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Difficulties in achieving and maintaining the goal of measles elimination in Bulgaria

R Komitova1, A Kevorkyan2, O Boykinova1

  • 1Department of Infectious Diseases, Parasitology and Tropical Medicine, Faculty of Medicine, Medical University, Plovdiv, Bulgaria; Department of Infectious Diseases, "St George" University Hospital, Plovdiv, Bulgaria.

Revue D'Epidemiologie Et De Sante Publique
|February 27, 2019
PubMed

Insights

Measles morbidity in Bulgaria significantly decreased by 99.5% from 1921 to 2017 due to mass immunization. A 2017 outbreak highlighted the need for increased vaccination coverage, especially for Roma children, to achieve measles elimination.

Area of Science:

  • Epidemiology
  • Public Health
  • Immunization

Background:

  • Measles has been registered in Bulgaria for nearly a century, with mass immunization implemented since 1969.
  • A significant decline in measles morbidity has been observed, but a notable outbreak occurred in 2017.

Purpose of the Study:

  • To analyze measles morbidity trends in Bulgaria from 1921 to 2017.
  • To investigate the epidemiological characteristics of the 2017 measles outbreak in Plovdiv.

Main Methods:

  • Analysis of historical measles morbidity data from 1921-2017.
  • Epidemiological investigation of the 2017 Plovdiv outbreak.
  • Application of ARIMA model for short-term morbidity forecasting.

Main Results:

  • Measles morbidity decreased by 99.5% from 525.02%ооо in 1921 to 2.32%ооо in 2017.
  • The 2017 Plovdiv outbreak involved 141 cases, primarily unvaccinated Roma children and infants.
  • The outbreak's characteristics suggest relatively high overall vaccination coverage despite imported cases.

Conclusions:

  • Mass immunization has drastically reduced measles morbidity in Bulgaria.
  • Targeted efforts to increase vaccination coverage, particularly among Roma children, are crucial for measles elimination.
  • Enhanced surveillance and vaccination strategies are necessary to prevent future outbreaks.
Keywords:
ChildrenEnfantsMeaslesMorbidityMorbiditéOutbreakRougeoleVaccinationÉpidémie

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