The pre-vaccination regional epidemiological landscape of measles in Italy: contact patterns, effort needed for eradication, and comparison with other regions of Europe |
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Authors: | Manfredi Piero Cleur Eugene M Williams John R Salmaso Stefania Atti Marta Ciofi Degli |
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Institution: | Department of Infectious Disease Epidemiology, Division of Primary Care & Population Health Sciences, Faculty of Medicine, Imperial College London, Norfolk Place, London W2 1PG, UK. jr.williams@imperial.ac.uk. |
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Abstract: | Background Strong regional heterogeneity and generally sub-optimal rates of measles vaccination in Italy have, to date, hampered attainment
of WHO targets for measles elimination, and have generated the need for the new Italian National Measles Elimination Plan.
Crucial to success of the plan is the identification of intervention priorities based upon a clear picture of the regional
epidemiology of measles derived from the use of data to estimate basic parameters. Previous estimates of measles force of
infection for Italy have appeared anomalously low. It has been argued elsewhere that this results from Italian selective under-reporting
by age of cases and that the true measles force of infection in Italy is probably similar to that of other European countries.
A deeper examination of the evidence for this conjecture is undertaken in the present paper. |
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