Immunological Susceptibility of Metropolis Population to Measles in its Elimination Stage

Relevance. In the context of high coverage of the population with preventive measles vaccination (more than 90% according to official statistics), in recent years there has been a complication of the epidemic situation for this infection, which necessitates an in-depth study of the causes and factors that contributed to the increase in morbidity. The aim of the study was to assess the susceptibility of the population of Moscow to measles on the basis of preventive vaccinations coverage data in a planned immunization and on epidemic indications. Materials and methods. To achieve this goal, epidemiological, statistical methods and Geographic Information System (GIS) technologies were used; the electronic database of materials of sanitary and epidemiological investigation in measles foci was created. Results. Тhe practical applicability of the proposed approach was shown, risk groups for measles incidence were identified. Due to the low coverage of routine preventive vaccinations and epidemic indications (compared with official statistics), the most vulnerable to measles are the age groups from one to two years and from three to six years, where these indicators were the lowest among the total population surveyed (routine and epidemic indications: about 55.9%, 10.8% and 75.3%, 40% respectively). Among the adult population, a decrease in the coverage of preventive vaccinations was revealed as the age of contact persons increased from 81.3% in the age group 20–35 to 51.0% in the age group 36 years and older. With the help of GIS technology, the possibility of visualization of the disease spread in a specific period of time in a certain area of the observed city was shown. Conclusions. According to the results the situation with measles in Moscow remains tense. There is a need for correction of the population immunization with the aim of increasing vaccination coverage in the individual age groups, and correction of statistical accounting of the facts of vaccination.

susceptibility, population immunity (Herd immunity), immunization coverage, vaccination, vaccine failure, measles

1. Who’s Certified [Internet]. WHO Epidata. Available at: http://www.euro.who.int/en/health-topics/disease-prevention/vaccines-and-immunization/publications/ surveillance-and-data/who-epidata/who-epidata,-no.-122018. Accessed: 10 Feb 2019.

2. National plan of measures for the implementation of the program «Elimination of measles and rubella in the Russian Federation (2016–2020)» (approved by Rospotrebnadzor on 28.12.2015, Ministry of Health of Russia 31.12.2015. Available at: http://rospotrebnadzor.ru/deyatelnost/epidemiological-surveillance /? ELEMENT_ID = 5968. Accessed: 10 Feb 2019 (in Russ).

3. Onishchenko GG, Popova AYu, Aleshkin VA, editors. Measles in Russia: the problem of elimination. Moscow: Dynasty; 2017 (In Russ).

4. Fel’dblyum IV. Epidemiological surveillance of vaccine prophylaxis. Zhurnal MediAl’. 2014; 13(3): 37–55 (In Russ).

5. Kostinov MP, Shmitko AD, Bocharova AI, et al. The level of IgG antibodies to measles virus in the cord blood of newborns taking into account the age of mothers. Epidemiology and Vaccinal Prevention. 2014; 3: 30–34 (In Russ).

6. Nozdracheva AV, Gritsik AA, Kuzin SN, et al. Estimating the actual susceptibility of decreed population to measles, rubella and mumps. Bulletin of RSMU. 2017; 5: 54–58 (in Russ). doi: 10.24075/brsmu.2017-05-05

7. Gotvjanskaja TP, Nozdracheva AV, Rusakova EV, et al. The state of populatiоn immunity against preventable diseases among health care workers (on serum bank materials). Epidemiology and infectious diseases. Current items. 2016; 3: 8–16 (In Russ).

8. Nozdracheva AV, Semenenko TA, Mardanly SG, et al. Assessment of humoral immunity to measles and rubella among pregnant women in Moscow. Journal of Microbiology, Epidemiology and Immunobiology. 2017; 3: 91–94. (In Russ).

9. Gidding H, Quinn H, Hueston L, et al. Declining measles antibodies in the era of elimination: Australia’s experience. Vaccine. 2017; 36(4):507–513. doi: 10.1016/j. vaccine.2017.12.002

10. Sanitary regulations SP 3.1.2952 -11 «Profilaktika kori, krasnuhi, epidemicheskogo parotita». Available at: http://snipov.net/database/c_4163967195_doc_4293851299. html. Accessed: 10 Jan 2019 (In Russ).

11. Methodical instructions MU 3.1.2943-11 «Organizatsiya i provedenie serologicheskogo monitoringa sostoyaniya kollektivnogo immuniteta k infektsiyam, upravlyaemyim sredstvami spetsificheskoy profilaktiki (difteriya, stolbnyak, koklyush, kor, krasnuha, epidemicheskiy parotit, poliomielit, gepatit B». Available at: http://rospotrebnadzor.ru/ documents/details.php?ELEMENT_ID=4852. Accessed: 10 Feb 2019. (In Russ).

12. Asatryan MN. Modeling of the epidemic process of hepatitis B on the basis of computer technology [Author. diss.]. Moscow; 2013. (in Russ). Available at: https://new-disser. ru/_avtoreferats/01005095437.pdf. Accessed: 10 Feb 2019. (In Russ).

13. Collection of the work papers of the 3rd and 4th All-Russian Conference with international participation «GIS in the health care of the Russian Federation: Data, analytics, solutions»; St. Petersburg; 2016. Available at: http://gishealth.ru/?page_id=1139. Accessed: 10 Feb 2019. (In Russ).

14. The Order of the Ministry of health of Russia №. 125n dated 21.03.2014 «Approval of calendar of national preventive vaccination and preventive vaccination for epidemic indications». Available at: https://rg.ru/2014/05/16/kalendar-dok.html. Accessed: 10 Feb 2019. (In Russ).

15. Tsvirkun OV, Gerasimova AG, Tikhonova NT, et al. Measles cases by age group during the elimination of infection. Epidemiology and Vaccinal Prevention. 2017; 16(3):18–25. (In Russ). doi:2073-3046-2017-16-3-18-25.

16. Who’s Certified [Internet]. WHO: Global Health Observatory data repository. Immunization coverage estimates by country. Available at: http://apps.who.int/gho/data/view. main.80100?lang=en. Accessed: 10 Feb 2019.

17. Semenenko TA, Ezhlova EB, Nozdracheva AV, et al. Manifestation features of the measles epidemic process in Moscow in 1992–2014. Epidemiology and Vaccinal Prevention. 2015;14(6):16–22. (In Russ). doi:2073-3046-2015-14-6-16-22. (In Russ).

18. Semenenko TA, Akimkin VG. Seroepidemiology in the surveillance of vaccine-preventable diseases. Journal of Microbiology, Epidemiology and Immunobiology. 2018; 2:8794. (In Russ).