Immunoprophylaxis of measles in Dobrich region as a result of good organization of health care for full coverage of the groups subject to control

Abstract

Introduction: Currently, health practice has monovalent and combined live viral vaccines that have the potential to achieve highly effective control and measles elimination. The risk factors for disease acquisition for susceptible persons are complex and varied, ranging from personal knowledge of the vaccine to access to health care. At the beginning of the 21st century, measles again gained epidemic dimension both on the European continent and in Bulgaria.
Aim: The aim of this paper is to investigate the peculiarities of the epidemic process in measles in the conditions of obligatory immunoprophylaxis in the Republic of Bulgaria and the Dobrich region for the period 2005-2015 as well as the reasons for its epidemic spread in 2009-2011.The objective is to investigate types of measles vaccines, the scope of the specific immunoprophylaxis with measles vaccine in the Dobrich region for the period 2005-2015 compared to the coun try and the immune status of the patients during the 2009-2011 epidemic.
Materials and Methods: We have used data from the National System for Surveillance of Contagious Diseases, annual reports of the Ministry of Health, data from the Directorate of Surveillance of Communicable Diseases at RHI-Dobrich for the period 2005- 2015. Data from annual reports on immunizations submitted to the Directorate of Surveillance of Communicable Diseases at RHI-Dobrich for the period 2005-2015. For the analysis of the data we used an ep-idemiological method, documentary method, statistical method and comparative analysis
Results: The country population is vaccinated with a combination of trivalent attenuated live vaccine for measles, mumps, rubella following a 13-month immunization regimen and 12 years of reimmunization, subcutaneously or intramuscularly in the deltoid area of the arm.
For the period 2005-2015 and after 12 years without measles cases in 2009, in the region of Dobrich, 614 patients (304.72%ооо) and 163 cases (80.89% ооо) for 2010 were registered, with the morbidity for 2009 significantly exceeding the country average. For the same period, measles morbidity in Bulgaria was in the range of 0.01% to 292.92%ooo. Since June 2009 until May 2010 (last case) in the Dobrich region, there were 777 cases of measles-infected with a morbidity of 383.15% from 6 days old to 42 years of age.
Conclusions: Immunoprophylaxis as a state policy in the Dobrich region contributes to limiting measles diseases for the period 2005-2015, confirming the opinion on the accumulation of a susceptible population in time, 2009-2011, and the occurrence of an epidemic. The most affected are children under one year of age, those in early childhood and school age. There is a need to maintain high vaccine coverage, both at national and regional level, and to increase the immunity of all communities to achieve measles elimination.
Measles is a disease that will continue to excite scientific thought in the future. Control of epidemics is difficult. Applying an appropriate strategy would help combat measles to realize the ultimate goal of eliminating and eradicating the disease.