جستجوی مقالات مرتبط با کلیدواژه "سرخک" در نشریات گروه "پزشکی"

Identifying the epidemiological features of reported measles outbreaks including the size, period, and generation of the outbreaks plays a significant role in preventing new outbreaks and estimating effective reproduction number (R) as an indication of measles elimination. This study was conducted to describe the reported measles outbreaks in the world in 2018.

The PubMed, Scopus, and Web of Sciences databases were searched using related keywords to retrieve articles that reported 2018 measles outbreaks. From the full-texts of the articles that met the inclusion criteria, the data including gender, season, age group, country, genotype, and vaccination status as well as shape, size, period of outbreaks and number of generations of each outbreak were extracted and reported using the relevant epidemiological curves.

The search results led to the retrieval of 2806 articles. After screening, 16 studies were used for final analysis. Most outbreaks were reported in the winter (56.25%) with genotypes B3 and D8. The sex female (38.64%, 308 cases) was mostly in Asia and Europe. On average, the minimum and maximum number of outbreaks size was 1 and 23, which spread to 3-4 generations. In terms of death, only one case of death was reported in Ethiopia.

The results of this study are useful for identifying measles outbreaks in other countries according to the at-risk groups. However, publication bias and non-reporting of all outbreaks should be considered as limitations in the generalization of the results.

Due to the global burden of measles, many measures have always been taken to control and eradicate this disease. However, epidemics of this disease still sometimes occur in some parts of the world and Iran. The aim of this study was to investigate the epidemiology of measles cases in the south of Kerman Province during 2014-2015.

This descriptive cross-sectional study was performed on 326-suspected cases of measles using a checklist and review forms. Data were analyzed by SPSS software version 16.

During the years of 2004 and 2005, out of the total number of suspected cases (n=326), 23% were laboratory confirmed. The highest percentage of measles was in the age group of 1 to 4 years (45.3%) and above 10 years (30.7%) and the highest cases of measles were among males (61.3%). Most cases of definite measles were in people without a history of vaccination (61.3%), in Iranians (81.3%) and in rural areas (73.3%).

According to the results of the study, there is a need to pay attention to additional immunization in remote areas and in places of gathering of foreign nationals. The highest prevalence of measles were among people who did not have a history of measles vaccination, it seems that the measles vaccination program has not been very successful in the cities covered by the Jiroft University of Medical Sciences. It is recommended that additional studies be performed to determine the risk factors for measles.

Measles is a severe acute respiratory viral infection. The single-stranded RNA morbillivirus from the Paramixoviridea family is easily transmitted among humans through coughing or sneezing droplets.

This was a case-control study that was carried out among people living in cities under coverage of Jiroft University of Medical Sciences, Jiroft, Iran in 2014-2015. Seventy-five patients with confirmed measles (case group) and 150 healthy individuals (control group) were selected for the study. The case group included entered into the study through census method. The control group was randomly selected by simple random sampling from the people who had the inclusion criteria. To control the confounding factors, each case was matched with two persons from the control group for age and gender. Conditional logistic regression was used to analyze the data.

After adjusting for confounding variables, a significant relationship between measles and, not receiving the vaccine (OR=14.35, CI 95%=7.03-29.27), the history of contact with the definite cases of measles (OR=1.9, CI 95%=1.09-3.43), non-native residents (OR=5.46, CI 95%=1.88-15.78), motherchr('39')s age of older than 30 years at birth (OR=2.8, CI 95%=1.23-6.38) were identified.

Based on the findings independent risk factors for developing measles disease were not having measles vaccine, non-native people, history of contact with definite cases of measles and, motherchr('39')s age at birth.

Elimination and eradication of measles requires designing and implementing an enhanced surveillance system. The purpose of this study was to review the measles surveillance system in Iran.

The data of this study were obtained from the surveillance system of the Center for Communicable Disease Control; a review of the records, documents, books, and published articles; and interviews with process owners and experts of measles surveillance in 2017-2019.

