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      Epidemiological and Clinical Characteristics of Measles in Jinan, Shandong Province, China, from 1991 to 2022

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          Abstract

          Objective

          This study aimed to analyze the epidemiological and clinical characteristics of measles in Jinan, Shandong, China, over a 32-year stage to facilitate measles prevention in the future.

          Methods

          Data on measles cases from 1991 to 2022 were obtained from the public health department and medical records of patients at Shandong Public Health Clinical Center. Retrospective analysis was conducted on the distribution of measles cases in different years, months, and age groups, and observation of the differences in clinical manifestations and complications among different age groups.

          Results

          From January 1991 to December 2022, 7531 measles cases were recorded at Shandong Public Health Clinical Center. During the 32-year period, there were two outbreaks of measles in 2008 and 2016, respectively. During the COVID-19 pandemic period from 2020 to 2022, the number of cases reached the lowest point in the past 30 years. The number and percentage of cases in the 0–1y groups was significantly higher than in other age groups, and 97.75% patients in this group did not receive measles vaccine. Complications such as pneumonia and myocarditis appeared more frequent in patients under 12 years of age, but liver function damage is more common in adult patients.

          Conclusion

          Although the measles epidemic has been greatly controlled since the use of measles vaccine, intermittent outbreaks still exist, so there is still a long way to go to eliminate measles. The proportion of infants under the age of 1 without measles vaccine and adults over 24 years old accounts for nearly 80% of the total. This group of people should be of concern, and feasible measures should be designated to protect these susceptible populations.

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          Most cited references12

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          Nosocomial transmission of measles: an updated review.

          Despite a decrease in global incidence, measles outbreaks continue to occur in developed countries as a result of suboptimal vaccine coverage. Currently, an important mode of measles transmission appears to be nosocomial, especially in countries where measles is largely under control. We therefore conducted a review of the literature by searching PubMed for the term "measles" plus either "nosocomial" or "hospital acquired" between 1997 (the date of the last review in the field) and 2011. The reports indicate that measles is being transmitted from patients to health care workers (HCWs) and from HCWs to patients and colleagues. Here, we explain how outbreaks of measles occurring in healthcare settings differ in some ways from cases of community transmission. We also highlight the need for all HCWs to be immunized against measles. Copyright © 2012 Elsevier Ltd. All rights reserved.
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            Global measles elimination

            Key Points Measles remains a leading vaccine-preventable cause of child mortality in Africa and Asia, and continues to cause outbreaks in industrialized countries. Remarkable progress in reducing measles incidence and mortality has been made in resource-poor countries, particularly in sub-Saharan Africa, as a consequence of increasing measles vaccine coverage and provision of a second opportunity for measles vaccination through supplementary immunization activities. Measles virus (MV) is highly infectious, requiring a high level of population immunity to interrupt transmission, and might be more difficult to eliminate in regions of high population density and high prevalence of human immunodeficiency virus type 1 (HIV-1) infection. The global elimination of measles has been debated since the 1960's, shortly after measles vaccines were first licensed. Criteria necessary for disease eradication include: first, humans must be required for virus transmission; second, sensitive and specific diagnostic tools must exist; and finally an effective intervention must be available. Measles is thought by many experts to meet all of these criteria Measles vaccines are safe, effective and have interrupted MV transmission in large geographic areas, providing a suitable tool for global measles elimination. The ideal measles vaccine would be inexpensive, safe, heat-stable, immunogenic in neonates or very young infants, administered as a single dose without needle or syringe, and would not prime individuals for atypical measles or be associated with prolonged immunosuppression. Several vaccine candidates with some of these characteristics are undergoing development. A significant challenge to global measles elimination efforts will be to maintain the resources, political will and public confidence to implement measles vaccination and surveillance programmes.
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              International Importations of Measles Virus into the United States During the Postelimination Era, 2001–2016

              Although measles was declared eliminated from the United States in 2000, measles cases and outbreaks continue to occur, resulting from importations of the disease from countries where it remains endemic. We describe the epidemiology of international importations of measles virus into the United States during the post-elimination era. From 2001 to 2016, 553 imported measles cases were reported to the Centers for Disease Control and Prevention. A median of 28 importations occurred each year (range: 18–80). The median age of imported case-patients was 18 years (range: three months–75 years); 87% were unvaccinated or had an unknown vaccination status. U.S. residents (as opposed to foreign visitors) accounted for 62% of imported measles cases. Overall, 62% of all imported case-patients reported travel to countries in the Western Pacific and European Regions of the World Health Organization during their exposure periods. The number of measles importations from specific countries was related to the incidence of measles in and the volume of travel to and from the source country. Our findings emphasize the importance of measles vaccination of U.S. residents aged ≥6 months before international travel according to Advisory Committee on Immunization Practices recommendations and supporting global measles elimination efforts. We describe the epidemiology of international importations of measles virus into the United States during the post-elimination era (2001–2016). Our findings emphasize the importance of measles vaccination before international travel and supporting global measles elimination efforts.
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                Author and article information

                Journal
                Int J Gen Med
                Int J Gen Med
                ijgm
                International Journal of General Medicine
                Dove
                1178-7074
                06 June 2023
                2023
                : 16
                : 2305-2312
                Affiliations
                [1 ]Infectious Diseases Department II, Shandong Public Health Clinical Center , Jinan, 250000, People’s Republic of China
                [2 ]Public Health Department, Shandong Public Health Clinical Center , Jinan, 250000, People’s Republic of China
                [3 ]Medical Insurance Office, Shandong Public Health Clinical Center , Jinan, 250000, People’s Republic of China
                [4 ]TCM & Western Medicine Department, Shandong Public Health Clinical Center , Jinan, 250000, People’s Republic of China
                Author notes
                Correspondence: An-Zhao Wu, TCM & Western Medicine Department, Shandong Public Health Clinical Center , 2999 Gangxing West Road, High Tech District, Jinan, 250000, People’s Republic of China, Tel +86 531-86568184, Email anzhaowu564@outlook.com
                Article
                407121
                10.2147/IJGM.S407121
                10257416
                37304905
                393f68f1-1e16-445c-bf5c-c8301d894fe3
                © 2023 Wang et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 03 February 2023
                : 19 May 2023
                Page count
                Figures: 1, Tables: 2, References: 16, Pages: 8
                Categories
                Original Research

                Medicine
                measles,epidemiology,clinical characteristics,vaccination,china
                Medicine
                measles, epidemiology, clinical characteristics, vaccination, china

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