Vaccine prophylaxis of measles and ways of its optimization at the final stage of infection elimination

Abstract

Objective. The purpose of the study - based on the analysis of the local epidemic situation to determine the key areas for improving the system of epidemiological surveillance of measles infection in specific conditions of time and place. Methods. As materials of the research were used data from the official registration of the incidence of measles the population of Ekaterinburg for 1988-2017, medical documentation of cases of measles in 2016, the results of serological screening for measles IgG employees of medical organizations in the period of outbreaks of measles and materials routine serological monitoring of measles immunity in the "indicator" populations for 2014-2016 used in epidemiological, clinical, serological and statistical research methods. Results. It is established that in modern conditions the epidemic process of measles in the metropolis has become intermittent, which does not exclude the occurrence of a local outbreak, with primary involvement in the epidemic process of previously unvaccinated children and adults, with the most active spread of infection in medical organizations. Serological studies of immunity to measles, conducted among employees of medical organizations, showed that up to 80 % of the surveyed in the IFA had a protective level of prtivokorevyh antibodies, with the largest number of such persons in the age group over 50 years. Among seronegative to 40 % of employees had an interval from the last vaccination for more than 10 years. When analyzing the results of planned serological monitoring of anticorruption immunity in the "indicator" groups, it was found that the excess of the permissible number of seronegative persons (more than 7 %) in the "indicator" groups occurred both in the short and long terms after vaccination and revaccination. The most unfavourable indicators of seroprotection were obtained among adolescents aged 16-17 and adults. Conclusions. To control the epidemic situation of measles, it is necessary to maintain vaccination coverage of children in the age groups (12 months) in the national vaccination calendar (6 years) at least 95-98 %, as well as to decide on the planned revaccination of the population under 50 years of age with an interval between vaccinations at 10 years.