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Archive Number 20070615.1955
Published Date 15-JUN-2007
Subject PRO/EDR> Measles - Russia (Primorsky) ex China

MEASLES - RUSSIA (PRIMORSKY) ex CHINA
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A ProMED-mail post
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ProMED-mail is a program of the
International Society for Infectious Diseases
< http://www.isid.org>

Date: 9 Jun 2007
Source: IA Regnum.ru [9 Jun 2007 trans. by Mod.NR, edited]
<http://www.regnum.ru/news/841045.html>


More people infected with measles
---------------------------------------
The 2nd stage [of] preventive measures were not completed in 
Primorsky kray [region] last year  [?referring to a 2nd round of 
vaccination activities?- Mod.MPP]. As a result, an epidemic zone was 
formed in 2007 that led to 11 cases of measles: 10 among adults (from 
Vladivostok and Ussuriysk cities) and one in teenager from Ussuriysk, 
of whom 8 were laboratory confirmed.

It is assumed that infection was imported from China, since the 1st 3 
people to develop measles were part of a tourist group returning from 
China. That was the conclusion made by the chief sanitary doctor of 
Primorye, Dr. Dmitriy Maslov, who also added that "Measles cases 
occurred among those adults that did not have a history of 
vaccination.. The infection spread among those adults with inadequate 
measles vaccination: by January 2007,  only 93.3 percent of adults 
aged 18-35 had some immunity against measles, out of them 2.6 percent 
already had measles, 39 percent had a history of 2 doses of measles 
containing vaccine [i.e., were adequately vaccinated - Mod.MPP], and 
51.8 percent were vaccinated once [i.e., inadequately vaccinated - 
Mod.MPP].

According to a physician those individuals that had never been 
vaccinated or had only received one dose of measles containing 
vaccine are considered to be at risk of measles infection. According 
to an analysis conducted in 2006 - 13.8 percent of adults aged 23-25 
were not protected against measles (permissible level is 7 percent 
[this suggests that the recommended vaccination coverage at the 
community level is 93 percent who should have a history of 2 doses of 
measles vaccine - Mod.MPP]). This 13.8 percent of inadequately 
vaccinated adults are at high risk of measles infection.

In 2004-2006, supplementary immunization of adults up through age 35 
was conducted. As of 1 January 2007, 38 293 adults aged 18-35 years 
in the Primorsky Krai were not vaccinated against measles and were 
susceptible and 295 987 individuals had a history of one dose of 
vaccine. The plan for vaccination activities in 2007 is to vaccinate 
only 388 adults. Right now there are insufficient funds to cover the 
whole adult population, thus, the chief sanitary physician of 
Primorsky kray has issued a local decree to conduct a supplementary 
vaccination among adults up through age 35 who had inadequate 
vaccination histories [having received less than 2 doses of vaccine 
-- either one dose or no prior doses. - Mod.MPP]

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[It appears as though the vaccination program in the affected region 
(Primorsky) was unable to complete catch-up vaccinations of the 
entire adult population but plans to conduct vaccination activities 
among the identified high risk adult population, defined as those 
individuals less than 35 years of age (born after 1972) without a 
documented history of prior measles infection, and not having 
received 2 doses of measles containing vaccine.  According to the 
coverages cited, only 41.6 percent of this population was considered 
immune and not at risk of measles (immune defined as having had 
measles infection or having a history of 2 doses of measles 
containing vaccine).

Of note is that this outbreak began as a probable importation of 
measles from China as the 1st 3 cases recorded in this outbreak had 
just returned from a trip to China. As can be seen from the 
ProMED-mail prior postings below, the ongoing measles activity in one 
country carries with it the possibility (and probability) for 
importation to other countries.  In prior ProMED-mail posting (see 
Measles - USA (NM) ex India (02): importations background 
20070522.1633), Dr. Steve Berger from shared data on importation 
related measles outbreaks from the Global Infectious Disease & 
Epidemiology Network
(<http://www.gideononline.net>). These importation related outbreaks 
serve as a reminder that we do live in a global village, and events 
happening in countries geographically distant from us are important 
and may affect us in a short amount of time (the incubation period 
between exposure and onset of illness in a traveller.

Also of note is that the Primorsky region (kray) is located in the 
Far East of Asian Russia, sharing a border with China to the west, 
and on the Japanese Sea on the east. For a map of the Primorsky Kray, 
see:
<http://map.rin.ru/cgi-bin/main_e.pl?Region=primorsk>.
For a map of Russia with administrative divisions, showing Primorsky 
kray at the furthermost eastern reach of Russia see:
<http://www.lib.utexas.edu/maps/commonwealth/russia_admin_1994.pdf>.
- Mod.MPP]

[see also:
Measles - Taiwan ex Japan  20070614.1945
Measles - Japan (04): update  20070609.1887
Measles, imported - USA ex Japan  20070608.1861
Measles - Canada ex Japan: susp.  20070601.1766
Measles - Japan (03): Tokyo, Chiba, Saitama, Kanagawa  20070523.1655
Measles - Japan (02): Tokyo, Chiba, Saitama, Kanagawa  20070522.1638
Measles - Japan (Tokyo, Saitama): alert, RFI  20070424.1337
Measles - China (Shanxi): RFI  20070601.1765
Measles - China: RFI  20070313.0888
Measles, adult, adoption linked - USA ex China  20070228.0715
Measles - China (Guangzhou)  20070111.0122
Measles - Norway ex UK (England)  20070525.1673
Measles - USA (NM) ex India (02): importations background  20070522.1633
Measles - USA (NM) ex India  20070521.1629
Measles - Australia (VIC) ex UK: correction  20060526.1481
Measles - Australia (VIC) ex Europe  20060519.1410
2005
----
Measles - Russia (Novosibirsk): ex Kazakhstan  20050224.0587
2004
----
Measles - Norway ex China: correction  20040525.1407
Measles - Norway ex China  20040520.1356
Measles, adoptees - USA ex China (03)  20040625.1688
Measles, adoptees - USA ex China (02)  20040416.1050
Measles, adoptees - USA ex China  20040411.0985
Measles, imported - Mexico ex Asia (02)  20040605.1523
Measles, imported - Mexico ex Asia: alert  20040429.1195
2003
----
Measles, colleges & schools - Japan  20030707.1665
Measles, imported - USA ex Philippines: alert   20030131.0271
2002
----
Measles, imported - Taiwan ex Philippines (02)  20020511.4171
Measles, imported - Taiwan ex Philippines  20020511.4162
Measles virus, outbreak of H1 genotype - Japan (02)  20021101.5681
Measles virus, outbreak of H1 genotype - Japan  20021030.5670
Measles, imported - Australia ex Indonesia  20020113.3249
2001
----
Measles, imported - Brazil ex Japan (03)  20010701.1257
Measles, imported - Brazil ex Japan (02)  20010629.1238
Measles, imported - Brazil ex Japan  20010627.1223]
Measles, imported cases - Mexico ex USA (02)  20010505.0868
Measles, imported cases - Mexico ex USA  20010504.0857
1999
----
Measles - Australia ex Indonesia (02)  19990329.0500
Measles - Australia ex Indonesia  19990319.0433
.......................nr/mpp/ejp
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