Iran has a surveillance plan to eliminate the measles. The current design for suspected cases of measles in Iran is a case-based surveillance system, in which for each identified case with fever and maculopapular rashes, some activities such reporting, laboratory confirmation, clinical and epidemiological investigation and case registration in individual forms are done.

Complete surveillance of cases suspicious of measles and high coverage of vaccination in children less than 2 years in a cohesive surveillance system and rapid response to the outbreak have led to lack of occurrence of indigenous measles in Iran. Although the current status of the measles surveillance system in Iran seems to be favorable, since Iran is at the stage of measles elimination, it is essential to increase the sensitivity of the reporting system for suspected cases of measles and to maintain the status of vaccine coverage to save elimination status.

Measles is one of the most highly communicable of all infectious diseases in healthcare settings, and may transmit to medical personnel. This study was designed to assess measles immunity in a group of healthcare workers (medical students) and its relationship with age, sex and duration of working in hospital.
Material and All medical students of the clinical courses were informed of the study in spring and summer of 2016. After collecting demographic information, 5 ml of blood was drawn from each student. Serum level of measles IgG was measured using IBL-America enzyme-linked immunosorbent assays kits in the laboratory of the Persian Gulf Research Center for Infectious Diseases.
A total of 90 students with a mean age of 25±3.2 years were included. All students had a history of one shot of measles vaccination. The positivity rate of measles antibody was found 48.9% (44 cases) while 12.2% (11 cases) had borderline titers and 35 (38.9%) were reported negative. No relationship was observed between positivity of measles antibody and the variables of age, sex and duration of working in hospital.
This study demonstrates more than one-third of medical students were at risk of measles, which mandates periodic surveillance and revaccination of susceptible healthcare workers. Furthermore, adequate respiratory precautions should be taken when visiting patients with febrile exanthema and cough.

The results showed success of the health system to detect suspected cases of the measles and appropriate sampling from suspected cases that were more than expected. In addition, per every one million population of Iran in 2014, 1.27 of cases of measles were reported; that a numbers of confirmed cases observed in Afghan refugees. Low levels of immunization coverage in eastern neighboring countries and high immigration to Iran, are the main challenge of measles elimination in Iran. The gradual accumulation of susceptible individuals, due to lack of proper vaccination or failure to respond to immunization, may underlie the development of outbreaks of measles in Iran.

The identifying incidence rate trend of disease and its changes lead to update response of surveillance system. Syndromic surveillance system is based on the suspected cases, so it has high speed in detecting outbreaks. This study aimed to evaluate trend of fever and rash incidence rates and detect affecting factors.

This study was a retrospective cohort study and the data included the suspected measles cases in provinces of Iran in 1977-2012, which extracted from surveillance system of vaccine preventable diseases. We fitted Poisson and Negative-Binomial regression models with random effect. Modeling and inferences were based on a Bayesian algorithm. We used R and OpenBUGS software. The fitted models were compared based on Deviance and Chi-square goodness of fit statistics.

Interaction effect between year and immunization campaign was statistically significant (95% CrI:1.083,1.737), after immunization campaign, trend was increasing. The variance of random component in model was statistically significant (95% CrI: 0.219,0.430). On the other hand, province-specific characterizes found affecting factor on suspected incidence rate.

In attention to increasing trend of this incidence in Iran, especially in recently years, and affecting of province-specific characterizes on suspected incidence rate, We found that more accurate control and improvement of quality vaccination is essential

Due to the minor outbreak of measles and mumps in vaccinated individuals as well as its handling of early childhood and school age; hypothesis that decreased over time immunity from the vaccine is formed. This study was designed to investigate the theory. 5 cc bloods of 60 students were taken and serum separated. IgG levels were measured by ELISA for Measles and Mumps. Of the 20 females (33. 3%) and 40 boys (66. 7%). Measles antibody levels in 3 boys (5%) were in the range Equivocal. Between the sexes، the antibody level difference was not significant (p=0. 289). In connection with the mumps; antibody was negative in 2 boys and 1 girl and 2 boys and 6 girls were suffering equivocal antibody. The optimal mumps antibody levels between the sexes، no significant difference was observed (P = 0 /865). Since the population is immunized against mumps virus in the population in the study population is less than 95%، there is a risk of epidemics every few years. It seems necessary، more careful planning for vaccination against the disease and to evaluate the effect of vaccination on the antibody levels in the population.

