Measles,mumps, and rubella: A cross-sectional study of susceptibility to vaccine-preventable diseases among young people in India

BackgroundGlobal elimination of vaccine preventable diseases, such as measles, mumps and rubella is a priority. Many countries have reported diminishing of antibody titres against these diseases among young population as immunization coverage of adolescents and adults in not monitored. The objective of this study was to determine the susceptibility against measles, mumps and rubella among young adults.MethodsIn this cross-sectional study serological evidence of susceptibility to measles, mumps and rubella was determined by qualitative detection of IgG antibody titres by commercially available enzyme linked florescence assay (VIDAS, bioMerieux) in serum samples young adults.ResultsA total of 335 young individuals (mean age: 20.54 ± 1.37 years) participated voluntarily between May 2017 to September 2018, of which 183 (54.63%) were males. Seroprotection against measles, mumps and rubella were 87.16%, 82.69% and 79.10% respectively.ConclusionSerological surveillance is important to monitor immune status in population. Susceptibility of young adults to measles, mumps, and rubella indicates need for booster vaccination. With the recent launch of measles-rubella vaccination campaign in India, country specific data will be required to plan periodicity of such campaign, which in turn would be based on accumulation of susceptible individuals in a community. Lastly, inclusion of mumps vaccine in the national universal immunization program needs consideration.     

Measles immunisation: profit and loss in a general practice

A survey in one general practice of the occurrence of measles and of immunisation in patients who were born between 1963 and 1982 showed that immunisation not only brought some financial reward to the practice, but by preventing measles reduced the number of consultations related to measles by 40%. Although practice policy often entailed a home visit to immunise a patient, measles disease was three times more likely to require a visit. It is surprising that, considering the efficacy and safety of measles immunisation, in Britain measles has not become the rarity it now is in the United States.     

Strategies for immunisation against rubella: evidence from a study in the Kalutara District

OBJECTIVE: To simulate different immunisation programs against rubella and estimate the proportion of the population susceptible to rubella infection of each. METHODS: The impact of 3 immunisation schedules on the susceptibility of women of childbearing age and the community to rubella infection was simulated using a probabilistic approach. The first schedule involved selective immunisation of 12-year old girls, the second immunisation of all children at 3 years of age for different immunisation coverages, and the third comprised a combination of the first two. The proportion of different segments of the population currently susceptible to rubella was obtained from a field study conducted in the Kalutara District in 1999. RESULTS: An immunisation program of 12-year old girls will reduce the susceptibility to rubella in 5 years in only the 15 to 19 year age group. In 10 years, the susceptibility in both the 15 to 19 and 20 to 24 year age groups will be reduced. Immunisation only of children at 3 years will take 20 years for a reduction in the susceptibility to rubella infection in the 15 to 19 year and the 20 to 24 year age groups, and the proportion of the population susceptible to rubella can be reduced to less than 10% in 20 years if 90% coverage is attained. If a combination of the two strategies i.e. selective immunisation of girls at 12 years for 10 years and immunisation of all children at 3 years is adopted, the proportion of the community susceptible to rubella will be less than 14% in 10 years. CONCLUSIONS: The combination of immunising girls at 12 years of age for 10 years and all children at 3 years of age against rubella is recommended for Sri Lanka to reduce the risk of congenital rubella syndrome in the short term and the proportion susceptible to rubella in the community in the long term.     

Measles immunisation rates and the good practice allowance

The recent discussion document on primary health care proposes that a good practice allowance is paid to general practitioners based in part on the uptake of immunisation by patients. The variation between and the validity of practice immunisation rates for measles as determined by one district health authority's child health computer are assessed. In areas of low population mobility district health authority rates may be sufficiently accurate to base a good practice allowance on but should not be used until the social environment of each practice can also be characterised. In areas of high mobility intermittent surveys may be a preferable method of auditing performance.     

