Measles Epidemiology in Italy

Abstract

In preparation for a mass vaccination programme, the immune status with regard to measles was determined in over 8300 unvaccinated children aged 0-13 years, residing in eight Italian cities with different socioeconomic situations and geographical locations. The age corresponding to the 50% prevalence of immunes appeared to be intermediate (2.9-5.5 years) between that reported for industrialized (6-7 years) and developing countries (1-2 years). The 50% prevalence of natural immunity was reached at an earlier age in southern cities in which poorer socioeconomic and hygienic conditions prevailed; the earlier occurrence of measles in these areas was confirmed by a more detailed serological study of children in the first 24 months of life. For children aged 2-13 years, serological results showed that the history of measles reported by parents on questionnaires gave high positive predictive values (over 85%). Our seroepidemiological study shows that, on the basis of the ages of 25 and 75% prevalence of immunes, the target population for a mass immunization programme in Italy can be assumed to be aged from 12 months to 7 years. However, special attention should be given to the poorest areas, especially in southern Italy, where measles occurs earlier and can be particularly severe.

Seroepidemiology of measles in Catalonia (Spain) 1985–1986

“…About 50% of the children aged 3 to 4 years, who were surveyed in that study, already had measles antibodies. Similar results have been found by Santoro et al in Italy, a country with socioeconomic and geographic characteristics similar to those of Spain (26).…”

Year of birth, sex and residence, as ? determinants ? of tetanus incidence and immunity in Italy

“…Official data in 1981 show that 4 out of 40 (10%) n o r t h e r n provinces, 3 out of 24 (12.5%) central provinces and 8 out of 30 (27%) southern provinces reported more deaths than cases of tetanus (7). A similar differential underreporting was also observed for measles (14). The case fatality rate of about 60% calculated by official notifications (Table 1 ) would be overestimated and probably the actual value would be closer to 10% estimated in England (5) or 26% estimated in the USA (3).…”

The seroepidemiology of measles in Western Europe

“…By the age of 10 years, 20 % of the population are still seronegative, considerably more than the 8 % observed in the prevaccination era [19]. Vaccination has thus resulted in a shift in the mean age of infection -with 13-18 % of measles cases over 10 years of age during the 1970s compared to 40-50 % in recent years [20].…”