Measles and rubella are included vaccine-preventable infectious diseases. Despite vaccination coverage، there is the possibility of sporadic cases and mortality، especially in developing countries. The aim of this study was to examine the levels of antibodies to measles and rubella among medical students. This cross-sectional study was conducted on 236 students who were randomly selected in 2012. After filling out a questionnaire containing demographic information and medical records، 5 cc venous blood was collected from each individual and IgG antibody against measles and rubella were tested by using ELISA. The mean age of 236 students was 22. 12±3. 35. 81 cases (34. 3%) were male and 155 students (65. 7%) were female، 169 (71. 6%) and 67 students (28. 4%) were native of Mazandaran province and non-native، respectively. Rate of IgG antibody levels against measles in 123 students (52. 11%)، 40 cases (16. 94%) and 73 students (30. 93%) were positive، suspected and negative، respectively. This ratio for Rubella were identified in 233 (98. 72%)، 1 (0. 42%) and 2 (0. 84%) students، respectively. The results showed that the immunity level against rubella was acceptable، but it seems that the immunity level against measles is not enough to prevent sporadic and small outbreaks of measles. It is recommended that the serological status of measles should be evaluated for preventive measures.

Timely response to emerging diseases and outbreaks are a major public health and health systems priority. There are few published studies that evaluate the performance of cumulative sum (CUSUM) on identical data using semi- synthetic simulation approach. This study was undertaken to determine the performance of the CUSUM in timely detection of 831 days of simulated outbreaks. We evaluated the performances of the CUSUM as an outbreak detection method on simulated outbreaks injected to daily counts of suspected cases of measles as baseline data in Iran between 21 March 2008 till 20 March 2011. Data obtained from the Iranian national surveillance system. The performance of algorithms was evaluated using sensitivity، false alarm rate، likelihood ratios and Area under the Receiver Operating Characteristic (ROC) curve. Generally the sensitivity of the CUSUM algorithm in detecting simulated outbreaks was 50% (95% CI: 47- 54). The corresponding values are disaggregated according to outbreak size، shape and duration. The CUSUM algorithm detected the half of outbreaks after 13. 84 days on average. We concluded that CUSUM algorithm performed good in detection of large outbreaks with short periods and poorly in detecting long period outbreaks، particularly those simulated outbreaks that did not begin with a surge of cases.

Evaluating the performance of outbreak detection methods using real data testing provide the highest degree of validity. The aim of this study was to determine the performance of the Exponentially Weighted Moving Average (EWMA) in real time detection of two local outbreaks in Iran. The EWMA algorithm (both ƛ= 0.3 and 0.6) applied on daily counts of suspected cases of measles to detect local outbreaks which had been occurred in Mashhad and Bandar Abbas cities during 2010. The performance of The EWMA algorithms were evaluated using real data testing approach and reported by correlation analysis. Mashhad outbreak was detected with a delay of about 2 to 7 days using EWMA algorithms as outbreak detection method while the utility of EWMA algorithms in real time detection of Bandar Abbas'' outbreak were on time good optimal. Maximum correlation value for EWMA 2 in relation to Mashhad outbreak was 0.60 at lag 2. Applying the EWMA algorithm as an outbreak detection method at local levels is not suggested. However the characteristics of data are determinant of the performance of such detection methods.

