-epidemiological survey

In Spain, measles, mumps and rubella vaccination was introduced in 1981, with one dose at the age of 15 months and another at the age of 11 years being administered since 1995. Reported disease incidence was less than one case per 100,000 people for measles and rubella, and 23 cases per 100,000 people for mumps. A seroepidemiological survey was undertaken to estimate the frequency of susceptible individuals by age and environment; and vaccination coverage and efficacy of the vaccines administered. A population-based cross-sectional study was then conducted, covering the population aged 2–39 years, residing in Spain (excluding Catalonia). The sample was stratified by age and rural/urban environment and informed consent obtained to take blood specimens from subjects attending blood-extraction centres. The final sample totalled 3932 persons. IgG antibodies were detected by an enzyme-linked immunosorbent assay. Estimated vaccination coverage was 96% for children aged 2–5 years; vaccine efficacies were 96.7% for measles, 97.2% for rubella and 79.3% for mumps. Immunity was the lowest in the 6–9 year age group for measles (90.8%) and in males aged between 15 and 24 years for rubella (86 and 89.8%, respectively). In the case of mumps, this proved the lowest in the 2–5 year age group (76.7%) and in those autonomous regions in which only the Rubini strain had been administered. The incidence of measles has enabled the National Measles Elimination Plan to be implemented by which the elimination of congenital rubella syndrome could now be initiated. A possible explanation for the higher susceptibility observed for mumps might lie in the Rubini strain's low efficacy.     

上海市闸北区风疹发病特征分析与免疫接种策略探讨

[目的]了解上海市闸北区风疹的发病状况和流行趋势,为卫生行政部门制定风疹免疫接种策略提供依据。[方法]对闸北区1990—2012年风疹报告和疫情监测资料进行流行病学分析。[结果]1990—2012年,辖区共报告风疹病例9003例,年平均发病率52.75/10万;1993年辖区报告风疹病例最多,共8856例,发病率1315.45/10万;2007—2008年,辖区无风疹病例报告。男女发病性别比为1∶1.04;5～14岁病例占73.68%;幼托儿童、中小学生是高发人群;风疹发病有明显的季节性,发病高峰为冬春季和春夏季;病例分布无地域聚集性趋势;疫苗使用后,风疹病例大幅度减少,1995—2012年,风疹病例共57例,且0~4岁、20岁以上病例在总病例中占有的构成比有上升趋势。[结论]接种疫苗是预防风疹发病的有效措施;疫苗使用后,风疹发病的年龄构成有所变化;用免疫手段,为更多成年人,特别是育龄期妇女提供保护,减少先天性风疹综合征的发生。