The epidemiological and serological characteristics of measles in Dongguan, China, 2005–2014

Abstract

This study examined the epidemiological and serological characteristics of measles in Dongguan, China. From 2005 to 2014, a total of 8,224 measles cases were reported in Dongguan, 33.5% of which were aged <1 y and 30.6% >14 y. From 2005 to 2014, the proportion of the <1 y measles cases increased year by year from 24.3% to 47.9%. Of the cases aged 8 months (n D 6,768 cases), only 11.6% had been immunized with at least one dose of measles vaccine. Of the 2,213 cases who had never been immunized with measles vaccine, immigrants accounted for 82.4%. 52.4% of the measles cases were diagnosed with pneumonia, and 12 cases died from respiratory failure. Seroprevalence rate in women and their newborns was 86.0% and 82.5%, respectively. Measurement of serum measles antibody levels for infants aged less than 8 months indicated that seroprevalence rate dramatically declined from 97.3% at birth to 9.3% and 13.2% at 6-and 7-month old. The existence of a sufficient pool of unvaccinated people (especially immigrants) and decreased level of passively transferred measles antibodies in infants from vaccinated mothers contributed to the sustained transmission observed in Dongguan. In addition to high routine vaccination coverage, new strategies and innovations for measles vaccination are needed to eliminate measles.

Pre-vaccination evolution of antibodies among infants 0, 3 and 6 months of age: A longitudinal analysis of measles, enterovirus 71 and coxsackievirus 16

“…Indeed, in a city in southern China, from 2005 to 2014, the proportion of total measles cases among children <1 year increased from 24.3% to 47.9% [27]. In Tianjin, northern China during 2014, 558 measles cases (20.58%) were among infants aged <1 year [28].…”

Diagnostic, Management, and Research Considerations for Pediatric Acute Respiratory Distress Syndrome in Resource-Limited Settings: From the Second Pediatric Acute Lung Injury Consensus Conference

“…There are multiple reports describing diseases and comorbidities common in RLS, which may lead to or predispose to developing PARDS, often associated with poor outcomes and which are uncommon in most high-income settings. Although PALICC-2 search criteria did not aim to identify all conditions associated with hypoxemia and respiratory failure in children living in RLS, our search identified severe acute malnutrition (4)(5)(6)(19)(20)(21)(22)(23), dengue fever (24)(25)(26)(27), malaria (28)(29)(30), measles (31)(32)(33), scrub typhus (12,(34)(35)(36)(37)(38), influenza virus infection (including H1N1 and H5N1) (13,(39)(40)(41)(42)(43)(44), HIV disease and associated opportunistic infections (19,45), tuberculosis (46), leptospirosis (47), and diarrhea (9,48) as conditions associated with hypoxemic respiratory failure in these settings. In addition, during the COVID-19 pandemic, there were growing reports of COVID-19 infection precipitating PARDS in children, including those living in RLS (49)(50)(51).…”

Measles, the need for a paradigm shift

“…In 2018, 8% of all cases reported from the European region were in children younger than 1 year, which represented more than 6600 cases [18]. Likewise, in a Chinese province, the proportion of cases in children less than 1 year old has increased over time to almost 50% [19]. In Brazil and Colombia, where the highest incidence rate is among children under 1 year old, vaccination campaigns targeting 6-month-old children have been implemented [20,21].…”

“…In the 1990s, cases of healthcare workers who developed measles despite pre-existing anti-measles antibody levels were emphasized [100]. During recent outbreaks, when investigated, secondary failures were documented in substantial proportions [19,[101][102][103]. In Japan, during an importationrelated measles outbreak in 2017, 16/60 (26%) cases were secondary failures (mild disease without IgM) infected with a D8 variant [104].…”