Knowledge of the presence of seasonal trends and other explainable patterns in the prediagnostic data sources and removing such patterns before applying outbreak detection methods seem very important. This study aimed to detect and remove the explainable patterns such as seasonality, day-of-week (DOW) and holiday effects of the daily counts of suspected cases of measles in Iran. Data on daily counts of suspected cases of measles as a pre-diagnostic data source were obtained from Iranian national surveillance system between 21 March 2008 and 20 March 2011. We used lines plot, moving average chart, autocorrelation and partial autocorrelation functions for detecting explainable patterns. Moving average (MA) and Holt- Winters (HW) exponential smoothing method are used for removing explainable patterns. Our findings indicate the presence of seasonality, DOW effect, holidays and weekend effects in the daily counts of suspected cases of measles. The good performance of HW exponential smoothing technique in removing seasonal patterns is evident. MA technique showed better performance regarding assumption violation on outbreak detection methods. Because of the presence of explainable patterns in the daily counts of suspected cases of measles, considering such patterns before applying outbreak detection algorithms is very important. Implementing both MA (7 days) techniques for its simplicity as a pre- processing method and HW method for its efficacy in removing seasonal patterns is recommended.

Measles، rubella and mumps vaccination prevented the viral diseases threatening children during the recent decades. The incidences of these diseases in countries with high vaccination coverage have reduced significantly. Initial vaccination was as a single dose and then two dose vaccination was introduced. This change in the vaccination schedule still is renewed but the level of immunity، protection، production and stability of antibodies in the body is unknown. The aim of this study was the comparison of antibody levels among the children who received single or double doses of MMR vaccination. In this study، 200 children were classified as 100 patients with single dose vaccination (at age 12 months) and 100 with a double vaccination (at age 18 months). There was no relation between the serum level of antibody and gender of children. The positive serum level of IgM antibody against measles in single and double vaccination groups was 33% and 39% respectively with no significant difference. The positive serum level of IgG antibody against measles in single and double vaccination groups was 76% and 99% respectively with significant difference. The positive serum level of IgM antibody against mumps in single and double vaccination groups was 84% and 99% respectively with significant difference. The positive serum level of IgG antibody against mumps in single and double vaccination groups was 97% and 99% respectively with no significant difference. The positive serum level of IgM antibody against rubella in single and double vaccination groups was 21% and 14% respectively with no significant difference. The positive serum level of IgG antibody against rubella in single and double vaccination groups was 84% and 97% respectively with significant difference. The quantitative amounts of IgM and IgG against three diseases measles، mumps and rubella in children with second vaccination were more than once administration significantly. Finally، two time vaccination schedule in 12 and 18 months of age can immunize better than other vaccination programs and is more effective.

Measles is a highly infectious virus and human is the only natural host of this virus. This study was carried out to examine the insolubility of vaccine-induced antibodies. This cross-sectional study carried out in Tehran، Iran. Obtaining consent، the blood was collected from 810 male at the age of 19 years old. Then we used ELISA to assess the measles antibody titer. Then، the executor completed the form which included demographic information، vaccination، past medical history and laboratory data for each participant. Our results show that out of 810 cases 67. 7% were still seropositive for measles. 50% of all participants had received measles vaccination. There was a significant relationship between measles antibody titer and all variables. The vaccination-induced measles virus antibodies decline in duration of time. Declining titers suggest the need for vigilance in ensuring disease protection for the vaccinated population. According to measles incidence rate and its bioterrorism danger for military the present study suggests that new military students should be revaccinated for measles disease.

Noticing the sensitivity of measles virus to temperature and light, maintaining its stability is highly important in live vaccines. The aim of the study is to evaluate the stability of measles vaccine produced by AIK-C strain. In this experimental study, three lyophilized vaccine vials were incubated at 37˚C for one week and their stability was evaluated via accelerated test. In addition, reconstituted vaccines were incubated at 4˚C, 25˚C, and 37˚C for 0, 4, 8, 12, 16 hours after reconstitution and their remaining infectious virus titer was measured using CCID50 method. Half-life of the reconstituted measles vaccine was evaluated according to linear regression analysis. When the reconstituted vaccine was incubated at 4˚C, 25˚C, and 37˚C, the titer loss per hour was equal to 0.05, 0.1 and 0.2 Log10 CCID50, respectively. Also, the half-life of this vaccine at these temperatures was 5.31, 2.26, and 1.36 hours, respectively. The loss of potency for measles vaccine produced by AIK-C strain is 0.33 Log after storage at 37°C for one week, while the reported amounts for commercial vaccines such as Mevilin-L, Attenuvax, Edmonston-Zagreb, and Rimevax are 0.7, 0.7, 1 and 0.78, respectively. Lyophilized and reconstituted vaccine containing AIK-C strain is more stable in comparison with Edmonston B, Schwartz, Biken-CAM, and Leningrad strains. The stability of the reconstituted AIK-C strain vaccine is similar to Moraten strain at 37˚C.

