Epidemiological features of the measles in kirovograd region in 2004 – 2015

Анотація

Introduction.The incidence of measles in Ukraine remains an actual problem. Measle is related to vaccine - controled infections. However, low levels of imunization of the child population by planned measles vaccine, insufficient provision of immunobiological drugs (vaccines) in recent years, anti-vaccine companies contribute to the increase of the measles morbidity in Ukraine.Prominent scientist L.V. Gromashevsky spoke about measles, which is a "disease of unique distribution". In the implementation of the Program for the elimination of measles, an important role is assigned to laboratory diagnostics as an integral part of epidemiological surveillance, which assures laboratory confirmation of all cases of measles disease. The purpose of the study: to analyze the peculiarities of the epidemic situation of measles in the Kirovograd region, the state of laboratory diagnosis of measles. Materials and methods: Data from the official statistical reporting of the state institution "Kirovograd Regional Laboratory Center of the Ministry of Health of Ukraine" (forms №1, № 2, № 40), demographic annual indicators of the State Statistics Service of Ukraine and the Main Department of Statistics in Kirovograd region. Results and discussion: The epidemiological analysis of measles incidence in the Kirovograd region in the period 2004-2015 and the results of laboratory diagnosis of cases in measles in this period of observation have been carried out.The peculiarities of manifestation of the epidemic process of measles in the Kirovograd region require a detailed study also because Kirovograd region is the only region in Ukraine with rich natural reserves of uranium ore. The presence of uranium raw materials on the territory of the region in turn increases the natural radiation background.The technological process of which enhances natural ionizing radiation technogenously. The effect of technogenic contamination by natural radionuclide of the environment and the increased natural radiation background on the human immune state, as well as the manifestations of the epidemic process of the measles, the influence on the properties of viruses is not excluded. From 2004 to 2015, the incidence of measles in Ukraine ranged from 0.06 (2009) to 90.7 per 100 thousand population (2006). During this period, there were twopeaks of the measles in Ukraine: in 2006 - 90.7 per 100 thousand and in 2012 - 27.9 per 100 thousand populations.During 2007-2010, the incidence of measles in Ukraine gradually decreased (2.15, 0.11, 0.06, and 0.08 per 100 thousand populations, respectively). The dynamics of measles morbidity in the Kirovograd region for the period 2004-2015 is characterized by unstable levels. The trend of the morbidity of the population of the region repeats the course of measles morbidity in Ukraine with a slight decrease or excess. In this period, the incidence rates of the Kirovograd region were lower than the Republican figures in 2005 (by 49%); 2007 (by 67%); 2008 (by 9.0%); 2011 (by 76%); 2013 (by 67%) according to similar indicators in Ukraine. In 2010 and 2015, the incidence of measles in the Kirovograd region was not recorded. In all other years of the observation period, the incidence rates of measles in the Kirovograd region were higher than in Ukraine as a whole. In the region, one peak of the incidence of growth was observed in 2006, when the incidence rate in the Kirovograd region (147.9 per 100 thousand populations) exceeded the similar indicator in Ukraine (90.7 per 100 thousand populations) in 1, 63 times. During this time, 1,741 inhabitants of the region suffered from measles, including - 472 (21, 1%) children and 1269 (78,9%) adults. If the share of children's population in the overall incidence of measles in the Kirovograd oblast amounted to 85.7% in 2007; in 2013 - 62.5%; in 2005 - 53,6%; then in 2006 - 25.2%; in 2011 - 28.6%; in 2014 - 36.8%. The laboratories confirmation of a clinical diagnosis in the early stages of the development of the outbreak improving the effectiveness of epidemiological surveillance of the measles promotes. 214 samples of blood serums from patients with suspected measles and a clinical diagnosis of "Measles" were received to the virusological laboratory of the Kirovograd Regional Laboratory, accounting for 12.3% of all reported cases of measles in 2004-2015.214 samples (100%) were investigated for the detection of antibodies to the IgM class of the virus of the measles.In the study of blood serum antibodies of the class IgM found in 42.5% (91 people). Thelevels ofimmunizationagainst the measles population in the Kirovograd region since 2009 were insufficient and below 95%. The plan for vaccination against measles in children in 1 year is fulfilled: on 75,9% (2009), 52,8 (2010); 62.3% (2011); 89, 8% (2012); 80.7% (2013); 86.5% (2014); to 39.6% (2015). The plan of the revaccination plan for children 6 years of age is secured by 71.6% (2009); 31, 5% (2010); 31.0% (2011); 89.2% (2012); 77.9% (2013); 73.0% (2014); 27.4% (2015). Conclusions. Despite the fact that the intensity of the epidemic process of measles in the Kirovograd region during the last epidemic peak was significantly lower than in Ukraine in general, the marked tendency to increase the incidence among children and insufficient coverage of children by vaccination and revaccination is an unfavorable prognostic sign. This refers to the risk of further growth of the intensity of the epidemic process at the expense of those age groups of the population who must be protected in accordance with the vaccination calendar, and the loss of the measles infection as a "managed" status. The current situation requires immediate action to restore immunization in the country in full.