Mercredi 11 Mars 2009
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POST 01401E: RESURGENCE OF MEASLES 11 MARCH 2009 ****************************************** In some countries where measles was near elimination there has been a sudden resurgence of the disease. Low vaccine coverage could have many reasons, including financial impediments, and geographical inaccessibility. But, in the European countries, vaccine skepticism and religious beliefs have been the primary reason for vaccine refusal among clustered communities. It has made pockets of population vulnerable, and exposed others in the community to risk. Strangely enough, the success of past immunization programmes has given parents the illusion of freedom of choice, raising many questions. The irony is that Europe could, in fact, become a significant source of exported measles to some of the poorer countries that have succeeded in eliminating the virus! WHO calls for scaling up of measles vaccination. Children in affluent European countries have a higher risk of infection (26 February 2009) The WHO Regional Office for Europe calls on governments, health professionals, civil society and donors rapidly to scale up national immunization programmes, as outbreaks of measles grow larger and cross country borders. .... According to the latest reports, the provisional total number of measles cases in England and Wales was 1348 in 2008 (1). In Switzerland, a measles outbreak began in November 2006 with 73 reported cases, and peaked in March 2008, with 2195 reported cases for that year; 500 of them involved complications. This outbreak is continuing. In up to 98% of all cases, the sick children were unvaccinated or only partly vaccinated, mainly by the decision of their parents. In 2008, outbreaks caused by the virus strain from Switzerland were reported in Germany (50 cases), Austria (202 cases) and Norway (4 cases). Measles in Europe: an epidemiological assessment (The Lancet, 31 January 2009) ... The upsurge of measles in Europe reported in this paper is putting the WHO goal of measles elimination in Europe by 2010 under severe threat. The majority of patients with measles were unvaccinated or incompletely vaccinated. ... Measles resurgence in France in 2008, a preliminary report (Eurosurveillance, Volume 14, Issue 6, 12 February 2009) Since the beginning of 2008, France has been experiencing a resurgence of measles. It started in a religious traditionalist group with low coverage and secondarily spread to the general population. This situation is the consequence of the insufficient vaccine coverage (less than 90 % at 24 months of age) which had led to the accumulation of susceptibles over the last years. More than 550 cases have been notified in 2008, the vast majority being unvaccinated. One measles-related death has occurred early 2009. Efforts to enhance communication to the general public and the health professionals on measles vaccination and control measures around cases are ongoing. MMR vaccine: 'No jab, no school' (The Guardian, 10 Feb. 2009) As British health experts become increasingly anxious about declining rates of immunisation and the risk of a serious measles epidemic in the UK, the American authorities are convinced that their tougher rules are the answer. Parents in the US are not simply advised by the health authorities to get their children vaccinated against measles - they are obliged to do it by law. Children who have not been immunised face a "no jab, no school" exclusion from daycare, nursery and school. In extreme cases, their parents have been threatened with fines and jail. ... The number of measles cases in England and Wales hit 1,348 last year - the highest for 13 years, according to the Health Protection Agency. About 3 million children - one in four - have not had both MMR doses, which are necessary to ensure they are fully protected. The HPA warns that without wider uptake of the vaccine, there is a real risk of an epidemic of between 30,000 to 100,000 measles cases. Measles Resurgence 1989-1991 ... The resurgence was particularly severe accounting for more than 11,000 hospitalizations and 123 deaths. The cases were predominantly unvaccinated preschoolers but, particularly early in the outbreak, there were many college students affected who had received one dose of vaccine previously. .... The measles resurgence was viewed as an indicator of a whole immunization system that was in trouble. A response to the measles resurgence offered the opportunity to design the immunization program of the future. Post generated using Mail2Forum (http://www.mail2forum.com)
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