A 60-year review on the changing epidemiology of measles in capital Beijing, China, 1951-2011

Tuesday, 5th of November 2013

[source]BMC Public Health[|source]

Using epidemiological data from Beijing, this article presents a unique story of five stages of measles elimination continuum namely Stage 1: Period prior to vaccination (1951–1965); Stage 2: Initial period of measles immunization (1966–1977); Stage 3: Period of planned immunization (1978–1996); Stage 4: Accelerated measles control period (1997–2004); and Stage 5: Measles elimination period (2005–2011).

 The authors present trend analyses from previous 60 years that show that the measures of prevention and control measles at different stages had a tremendous effect on the epidemic dynamics of measles. Their data shows that with increasing vaccination coverage in Beijing, the age distribution of cases shifted from younger children of 1–4 years to older children of 5–14 years and adults of 15–30 years; the upward shift in the age of measles cases to older age groups with increasing MV coverage. The report concludes that any failures to implement all components of the measles control strategy, and especially gaps in coverage of the two routine measles doses are vital. More details are available at: http://www.biomedcentral.com/1471-2458/13/986

 

Abstract

Background: China pledged to join the global effort to eliminate measles by 2012. To improve measles control strategy, the epidemic trend and population immunity of measles were investigated in 1951–2011 in Beijing.

Methods: The changing trend of measles since 1951 was described based on measles surveillance data from Beijing Centre of Disease Control and Prevention (CDC). The measles vaccination coverage and antibody level were assessed by routinely reported measles vaccination data and twenty-one sero-epidemiological surveys.

Results: The incidence of measles has decreased significantly from 593.5/100,000 in 1951 (peaked at 2721.0/100,000 in 1955), to 0.5/100,000 in 2011 due to increasing vaccination coverage of 95%-99%. Incidence rebounded from 6.6/100,000 to 24.5/100,000 since 2005 and decreased after measles vaccine (MV) supplementary immunization activities (SIAs) in 2010. Measles antibody positive rate was 85%-95% in most of years since 1981. High-risk districts were spotted in Chaoyang, Fengtai and Changping districts in recent 15 years. Age-specific incidence and proportion of measles varied over time. The most affected population were younger children of 1–4 years before 1978, older children of 5–14 years in 1978–1996, infant of <1 years and adults of ≥15 years in period of aim to measles elimination.

Conclusion: Strategies at different stages had a prevailing effect on the epidemic dynamics of measles in recent 60 years in Beijing. It will be essential to validate reported vaccination coverage, improve vaccination coverage in adults and strengthen measles surveillance in the anticipated elimination campaign for measles.