The Epidemiology and Diagnosis of Measles—Special Aspects Relating to Low Incidence.

IF 6.5 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Dorothea Matysiak-Klose, Annette Mankertz, Heidemarie Holzmann
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引用次数: 0

Abstract

Background: Measles is a highly contagious viral disease (contagion index near 100%) with a complication rate of up to 30%. The worldwide incidence for 2022 was calculated as 29 cases per million people. Measles can be eliminated if 95% of the population is either vaccinated or immune and measures are taken to limit its spread as soon as an initial suspected case is encountered. However, the worldwide immunization rate has fallen since 2020 (from 86% in 2019 to 81% in 2021).

Methods: To assess the epidemiological situation and describe the state of scientific knowledge regarding laboratory tests for measles, we analyzed recent epidemiological data from the Robert-Koch Institute (RKI) and reviewed pertinent publications retrieved by a selective literature search.

Results: Repeated importations of measles virus have led to a new rise in case numbers in Germany since last year. 79 cases of measles were reported to the RKI in 2023, and 475 in the first eight months of 2024. The latter figure corresponds to the pre-pandemic level. There are still immunization gaps in the population: for instance, by the age of 24 months, 93.7% of children have received their first immunization, and only 80.5% have received the second. Every suspected case must be confirmed by laboratory testing so that targeted measures can be initiated. Serology is no longer considered sufficiently reliable; a reliable diagnosis now requires a poly merase chain reaction (PCR) test. The specimen can be a throat swab or a urine sample. PCR also enables the differentiation of measles virus variants and the tracing of transmission chains.

Conclusion: Reliable laboratory testing makes it possible to detect measles cases rapidly, initiate measures to slow the spread of the disease, trace infection chains, and assess the risk exposure for measles in Germany.

麻疹的流行病学和诊断:与低发病率有关的特殊方面。
背景:麻疹是一种传染性极强的病毒性疾病(传染指数接近 100%),并发症发生率高达 30%。据计算,2022 年全球发病率为每百万人中有 29 例。如果 95% 的人口接种了疫苗或具有免疫力,并且一旦发现疑似麻疹病例就立即采取措施限制其传播,那么麻疹就可以被消灭。然而,自 2020 年以来,全球免疫接种率有所下降(从 2019 年的 86% 降至 2021 年的 81%):为了评估流行病学形势并描述麻疹实验室检测的科学知识现状,我们分析了罗伯特-科赫研究所(RKI)最近的流行病学数据,并通过选择性文献检索查阅了相关出版物:结果:自去年以来,麻疹病毒的多次输入导致德国的病例数再次上升。2023 年,德国麻疹研究所接报了 79 例麻疹病例,2024 年前 8 个月接报了 475 例。后一数字相当于流行前的水平。人口中的免疫接种率仍然存在差距:例如,在 24 个月大的儿童中,93.7% 接受了第一次免疫接种,只有 80.5%接受了第二次免疫接种。每一个疑似病例都必须经过实验室检测确认,以便采取有针对性的措施。血清学已不再被认为足够可靠;现在,可靠的诊断需要聚合酶链反应(PCR)检测。标本可以是咽拭子或尿样。聚合酶链反应还能区分麻疹病毒的变种并追踪传播链:可靠的实验室检测可以迅速发现麻疹病例,采取措施减缓疾病的传播,追踪传染链,并评估德国的麻疹风险暴露。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Deutsches Arzteblatt international
Deutsches Arzteblatt international 医学-医学:内科
CiteScore
4.10
自引率
5.20%
发文量
306
审稿时长
4-8 weeks
期刊介绍: Deutsches Ärzteblatt International is a bilingual (German and English) weekly online journal that focuses on clinical medicine and public health. It serves as the official publication for both the German Medical Association and the National Association of Statutory Health Insurance Physicians. The journal is dedicated to publishing independent, peer-reviewed articles that cover a wide range of clinical medicine disciplines. It also features editorials and a dedicated section for scientific discussion, known as correspondence. The journal aims to provide valuable medical information to its international readership and offers insights into the German medical landscape. Since its launch in January 2008, Deutsches Ärzteblatt International has been recognized and included in several prestigious databases, which helps to ensure its content is accessible and credible to the global medical community. These databases include: Carelit CINAHL (Cumulative Index to Nursing and Allied Health Literature) Compendex DOAJ (Directory of Open Access Journals) EMBASE (Excerpta Medica database) EMNursing GEOBASE (Geoscience & Environmental Data) HINARI (Health InterNetwork Access to Research Initiative) Index Copernicus Medline (MEDLARS Online) Medpilot PsycINFO (Psychological Information Database) Science Citation Index Expanded Scopus By being indexed in these databases, Deutsches Ärzteblatt International's articles are made available to researchers, clinicians, and healthcare professionals worldwide, contributing to the global exchange of medical knowledge and research.
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