Measles: What is the current situation? August 22, 2019 Susan - - PowerPoint PPT Presentation

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The image part with relationship ID rId3 was not found in the file. Measles: What is the current situation? August 22, 2019 Susan Robinson, MPH | Vaccine Preventable Disease Program Manager Measles The basics: o Caused by measles viruses and is

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Measles: What is the current situation?

August 22, 2019 Susan Robinson, MPH | Vaccine Preventable Disease Program Manager

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Measles

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Measles

Caused by measles viruses and is one of

the most infectious agents we know of

The basics:

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Measles

Caused by measles viruses and is one of

the most infectious agents we know of

People can spread measles 4 days before

the rash onset through 4 days after

The basics:

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Measles

Caused by measles viruses and is one of

the most infectious agents we know of

People can spread measles 4 days before

the rash onset through 4 days after

The measles vaccine is 95% effective after

the 1st dose and up to 99% after two doses

The basics:

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Global perspective:

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Measles Incidence Rate per Million (12M period)

Top 10** Country Cases Rate

Madagascar 150976 6064.62 Ukraine 84394 1899.11 Philippines 45847 443.74 India**** 39299 29.68 Nigeria 25814 138.79 Yemen 12001 435.07 Brazil 10241 49.32 Kazakhstan 9430 524.25 DR Congo 9244 117.4 Pakistan 8644 44.74

Other countries with high incidence rates*** Country Cases Rate

Georgia 4950 1261.02 The Republic of North Macedonia 1885 905.72 Kyrgyzstan 2928 491.63 Israel 3982 486.09 Bosnia and Herzegovina 1323 376.19

Notes: Based on data received 2019-08 and covering the period between 2018-07 and 2019-06 - Incidence: Number of cases / population* * 100,000 - * World population

prospects, 2019 revision - ** Countries with the highest number of cases for the period - *** Countries with the highest incidence rates (excluding those already listed in the table above) ****WHO classifies all suspected measles cases reported from India as measles clinically compatible if a specimen was not collected as per the algorithm for classification of suspected measles in the WHO VPD Surveillance Standards. Thus numbers might be different between what WHO reports and what India reports.

Measles cases from countries with known discrepancies between case-based and aggregate surveillance, as reported by country Country Year Cases in Case-based Cases in Aggregate Data Source for aggregate #s DR Congo 2018 5597 67072 SITUATION EPIDEMIOLOGIQUE DE LA ROUGEOLE EN RDC, Week of 06/08/2019 2019 6543 140,725 Somalia 2018 131 9135 Somali EPI/POL Weekly Update Week 30 2019 28 2397

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Number of Reported Measles Cases (6M period)

Top 10* Country Cases

Madagascar 127454 Ukraine 54246 Philippines 36253 Nigeria 24744 India** 24076 Kazakhstan 8855 DR Congo 6451 Yemen 5848 Myanmar 5029 Georgia 3874

Notes: Based on data received 2019-08 - Surveillance data from 2019-01 to 2019-06 - * Countries with highest number of cases for the period. **WHO classifies all suspected

measles cases reported from India as measles clinically compatible if a specimen was not collected as per the algorithm for classification of suspected measles in the WHO VPD Surveillance Standards. Thus numbers might be different between what WHO reports and what India reports.

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National perspective:

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Number of Reported Measles Cases by month – U.S., 2018–2019* (N=1505)

*Source: National Notifiable Diseases Surveillance System (passive surveillance); 2018 and 2019 data as of July 11, 2019

50 100 150 200 250 300 350 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Number of Cases Month of Rash Onset 2018 (n=382) 2019 (n=1123)

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Arizona perspective:

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1 2 2 1 3 7 31 1 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Arizona may see 1 -2 cases of measles every year.

In 2016, there was a large measles outbreak in an ICE detention center in Pinal.

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Article: DOI: https://doi.org/10.1016/S1473-3099(19)30231-2

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Vaccine Coverage:

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94.7% 94.4% 93.9% 92.7%

91.5% 92.0% 92.5% 93.0% 93.5% 94.0% 94.5% 95.0%

2015-16 2016-17 2017-18 2018-19

MMR coverage in kindergarten has been decreasing over the last several years.

* Data based on the IDR responses *

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10.2% 18.2% 20.0% 20.6% 25.0% 29.6% 33.3% 34.5% 38.6% 48.3% 52.5% 52.9% 60.7% 62.5% 78.6% Yavapai Gila La Paz Mohave Graham Navajo Greenlee Coconino Maricopa Pinal Cochise Santa Cruz Pima Apache Yuma

Only 5 out of 15 counties had over 50% of kindergarten classrooms with 95% MMR coverage or over. Overall there are over 5,000 Arizona kindergarteners who would be at risk for measles.

* Data based on the IDR responses for the 2018-19 school year*

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Public Health Response:

The virus is always ahead of public health

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Public Health Response:

The virus is always ahead of public health
Identifying contacts and exposures is crucial

and time-consuming

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Public Health Response:

The virus is always ahead of public health
Identifying contacts and exposures is crucial

and time-consuming

The window to provide prophy to high-risk

exposed individuals is short (72 hours for vaccine and 6 days for IGIV or IGIM)

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THANK YOU

Susan Robinson | Vaccine Preventable Disease Program Manager Susan.Robinson@azdhs.gov | 480-435-3929 azhealth.gov @azdhs facebook.com/azdhs