Background

Measles incidence and mortality rates have significantly decreased since vaccine introduction. Despite this progress, however, there has been a global resurgence of measles. To understand the current global epidemiology, we analyzed measles surveillance data.

Methods

We analyzed data on measles cases from 2013–2018 reported to the World Health Organization. Univariate analysis was undertaken based on age, vaccination history, onset year, World Health Organization region, and World Bank income status for the country where the case was reported, and a surrogate indicator of the historical strength of the country’s immunization program. Annual incidence and a 2013–2018 mean country incidence per million were calculated.

Results

From 2013 through 2018, there were 899 800 reported measles cases, of which 57% occurred unvaccinated or undervaccinated persons, with an unknown vaccination history in another 30%. Lower-middle-income countries accounted for 66% of cases, 23% occurred in persons ≥15 years of age. In countries with stronger historical vaccination programs and higher country income, case patients had higher median ages.

Conclusions

Although most measles case patients are <15 years of age, an age shift is seen in countries with a higher income or a stronger historical vaccination program. Countries must strengthen immunization programs to achieve high vaccination coverage; some must undertake strategies to reach persons ≥15 years of age and close immunity gaps.

中文翻译：

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2013-2018年不断变化的麻疹全球流行病学。

背景

自从引入疫苗以来，麻疹的发病率和死亡率已大大降低。尽管取得了这一进展，但是麻疹在全球范围内有所复苏。为了了解当前的全球流行病学，我们分析了麻疹监测数据。

方法

我们分析了报告给世界卫生组织的2013-2018年麻疹病例数据。根据年龄，疫苗接种史，发病年份，世界卫生组织区域和报告病例所在国家的世界银行收入状况，进行单变量分析，并显示该国免疫计划历史实力的替代指标。计算了年发病率和2013-2018年平均国家每百万发病率。

结果

从2013年到2018年，报告了899800例麻疹病例，其中57％发生在未接种疫苗或未接种疫苗的人群中，另外30％的接种史不明。中低收入国家占病例的66％，其中23％发生在15岁以上的人群中。在历史疫苗接种计划更强，国家收入更高的国家中，病例患者的中位年龄较高。

结论

尽管大多数麻疹病例患者的年龄小于15岁，但在收入较高或历史疫苗接种计划较强的国家中，年龄会发生变化。各国必须加强免疫计划，以实现较高的疫苗接种率；有些人必须采取策略来接触≥15岁的人并缩小免疫差距。