Morbillo in Australia
Il morbillo è una malattia
infettiva caratterizzata da febbre, eruzione esantematica tipica, secrezione
nasale, occhi irritati e tosse. Le complicazioni serie, compreso
polmonite, encefalite e morte, possono seguire l'infezione.
Il programma standard australiano di vaccinazione attualmente
prevede due dosi di vaccino contro morbillo, parotite epidemica e rosolia
(MMR), a 1 e 4 anni. Tutti i medici, laboratori, ospedali, scuole e centri di
cura di bambino, sono tenuti per legge ad notificare i
casi di morbillo.
Fra 1989 e 1998, 6 decessi, dei residenti di New South
Wales (NSW) sono stati attribuiti al morbillo e 8 morti sono stati
attribuiti alla panencefalite sclerosante sub-acuta,
una complicazione a lungo termine e devastante del morbillo.
NSW ha avuto l'ultima epidemia principale di morbillo nel 1993-94, e il tasso
di standardizzato per età di notifica nel 1993 fu di
40 per 100.000 (2.348 notifiche). In bambini sotto 15 anni, il tasso era intorno 150 per 100.000.
Per i bambini sotto 5 erano era più probabile l'ospedalizzazione, che si è
rivelata con un tasso di ammissione in questo gruppo d'età di 49 per 100.000
durante lo stesso anno. In 1998, il Consiglio di ricerca igienico sanitaria
nazionale ha suggerito che l'età per la seconda dose del vaccino di MMR fosse abbassata dalla fascia tra 10 e 16 anni a 4 anni. La
campagna nazionale di controllo di morbillo condotta durante quell'anno in tutte le scuole primarie in NSW prevedeva l'offerta della vaccinazione MMR a quei bambini
che non avevano contratto la malattia.
Fino al 1998 l'incidenza del morbillo in NSW fu ai livelli storicamente più
bassi. Il Settembre del 1999 fu il primo mese, poiché le notifiche del
laboratorio hanno cominciato ad essere raccolte nel 1991, in cui nessun caso
del morbillo è stato segnalato, indicando che la
trasmissione fu interrotta nel NSW: un successo stupefacente di sanità
pubblica. È probabile che questa fosse la prima volta
che la trasmissione si interruppe dai periodi coloniali. Per tutto il 2001, vi
furono soltanto 30 casi comunicati (tasso età-standardizzato
0.5 per 100.000).
Segnalato da Luigi Sudano, AzUSL, Valle d'Aosta
Fonte :
Public Health Division. The
health of the people of New South Wales -
Report of the Chief Health Officer.
Sydney: NSW Department of Health
Riferimento :
Vedi
l'ariticolo sul sito di New Health
Australia
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Report of the
New South Wales Chief Health Officer
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Communicable
diseases
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Note:
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Date of admission to hospital was used to best approximate date of
onset. Hospital admissions with measles as a principal or additional
diagnosis were included. Admissions were classified using ICD-9-CM up to June 1998
and ICD-10-AM from July 1998. Hospital
data were only available up to June 2000 at the time of publication. Rates
were age-adjusted using the standard Australian population as at |
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Source: |
Communicable
Diseases Branch NSW Notifiable Diseases Database,
NSW Inpatient Statistics Collection and ABS population estimates (HOIST).
Epidemiology and Surveillance Branch, NSW Department of Health. |
Measles is a communicable
disease characterised by fever, rash, runny nose, sore eyes, and cough. Serious
complications, including pneumonia, encephalitis and death, can follow
infection. The Australian Standard Vaccination Schedule currently recommends
two doses of measles, mumps and rubella (MMR) vaccine, at 1 and 4 years of age.
All doctors, laboratories,
hospitals, schools, and child care centres, are required by law to notify cases
of measles.
Between 1989 and 1998, 6
deaths of NSW residents were attributed to measles and 8 deaths were attributed
to subacute sclerosing panencephalitis, a devastating long-term complication of
measles.
NSW experienced its last
major epidemic of measles in 1993-94, with an age-standardised notification
rate in 1993 of 40 per 100,000 (2,348 notifications). In children aged under 15 years, the rate was around 150 per 100,000. Children
aged under 5 were most likely to be hospitalised, with
an admission rate in this age group of 49 per 100,000 in the same year.
In 1998, the National
Health and Medical Research Council recommended that the age for the second
dose of MMR vaccine be lowered from being given between ages 10 and 16 years to
age 4 years. The National Measles Control Campaign conducted in that year in
all primary schools in NSW to offered MMR vaccination to those children who
would otherwise have missed out on their second dose.
Since 1998 the incidence of
measles in NSW has been at historically low levels. September 1999 was the
first month, since laboratory notifications began being collected in 1991, in
which no cases of measles were reported, indicating that transmission was
interrupted in NSW: an amazing public health achievement. It is likely that
this was the first time that transmission was interrupted since colonial times.
For all of 2001, there were only 30 cases notified (age-standardised rate 0.5
per 100,000).
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National Health and Medical Research Council. The Australian immunisation
handbook. 7th ed. |
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The NSW
Public Health Bulletin includes monthly reports of notifiable
infectious diseases available at http://www.health.nsw.gov.au/public-health/phb/phb.html |
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National
communicable disease data are published in Communicable Disease Intelligence
available at http://www.health.gov.au/pubhlth/cdi/cdihtml.htm |
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EpiReview: Measles in NSW 1991-2000. NSW Public Health
Bulletin, July 2001;12: 200-204. |
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Copyright notice: |
This work is copyright NSW Department
of Health, 2002. It may be reproduced in whole or in part, subject to the
inclusion of an acknowledgement of the source. Commercial usage or sale is prohibited. |
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Public Health Division. The health of the people of New South Wales
- Report of the Chief Health Officer. |
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Produced by: |
Epidemiology and Surveillance Branch, Public Health Division, NSW Department of Health. |
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Last updated on: |
19 September
2002 |