Progress Towards Measles Elimination in China - Achievements and Challenges
Discover the progress made towards measles elimination in China, including reported incidence rates, regional trends, and elimination activities such as strengthening routine immunization and surveillance. Explore the data and outcomes from 1955 to 2010, highlighting initiatives to achieve and maintain high MCV coverage and enhance outbreak response.
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Presentation Transcript
Towards Measles Elimination in China Global Immunization Meeting, Geneva March, 2011
Outline Progress on Measles Elimination Elimination Activities Challenges
Reported measles incidence China, 1955-2010 achieved the lowest. Incidence in 2010 20 Incidence /100,000 28.6/million 15 38159 cases: Lab- confirmed: 69%; 10 5 1600 0 Incidence(/100,000) 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 1400 1200 Year 1000 800 600 400 200 0 1955 1957 1959 1961 1963 1965 1967 1969 1971 1973 1975 1977 1979 1981 Year 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 Source: National Notifiable Reporting System (NNDRS)
Reported measles incidence* by province, China, 2005 2010 2007 2006 2005 2010 2008 2009 Regional accumulated in different years * Incidence per 100,000 population Source: NNDRS
Reported measles incidence by age group, China, 2005-2010 1000 2005-2009 year average 2009 year incidence rate(/100 000) 2010 year 100 10 1 100.00 0 1 2 3 4 5 6 7 8 9 incidence rate(/100 000) Age Group (Years) 10.00 <1y old age group show the highest incidence 1.00 0.10 0.01 20-30 group relatively high 0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- Age Group (Years) Source: NNDRS
Strengthen routine immunization Achieve and maintain routine 2 doses MCV coverage > 95% Strengthen surveillance Strengthen school entry immunization Conducting SIAs Improve outbreak response Enhance social mobilization -----Action Programs for Measles Elimination in China, 2010-2012
Surveillance in 2009/2010 Index 2009 2010 Reported incidence of excluded cases 1.2/100 000 1.4/100 000 Rate of suspected cases investigated in 48 hours 86.9% 89% Rate of blood specimen collected in sporadic suspected cases 70.3% 77% Rate of blood test outcome reported in 7 days 75.3% 85%
Conducting SIAs Guidelines issued Nonselective vaccination 2004-2009 Catch up: 25/31 provinces, 8M -14Y Follow up: 6 provinces, 8M -6Y Approximately 140 million vaccinated 2010 Nationwide SIAs, September 11-20 102.3 million children vaccinated
Completed SIAs, China, 2004-2009 Catch up: 25 provinces,8M -14Y Follow up: 6 provinces, 8M -14Y
SIAs conducted, China, 2010 5 provinces:8M- 14Y 6 provinces, 8M- 6Y 20 provinces, 8M- 4Y
Number of reported cases by week, 2006-2011 4500 2006-2010 year average 4000 3500 2010 year case number case number 3000 2011 year 2500 2000 1500 1000 500 0 1 3 5 7 9 111315171921232527293133353739414345474951 week week Source: NNDRS
Proportion of measles by age group , China, 2005-2011 Age group 100% 35 year- 80% 15-34 year proportion 60% 7-14 year 40% 2-6 year 20% 9 month-1 year 0% 2005 2006 2007 2008 2009 2010 2011.1-2 8 month year 1 year: 28%( in 2005) 51%(in 2010) 82% 2-14 year: 41%( in 2005) 18%(in 2010) 56% 15 year: 29%( from 2005 to 2010) stable
Measles reported status in Jan-Feb,2011 reported cases 1418 Lab-confirmed: 91%; Declined 63% compared to 2010.1-2
Reported measles cases by county, China, Feb,2011
MCV immunization history of cases by age, China, Jan - Feb,2011 Age group 0 dose(%) 1 dose(%) 2 doses(%) unknown(%) 92 0 0 8 8 month 8 month 89 6 1 4 9-11 month 69 23 0 8 61 24 6 9 1 year 50 18 16 16 2-6 year 30 19 30 21 7-14 year 25 10 5 61 15-34 year 37 4 0 60 35 year 61 13 5 21 total Source: Measles Surveillance System
Huge population huge gaps between difference regions Floating population Nationwide SIAs conduct difficultly social mobilization population attitude anti-vaccine movement
Adults are potential problem Surveillance system Hospital-infection control and case management Need differentiate strategies and measures
Maintain the high immunization coverage 8M:MR ; 18-24M:MMR Conducting SIAs focus on target population Strengthen school entry immunization Strengthen surveillance syndromic surveillance ; rubella surveillance: CRS Improve outbreak response Health education 4.25
