论文部分内容阅读
Baekgroud: A prolonged measles epidemic occurred in City Y after a nationwide measles mass immunization campaign (MMIC) in 2010.We investigated this epidemic to know the cause of this epidemic and provide evidence-based recommendations for measles elimination strategies in China.Methods: Measles cases were diagnosed by national criteria.We collected the data on vaccination history for measles patients to estimate measles vaccine coverage of the population.A case-control study was conducted in Hospital Z among children < 1 year old.Case-patients were measles outpatients treated at Hospital Z from November 1 to December 31.We randomly selected control-patients among all other outpatients.We reviewed medical records of case and control-patients to compare their exposure history at Hospital Z 7-21 days before illness onset.Results: Measles attack rate for all ages was 3.3/100,000 compared to 113/100,000 for children <1 year old.For children who were not age-eligible for the MMIC but later became age-eligible for routine measles vaccination, the measles vaccination rate was 52%.Of 42 case-patients 60% had visited Hospital Z 7-21 days earlier compared with 21% of 168 control-patients (adjusted ORM-H=5.5, 95% CI=2.7-11).Among unvaccinated children who had visited Hospital Z, 84% of 25 case-patients compared 38% of 29 control-patients were treated in the intravenous drip room (adjusted ORM-H=9.2, 95% CI=1.5-59).Each day 1500 children are treated in the drip room, a single room of 500 m2.Conclusion: Lack of timely routine measles vaccination allowed measles transmission to resurge after MMIC.Treatment in a crowded intravenous drip room facilitated the epidemic.To reach the goal of measles elimination by 2012, health authorities should strengthen routine measles vaccination and improve hospital environment to reduce nosocomial measles infection.