Measles is caused by measles virus belonging to genus Morbillivirus of the family Paramyxoviridae. Vaccination has played a critical role in controlling measles infection worldwide. However, in the recent years, outbreaks of measles infection still occur in many developing countries. Here, we report an outbreak of measles among healthcare workers and among the 60 measles infected patients 50 were healthcare workers including doctors, nurses, staff, and medics. Fifty-one patients (85%) tested positive for IgM antibodies against the measles virus and 50 patients (83.3%) tested positive for measles virus RNA. Surprisingly, 73.3% of the infected individuals had been previously immunized against measles. Since there is no infection division in our hospital, the fever clinics are located in the Emergency Division. In addition, the fever and rash were not recognized as measles symptoms at the beginning of the outbreak. These factors result in delay in isolation and early confirmation of the suspected patients and eventually a measles outbreak in the hospital. Our report highlights the importance of following a two-dose measles vaccine program in people including the healthcare workers. In addition, vigilant attention should be paid to medical staff with clinical fever and rash symptoms to avoid a possible nosocomial transmission of measles infection.

BackgroundVulnerability to health-related poverty can predict the probability of families falling into poverty due to health risk impact. In this study, we measured the vulnerability to health-related poverty and examined the mediation path of physical multimorbidity on the vulnerability to health-related poverty of rural aging families in Ningxia, China.MethodsThis cross-sectional study was conducted in Ningxia, China, in February 2019. A multi-stage stratified cluster-randomized design was used to obtain a representative sample in each county. We included participants aged 60 years and older, who had lived there for more than 1 year. A total of 3,653 rural residents older than 60 years old were selected as the research subjects. The three-stage generalized least square method was used to calculate the expected vulnerability to poverty. We used mediating effect model to test the mediation path of poverty vulnerability related to the physical multimorbidity.ResultsUnder different poverty line standards, i.e., $1.9/day as low vs. $3.1/day as the high poverty line, the proportion of families that could fall into poverty in the future was 5.3 and 53.7%, respectively. The prevalence of chronic diseases and physical multimorbidity among rural residents >60 years old was 64.62 and 21.24%, respectively. The results of mediating effect test showed that self-rated health status (indirect effect a × b = −0.0052), non-agricultural employment (a × b= −0.0046), household cattle production (a × b = 0.0004), housing type (a × b = −0.0008), gift expenses (a × b = 0.0006) and loan for illness (a × b = 0.0034) were the mediation paths of poverty vulnerability related to the physical multimorbidity.ConclusionsConcerted efforts are needed to reduce poverty vulnerability related to the physical multimorbidity. The strategy of alleviating poverty should emphasis on promoting non-agricultural employment of vulnerable groups sustainability and developing rural economy, which are important paths to reduce family's vulnerability to health-related poverty.

In the past decade, the government of China has implemented healthcare reforms to provide universal access to healthcare by 2020. We aimed to systematically analyse the dynamic changes in health services and equity during the past 10 years to understand the correlation between health services and social-economic status. We performed a longitudinal study in which we extracted aggregated data mainly from a project (2009, 2011, 2012, 2015, 2019). A multi-stage stratified cluster randomized design was used to obtain a representative sample in each county. Concentration indexes were used to analyse the equity of the changes in utilization. We built multivariate random-effects generalized least squares regression models with the panel data to test whether the rate of receiving a medical consultation in the last 2 weeks or the rate of hospital admission or the prevalence of chronic illness was associated with social-economic status including education level and rural disposable income per capita. We found declines in both the rate of not receiving a medical consultation during the last 2 weeks (P < 0.05 intervention group) and the rate of hospital avoidance (P < 0.05) from 2009 to 2019. The equity in residents' health service utilization has improved constantly. We additionally found that rural disposable income per capita is a protective factor for the rate of a receiving a medical consultation during the last 2 weeks and the rate of hospital admission. China’s 2009 healthcare reform have positively influenced utilization rates and equity in health service utilization in the past decade, a range of health service-targeted strategies are needed including strengthen the prevention and treatment of chronic diseases, focus attention on the health status of elderly residents and improve social-economic status, especially the level of education.