The measles crisis in Europe-the need for a joined-up approach.
The measles crisis in Europe-the need for a joined-up approach.
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欧洲的麻疹危机——需要采取联合行动。
DOI：
10.1016/s0140-6736(19)31039-6
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Robert A
中科院分区：
文献类型：
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作者：
Robert A
欧洲消除麻疹的工作正处于危机之中。2018年，世卫组织欧洲区域53个国家报告了8万多例确诊病例，为20年来最高。该区域14个国家报告了500多例确诊病例，其中包括4个以前被认为已消除麻疹的国家（希腊、阿尔巴尼亚、以色列和联合王国），这些国家的麻疹传播中断了3年。迫切需要新的战略来使欧洲消除麻疹回到正轨。理论上，控制麻疹应该是直截了当的。两剂MMR（麻疹-腮腺炎-风疹）疫苗可提供高效、持久的保护。然而，在实践中，实现消除已证明具有挑战性。麻疹是最具传染性的疾病之一，即使国家一级的疫苗接种覆盖率很高，麻疹也会袭击易感人群。虽然宣布个别国家处于消灭状态可能是一种激励手段，但即使在中断传播数年后，各国也可能出现大规模疫情。希腊、德国和吉尔吉斯斯坦等国报告说，过去十年来麻疹和风疹发病率一直很高，但仍在经历疫情。此外，疫情并非孤立发生：它们跨越国界，有时持续数年，在不同时间影响不同国家1。
Measles elimination in Europe is in crisis. More than 80,000 confirmed cases were reported in 2018 in the 53 countries of the WHO European Region, the highest for 20 years. Fourteen countries in the region reported more than 500 confirmed cases, including four previously deemed to have eliminated measles (Greece, Albania, Israel and the United Kingdom), that is interrupted transmission for three years. New strategies are urgently needed to put measles elimination in Europe back on track.In theory, controlling measles should be straightforward. Two doses of the MMR (measles-mumps-rubella) vaccine provide highly efficacious long-lasting protection. Yet in practice, achieving elimination has proven challenging. One of the most contagious diseases, measles can strike susceptible pockets even if national-level vaccination coverage is high. While asserting elimination status for individual nations may serve as a motivational tool, countries can experience large outbreaks even after several years of interrupted transmission. Countries such as Greece, Germany and Kyrgyzstan reported consistently high MMR uptake over the past decade but are still experiencing outbreaks. Moreover, outbreaks do not occur in isolation: they traverse country borders, sometimes lasting years and affecting different countries at different times 1.