Analysis of measles serum antibody responses is an important tool for evaluating the level of immunity in vaccinated people and for determining the factors which influence protective immunity. Usually antibody concentration values which are determined by quantitative assays are left censored, so standard analysis such as simple linear regression model may not be appropriate. Measles antibodies were measured using Enzyme Linked Immunosorbent Assay (ELISA) in 200 person aged 5-25 years before and after vaccination. A censored regression model proposed in order to reduce the effects of censored data in parameter estimating. Twenty two persons (11 percent) of the sample had titer below detection limit which made censored data. 83 percent of children and teenagers (less than 16 years) and 88 percent of participant aged 16 and more were protective against measles disease, but there was no statistically significance between age and immunity (P= 0.4). Although the number of females who had protective antibodies against measles was less than males, they possessed an average titer 42 percent higher than males (without considering covariates). This proportion changed into 39% by using the censored regression model and adjusting with respect to “antibody titer before vaccination”. Both ratios showed higher vaccine- induced protection in females (P< 0.05).

Acute disseminated encephalomyelitis (ADEM) is an immune mediated disease of brain. It usually occurs following a viral infection or vaccination, but it may also appear spontaneously. Serious problems associated with receiving the Measles-mumps-rubella (MMR) vaccine are rare. We report a case of 12-month-old girl with fatal outcome of ADEM following MMR vaccine. She had taken MMR vaccine 10 days prior to admission. And finally the patient died with Glasgow Coma Scale (GCS) of 3 on the day of admission. ADEM should be suspected in a child with fever and neurologic abnormalities, including impaired consciousness, especially one to two weeks after a viral infection or after vaccination. And the proper cares and treatments should be performed rapidly.

Agents of measles, rubella, and parvovirus B19 are among the etiologies of skin exanthematous diseases. Due to similarity in appearance of their skin rashes, clinical differential diagnosis is difficult. The method of choice for diagnosis of active infection with all these three agents is detection of specific immunoglobulin M (IgM) against them by ELISA method. In this descriptive cross-sectional study, 424 sera samples taken from suspected measles cases in different cities of Khuzestan province were analyzed. 8 In the meanwhile, among the measles-positive patients, 104 cases (24.5%) had been previously vaccinated against measles, 55 cases (12.9%) of which had been vaccinated twice, and 49 (11.5%) had been vaccinated three times. Taking into consideration the relatively high frequency of measles among these patients, it seems that the vaccination program against measles has not been much successful in the Khuzestan province. Furthermore, since the majority of measles patients were young adults, it is proposed to revise the time interval between the two doses of the measles vaccine, and inject the first dose in 9-12 months of age and the second dose in pre-school age (4-6 years).

In this study we evaluate the outcome of pregnancy in the patient that received M. MR vaccine during M.MR vaccination program on Lorestan of fall 2003. This is a descriptive epidemiologic study, we evaluated all of women that vaccinated with M.MR vaccine during pre and post conception. We collected and analyzed all of information like prognosis of pregnancy, congenital rubella syndrome, gestational age weigh of newborn. In 92 pregnancy women infected with MMR vaccine, the prognosis of pregnancy clearly seen 88 pregnant women (96%) 73 (83%) had normal and healthy newborn infant and 5 (6%) had spontaneot abortion and 10 pregnant women (11%) had legal abortion. Mean gestational age at birth was 39.5 ± 2.1 and weigh of newborn was 3257 ± 535 grams. None of the live born infants had not congenital rubella syndrome. In this study we showed M.MR vaccination during pregnancy had not any complication pregnancy. But pregnancy yet is an contraindication for M.MR vaccibnation, vecause this patient theories have risk of congenital rubella syndrome.