Improvement of epidemiological diagnosis in the system of epidemiological surveillance of current infections by creating a database of the results of foci investigation

Abstract

Measles is one of the preventable infections that does not lose its relevance to this day. In Russia, as well as throughout the world, waves of an increase in the incidence of measles are still being recorded, so in 2019 the maximum incidence rate over the past 20 years (3.05 %ооо) was noted. According to the current Measles Elimination Program of the Russian Federation, each case of this infection is subject to investigation, based on the results of which the epidemiologist organizes measures to prevent its spread in the outbreak. The main anti-epidemic measures in this case are isolation of the patient (at home or in a hospital according to clinical indications) and vaccination of persons in contact with him who need it. Thus, in order to prevent the occurrence of secondary cases, it is necessary to determine the vaccination and infectious history of all persons in contact with the sick person and vaccinate them no later than the seventh day from the moment the outbreak was registered. To date, it is difficult to generalize data from investigations of measles cases, despite their value for epidemiological diagnosis and the development of epidemiological surveillance (ES) tactics. The aim of the work was to improve the information support for the investigation of measles cases by creating and analyzing a database. The authors proposed a method for summarizing and analyzing the results of the investigation of measles cases using the formation of a database. For this purpose, about 1000 acts and reports on the results of the investigation of measles foci (on paper) registered in Moscow in the period from 2013 to 2015 were analyzed. The data contained in these documents is entered into the database, systematized in separate blocks and processed by the appropriate software for the purpose of their subsequent accumulation, storage and analysis. Based on the results of the work, the age composition of measles patients was analyzed. It was found that children under 18 years of age were more likely to have this infection, while the largest share among them was in persons aged 3–6 (32.4 %) and 7–14 years (25.0 %). The use of the database made it possible to confirm the high epidemiological effectiveness of the measles vaccine — the protection factor (E) was 86 %. Using the database, it was found that adults aged 20–35 years old were most actively vaccinated in measles foci (vaccination coverage was 57.7 %). With the threat of this infection, only 25.9 % of children (under 17 years old) who needed vaccination agreed to be vaccinated, and the percentage of refusals varied from 69.8 % in the age group up to two years old to 42.3 % in the group 20–35 years old.