State of measles incidence in Kharkiv region in the period 2017 - 2019

Abstract

Introduction. Today, measles is one of the most common endemic infections, which in the modern world affects not only children but also adults. Fifty percent of the world's incidence of measles is in five countries: Madagascar, Somalia, Liberia, the Democratic Republic of the Congo (DRC), and Ukraine. It should be noted that according to the WHO, Ukraine is one of the five countries with the highest incidence of measles, and since 2018 Ukraine ranks second in the world in the incidence of measles. The sharp increase in the incidence began in 2017, when 4,782 people fell ill with measles. In 2018, more than 54,000 Ukrainians contracted a measles infection, which is almost 64% of all cases registered in Europe. In 2019, the number of patients reached 57 thousand people. During 2017-2019, a total of more than 115 thousand people fell ill, of whom 41 died (including 25 children) [2].As for the Kharkiv region, in 2017-2019 there was also a surge in the incidence of measles infection. Given the goal of the WHO and UNESCO (2015) program to address the elimination of measles infection in the world [3], the effectiveness of which determines the timeliness of specific prevention and surveillance, it remains urgent to monitor measles infection to assess the degree of endemic circulation of measles in Kharkiv region. Material & methods. The material of our work was statistical data and reporting forms on epidemiological, virological and serological tests for measles infection in the Kharkiv region for 2017-2019, provided by the State Institution "Kharkiv OLC of the Ministry of Health of Ukraine" under the agreement on scientific and practical cooperation from 02.01. 2017. Results & discussion.  In 2017, 11 cases of measles were registered (8 children and 3 adults), including 6 residents of Kharkiv, 3 in Barvinkivskyi, and 1 each in Kharkiv and Lozivskyi districts. Among the sick are 7 people of Roma nationality who do not have measles vaccinations. The diagnosis was confirmed in the laboratory in 9 patients. Starting from 2018 in Kharkiv region, as well as in Ukraine as a whole, there is an increase in the incidence of cow infection against the background of three years of epidemic well-being (in 2015, 1 measles patient was registered, in 2016 - 0 patients, in 2017 - 11 patients). At the same time, the level of collective immunity in the Kharkiv region in 2015 - 2016 - 2017 was 86.8% - 91.2% - 92.1%, respectively.In 2018, 627 cases of measles were registered, of which 289 were residents of Kharkiv, 175 - Kharkiv, 28 - Valkiv and Derhachiv, 27 - Vovchansk, 15 - Zmiiv, 11 - Loziv, 10 - Kupyansk, 9 - Sakhnovshchyna, 8 - Krasnogradsky, 6 - Izyumsky, 5 - Shevchenkivsky, 1 - Zolochiv, Kolomatsky, Pervomaisky and Pechenizky districts. Thus, during 2017-2019 there is an increase in the incidence of measles infection. Compared to 2017, in 2018 the share of children of the younger age group (1-4 years 3 times, children under 1 year from 0 to 11.6%) and the adult population significantly increased - 1.8 times in 2019 there is a further the incidence of measles increased 7.2 times and reached a total of 4,522 patients. The share of family morbidity in 2019 was 17.8%. 2964 people were hospitalized - 65.6% of patients in 2019, in 2018 - 547 people, which is 87.2% of patients, and the percentage of cases with severe cases in 2018 was 2.2%, and in 2019 - 1.1%. The diagnosis was confirmed in 2019: laboratory in 7.9% of cases, clinical - 75.1%, clinical and epidemiological - 17.0%; in 2018: laboratory in 52.8% of cases, clinical - 29.7%, clinical and epidemiological - 17.5%. The share of unvaccinated patients was 61.6% in 2018 and 70.6% in 2019. Analysis of the incidence of vaccinated shows that in 2018 35.3%, and in 2019 34.5% of patients have only one vaccination. The duration of the disease within 1-12 months from the last vaccination was observed in 57 people in 2018 and 251 people in 2019, which corresponds to 23.6% and 18.9% of all vaccinated. By social groups, the largest share was officially unemployed - 30.1% in 2019 and 22.6% in 2018, by ethnic groups, the largest number of patients is among the Roma (about 60%). Conclusion. According to the results of the study in the Kharkiv region there is an increase in the incidence of measles infection during 2017-2019, primarily due to unvaccinated persons and those who have only one vaccination. There is an increase in the proportion of adults among patients, as well as the number of severe diseases. The deterioration of the epidemic situation may also be associated with the migration of unvaccinated people in various hard-to-reach groups, which transmit the infection to the general population.

Keywords: measles incidence, Kharkiv region, Ukraine,  period 2017 - 2019