澳大利亚维多利亚州新冠肺炎大流行后输入性麻疹病例重新合并的经验教训。

Madeleine J Marsland, Janet Strachan, Rebecca F Gang, Miriam O'Hara, Nicole M Hughes, Anna Glynn-Robinson
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摘要

澳大利亚于2014年宣布消灭了地方性麻疹;然而,输入性病例继续构成疫情爆发的威胁。2019冠状病毒病(新冠肺炎)大流行期间的国际旅行限制导致麻疹病例迅速下降。将澳大利亚国际边境重新开放到麻疹流行地区,又增加了疫情的威胁,新冠肺炎大流行期间常规疫苗接种的中断可能会进一步加剧疫情的威胁。我们考虑从最近麻疹病例的公共卫生对策中吸取的经验教训。方法该病例系列包括2022年1月1日至12月31日期间向维多利亚州政府卫生部报告的符合国家病例定义的所有确诊麻疹病例。该部门根据国家指导方针,对所有病例进行了积极的病例发现和接触者追踪。对病例进行描述性分析。结果2022年,澳大利亚报告的7例麻疹病例中有6例发生在维多利亚州,他们都居住在澳大利亚,并在海外感染。三个病例没有关联,三个病例形成了一个有流行病学关联的家庭集群。一个病例部分接种了疫苗,一个没有资格接种,一个疫苗接种状态未知,三个未接种,其中一个未满12个月,但在前往流行地区之前有资格接种疫苗。这些病例均未导致澳大利亚境内的二次传播。讨论在新冠肺炎大流行之后,维多利亚州再次出现麻疹输入病例。尽管2022年很少发生麻疹病例,也没有一例导致进一步传播,但输入性麻疹病例仍然很复杂,需要大量的公共卫生随访。病例诊断和航班接触者追踪的延误构成了麻疹爆发的重大风险。需要公共卫生干预措施来保持高疫苗接种率,改善接触者追踪,并确保公共卫生当局和医疗保健提供者能够快速识别和应对输入性麻疹病例。
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Lessons from the re-emergence of imported measles cases following the COVID-19 pandemic in Victoria, Australia.

Introduction: Australia was declared to have eliminated endemic measles in 2014; however, imported cases continue to pose a threat of outbreaks. International travel restrictions during the coronavirus disease 2019 (COVID-19) pandemic led to a rapid decline in measles cases. The re-opening of the Australian international border to measles endemic regions returns the threat of outbreaks, which may be further compounded by disruptions in routine vaccinations during the COVID-19 pandemic. We consider lessons learned from the public health response to recent measles cases.

Methods: This case series includes all confirmed measles cases meeting the national case definition reported to the Victorian Government Department of Health (the Department) between 1 January and 31 December 2022. The Department conducted active case finding and contact tracing of all cases in line with national guidelines. Cases were descriptively analysed.

Results: In 2022, six of the seven measles cases reported in Australia occurred in Victoria, all of whom resided in Australia and acquired their infection overseas. Three cases were unlinked, and three formed an epidemiologically-linked household cluster. One case was partially vaccinated, one was not eligible for vaccination, one had unknown vaccination status, and three were unvaccinated, one of whom was under 12 months old but would have been eligible for vaccination prior to travel to endemic regions. None of the cases led to secondary transmission within Australia.

Discussion: Following the COVID-19 pandemic, measles importations have re-commenced in Victoria. Although few measles cases occurred in 2022 and none resulted in onwards transmission, imported measles cases remain complex and require substantial public health follow-up. Delays in case diagnosis and flight contact tracing pose a significant risk for outbreaks of measles. Public health interventions are needed to maintain high vaccination rates, improve contact tracing, and ensure public health authorities and healthcare providers can rapidly identify and respond to imported measles cases.

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期刊最新文献
Measles secondary vaccine failure in a childcare setting: an outbreak report. Meningococcal Surveillance Australia: Reporting period 1 April to 30 June 2024. Meningococcal Surveillance Australia: Reporting period 1 January to 31 March 2024. Never waste a measles outbreak. Learning from COVID-19: strengthening Australia's research capacity through preparedness and collaboration.
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