Towards elimination of measles and rubella in Italy: Progress and challenges


Autoři: Giovanna Adamo aff001;  Valentina Baccolini aff001;  Azzurra Massimi aff001;  Domenico Barbato aff001;  Rosario Cocchiara aff001;  Carolina Di Paolo aff001;  Annamaria Mele aff001;  Sara Cianfanelli aff001;  Aurora Angelozzi aff001;  Fulvio Castellani aff001;  Carla Salerno aff001;  Claudia Isonne aff001;  Antonino Bella aff003;  Antonietta Filia aff003;  Martina del Manso aff003;  Melissa Baggieri aff004;  Loredana Nicoletti aff004;  Fabio Magurano aff004;  Stefania Iannazzo aff005;  Carolina Marzuillo aff001;  Paolo Villari aff001
Působiště autorů: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy aff001;  National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy aff002;  Department of Infectious Diseases, National Institute of Health, Rome, Italy aff003;  National Reference Laboratory for Measles and Rubella, National Institute of Health, Rome, Italy aff004;  Infectious Diseases and International Prophylaxis Office, Ministry of Health, Rome, Italy aff005
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0226513

Souhrn

Introduction

In the WHO European Region, endemic transmission of measles and rubella had been interrupted by 37 and 42 of the 53 member states (MSs), respectively, by 2018. Sixteen MSs are still endemic for measles, 11 for rubella and nine for both diseases, the latter including Italy. Elimination is documented by each country’s National Verification Committee (NVC) through an annual status update (ASU).

Objective

By analysing data used to produce the ASUs, we aimed to describe the advances made by Italy towards elimination of measles and rubella. Moreover, we propose a set of major interventions that could facilitate the elimination process.

Methods

A total of 28 indicators were identified within the six core sections of the ASU form and these were evaluated for the period 2013–2018. These indicators relate to the incidence of measles/rubella; epidemiological investigation of cases; investigation of outbreaks; performance of the surveillance system; population immunity levels; and implementation of supplemental immunization activities (SIAs).

Results

From 2013 to 2018, epidemiological and laboratory analyses of measles cases in Italy improved substantially, allowing timely investigation in 2017 and 2018 of most outbreak and sporadic cases and identification of the majority of genotypic variants. Moreover, since 2017, vaccination coverage has increased significantly. Despite these improvements, several areas of concern emerged, prompting the following recommendations: i) improve outbreak monitoring; ii) strengthen the MoRoNet network; iii) increase the number of SIAs; iv) reinforce vaccination services; v) maintain regional monitoring; vi) design effective communication strategies; vii) foster the role of general practitioners and family paediatricians.

Conclusions

The review of national ASUs is a crucial step to provide the NVC with useful insights into the elimination process and to guide the development of targeted interventions. Against this background, the seven recommendations proposed by the NVC have been shared with the Italian Ministry of Health and the Technical Advisory Group on measles and rubella elimination and have been incorporated into the new Italian Elimination Plan 2019–2023 as a technical aid to facilitate the achievement of disease elimination goals.

Klíčová slova:

Government laboratories – Italian people – Italy – Measles – Measles virus – Rubella – Vaccination and immunization – Vaccines


Zdroje

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PLOS One


2019 Číslo 12