Risk Analysis for Measles Reintroduction After Global Certification of Eradication
Risk Analysis for Measles Reintroduction After Global Certification of Eradication
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DOI：
10.1093/infdis/jir133
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发表时间：
2011-07-15
影响因子：
6.4
通讯作者：
Featherstone, David
中科院分区：
文献类型：
--
作者：
Sanders, Raymond;Dabbagh, Alya;Featherstone, David
背景。在全球根除认证之后，麻疹病毒将继续存在于实验室、持续和慢性感染者体内以及可能存在于未被发现的传播灶中的病毒库和传染性材料中。进行了文献检索，以确定和评估在没有普遍麻疹免疫接种的情况下重新引入麻疹传播的主要风险。方法。使用 Pub Med 数据库进行一系列文献检索后进行了定性风险评估。结果。如果全球根除认证的标准严格并需要严格验证，那么认证后未发现麻疹传播的风险非常低。从任何来源（包括持续感染和实验室材料）意外重新引入的风险都较低至极低，但取决于麻疹疫苗的使用程度。如果免疫水平下降，麻疹将通过故意释放而成为生物恐怖主义的可靠媒介。结论。根除后风险较低，不应阻止任何根除麻疹的尝试。需要更多关于麻疹传播动态和非典型感染作用的信息，以确定全球根除认证的要求。通过制定和实施国际风险管理战略，包括根除后疫苗库存的要求，可以最大限度地减少根除后风险。
Background. Measles virus will continue to exist after certification of global eradication as virus stocks and infectious materials held in laboratories, in persistently and chronically infected individuals, and possibly in undetected foci of transmission. A literature search was undertaken to identify and evaluate the main risks for reintroduction of measles transmission in the absence of universal measles immunization.Methods. A qualitative risk assessment was conducted following a series of literature searches using the Pub Med database.Results. If the criteria for global certification of eradication are stringent and require rigorous validation, then the risk of undetected measles transmission after certification is very low. Risk of unintentional reintroduction from any source, including persistent infections and laboratory materials is low to very low but depends on the extent of measles vaccine use. If immunization levels decrease, measles will become a credible agent for bioterrorism through intentional release.Conclusions. Posteradication risks are low and should not deter any attempt at measles eradication. More information on measles transmission dynamics and the role of atypical infections is required to determine requirements for global certification of eradication. Posteradication risks would be minimized through development and implementation of an international risk management strategy, including requirements for a posteradication vaccine stockpile.