上海市虹口区麻风腮疫苗接种前后腮腺炎发病流行病学分析

目的 为了解麻风腮疫苗接种前后腮腺炎发病流行病学变化，为腮腺炎免疫策略提供科学依据。方法 采用前后比较的方法，对虹口区疫苗接种前（1992～1996年）与疫苗接种后（1997～2005年）腮腺炎发病情况进行分析比较。结果 腮腺炎发病率以学龄前儿童最高，平均1899．51／10万，其次是学生，186．84／10万，其中学龄前儿童中，幼托儿童发病率2376．79／10万显著高于散居儿童501．20／10万；疫苗接种后1997～2000年腮腺炎发病率逐年明显下降到最低水平，2000～2004年发病率维持在最低水平，年均发病率22．05／10万，较疫苗接种前腮腺炎年均发病率216．04／10万，下降约90％，经比较差异有非常显著性；同时接种后腮腺炎病例中，学生比例由接种前的20％增加到50％；接种后腮腺炎季节性高峰不明显，呈全年发病；在腮腺炎暴发疫情病例中，（10～69）％的儿童有1针麻风腮疫苗史。结论 对儿童推荐接种麻风腮疫苗，能有效控制腮腺炎野毒株的传播；并且12～18月龄儿童接种1剂麻风腮疫苗后，4～6岁时（学龄前）有必要再加强1剂。     

Measles immunisation: results of a local programme to increase vaccine uptake

Investigations showed that the measles immunisation programme in our health board was a failure. Surveys of health care staff and parents to determine the cause of the problem identified several aspects of concern: the immunisation of children was often left to parental initiative, with only 29% of general practitioners playing an active part in recalling children by the 15th month of age; general practitioners, clinical medical officers, paediatricians, and health visitors all required education on several aspects of measles immunisation; parents also required more information about the importance of preventing this disease. A coordinated effort to remedy these problems was introduced which achieved an increase of 13% in vaccine uptake during 1984. These findings may have implications beyond our own area.     

Measles, immunisation and disease: rapid epidemiological assessment in two trans-Yamuna villages of Delhi

A community investigation was conducted in 2 villages of east Delhi, having 15,000 population. Ten per cent households were selected from both the villages by systematic random sampling and all the under 3-year children in selected households were included in the study. A total of 126 under 3-year children from 360 households were investigated. Total children immunised against measles were 86. Most of the 86 immunised children were vaccinated between 9 and 11 completed months. Of the 80 children aged 12 months or above, 12(15%) were unimmunised. Main reason behind non-immunisation was parental apathy. Of the total 126 surviving under 3-year children, 12(9.52%) had a history of probable measles. Two of these children had already measles before they could be eligible for measles vaccination as per the current schedule.     

Mass vaccination programme aimed at eradicating measles, mumps, and rubella in Sweden: first experience

General vaccination with a combined measles, mumps, and rubella vaccine was introduced in Sweden in 1982. The immunisation schedule comprises two vaccine injections, given at 18 months and 12 years of age, respectively. A controlled field study was carried out in 150 children aged 18 months using two different batches of the vaccine. Seroconversion was seen in 96% against measles, 93% against mumps, and 99% against rubella--the same rates with both vaccine lots. Nevertheless, a difference was noted between the two batches with respect to postvaccination reactions. Fever and rash were recorded mainly five to 12 days after vaccination. Moderate fever (38.5-39.4 degrees C) was observed in 22 children, high fever (greater than or equal to 39.5 degrees C) in 33, and rash in 35. Preliminary results obtained by follow up of routinely vaccinated schoolchildren aged 12 indicated considerably lower rates of fever and rash during the postvaccination period, occurring in 3-10% of cases only. These findings show that complete eradication of measles, mumps, and rubella in Sweden is entirely practicable by the mass vaccination programme and that side effects of vaccination are likely to be few and mild.     

合肥市 2011 年健康人群麻疹、风疹、流行性腮腺炎抗体水平调查

目的研究人群麻疹、风疹、流行性腮腺炎免疫状况,为制定免疫对策提供科学依据。方法随机抽取1422名0～30岁健康人员及部分育龄期女性,用酶联免疫吸附试验检测麻疹、风疹、流行性腮腺炎IgG抗体水平,并进行分析。结果1422名健康人员麻疹抗体阳性1071人,抗体阳性率为75．3％;风疹抗体阳性1149人,抗体阳性率为80．8％;流腮抗体阳性1097人,抗体阳性率为77．1％。结论合肥市麻疹有出现散发和小范围流行的可能,风疹和流行性腮腺炎学龄组出现暴发的可能性较高。在认真完成麻疹疫苗的常规接种的前提下,对大年龄组儿童进行MMR疫苗的强化免疫或查漏补种是消除麻疹和控制风疹及流行性腮腺炎的有效方法和途径。