Epidemic Outbreak of Measles in the Region of Plovdiv, Bulgaria (March-July 2017)

• 作者: Andrei Petrov Maria Atanasova Mariana Mourdjeva Mariana Stoycheva Nikolay Vatev Petya Argirova
• 来源期刊: 疫苗(英文)
• 学科: 医学
• 关键词: MEASLES EPIDEMIC OUTBREAK IMMUNIZATION COMPLICATIONS
• 年，卷（期）: 2018,（1）
• 页码范围: 1-7
• 页数: 7页
• 分类号: R73

摘要

Object: To analyze the clinical, epidemiological and laboratory characteristics of the cases with measles in the Plovdiv region, Bulgaria, in the period March-July 2017. Materials and Methods: The study included 139 hospitalized patients with measles, treated in the Clinic of Infectious Diseases, University Hospital “St. George”—Plovdiv, during the observed period. Diagnosis was verified by ELISA in 133 of the patients. The following methods were used: clinical and epidemiological analysis, laboratory, microbiological and imaging tests. Results: The age distribution of the patients was: infants below 1 year were 23.8%;1 - 3 years—24.5%;4 - 17 years—30.9%;and over 18 years —20.8%. Ethnicity: from Roma origin were 83.5% and Bulgarians—16.5%. Most of the patients (62%) reported contact with a measles patient. Ninety eight of the patients were over 13 months of age and they should have been immunized, as the vaccine in Bulgaria is applied on the 13 month. Of these 98 patients, 49% were immunized, 28% were not, and for 23% there were not data. The most common clinical symptoms were: fever—97.1%, cough—98.6% and runny nose—82.7%. Conjunctivitis was observed in 82%, asthenia in 46%, and diarrhea in 51.1%. The rash appeared average on the 4th day of the onset of complaints. Koplik’s spots were observed in 71.9%, cervical lymphadenopathy in 56.1%, hepatomegaly—in 25.2%, and splenomegaly—in 7.9%;auscultation data for bronchitis/pneumonia—in 33.1%. Laboratory tests: leucopenia in 32.4%, leukocytosis—2.2%, normal results—in the rest 65.4%. ESR was increased in 39.1% and CRP in 76.5% of the patients. X-ray of the lung was performed under indication and was positive in 28/46. The serological test—anti-measles IgM (ELISA) was positive in 95.7% (133/139). We observed the following complications: pneumonia—12.2%, bronchitis—15.1%, laryngitis—4.3%, otitis—1.4%, gastroenteritis—14.4% and stomatitis—6.5%. The outcome was fatal for one patient. Conclusions: Measles still prevails during t