Молодежный инновационный вестник

2415-7805

Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации

10220

Conference Proceedings

Analysis of measles incidence in the Voronezh region: medical personnel as a risk group

Pobezhimova

Maria Alexandrovna

-pobezhimova.2000@mail.ruhttps://orcid.org/0000-0001-9112-7100Gabbasova

Natalya Vadimovna

M.D., Professor of the Department of Epidemiologynatalia_gabb@mail.ruhttps://orcid.org/0000-0001-5042-3739

Voronezh State Medical University named after N. N. Burdenko

25042025

14S1102105

04022025

13022025

2025

Introduction. In recent years, the number of measles cases has been increasing in the world among various population groups. The Voronezh Region, like other regions of the Russian Federation, is no exception. Of particular concern are cases of infection among medical personnel as one of the most vulnerable groups. Objective. To characterize the manifestations of the measles epidemic process in the Voronezh Region for the period 2012-2024 and to assess the contribution of individual population groups to the spread of infection. Methods: general scientific, epidemiological. Results. Analysis of the incidence of measles infection among medical personnel of healthcare institutions in the Voronezh Region for 2012-2024. showed its uneven distribution: cases were registered in 2012 (2.51 cases per 100 thousand contingent), 2014 (9.42 cases per 100 thousand contingent), 2023 (3.94 cases per 100 thousand contingent) and 2024 (2.60 cases per 100 thousand contingent). It is noted that despite the high vaccination coverage during the study period, 3 measles outbreaks were recorded among health care workers. Conclusion. The incidence of measles among medical personnel over the past twelve years had an uneven distribution. The structure of cases included both unvaccinated (57.14%) and immunized persons (42.86%).

measlesmorbidityvaccinationmedical personnel

корьзаболеваемостьвакцинопрофилактикамедицинский персонал

Introduction. In recent years, there has been a complication of the epidemiological situation with measles worldwide, including the Russian Federation [1]. The increase in the incidence of measles infection may be associated with a sharp decrease in vaccination coverage during the COVID-19 pandemic, which is primarily due to the untimely implementation of vaccination campaigns. Thus, by the end of 2024, 54% (105/194) of the world's countries were assessed as being at high risk of measles outbreaks [2]. In our region, in 2023, there was a significant increase in the incidence of infection among various categories of citizens [3]. Of particular concern are cases of measles among medical personnel. Healthcare workers, being the most vulnerable group, are at increased risk of infection and can become a source of spreading the infection among both patients and colleagues. The aim of the study. To characterize the manifestations of the measles epidemic process in the Voronezh region for the period 2012-2024 and to assess the contribution of individual population groups to the spread of the infection. Objectives: To analyze the dynamics of measles incidence among healthcare workers in the Voronezh region. To characterize measles foci. To identify factors influencing the formation of measles foci. Materials and research methods. Statistical analysis of the data was carried out using the Microsoft Excel 2018 software product with the calculation of the average (M) and relative values, standard error (m); the reliability of differences was determined by Student's t-test and 2 (chi-square), at a significance level of p 0.05. The incidence analysis was carried out on the basis of data from Form No. 2 of Rosstat, epidemiological investigation cards for a case of measles or a suspected case of this infection for 2012-2023. in the Voronezh region and extraordinary reports of cases of controlled infections for 2023-2024. The age of those infected ranged from 19 to 46 years (average age 31.00 3.77 years). Results of the study. Analysis of the obtained results showed that in 2012-2024 in the Voronezh region there was an uneven distribution of measles incidence among the medical personnel of healthcare institutions. The incidence of measles infection was recorded in 2012 - 2.51 cases (CI -2.41-7.44), 2014 - 9.42 cases (CI 0.19-18.65), 2023 - 3.94 cases (CI -3.78-11.67) and 2024 - 2.60 cases per 100 thousand contingent (CI -2.50-7.70) (Fig. 1). Fig. 1. Measles incidence among medical personnel of the Voronezh region for the period 2012-2024. During the assessment of the state of herd immunity for the period 2012-2024. It was found that the indicators remained stably high (95%): the seroprotection level averaged 100.050.96%. However, despite the high vaccination coverage rates (over 95%), 4 outbreaks of measles infection among healthcare workers were registered during the analyzed 13-year period. Thus, in 2012, a measles outbreak was detected without further spread of the infection. Measles was registered in the Semiluksky district among a nurse in the surgical room of a polyclinic. The source of infection was a patient with measles. It was established that the woman had not completed the measles vaccination course. In 2014, multiple local outbreaks (4 cases) of nosocomial measles infection among healthcare personnel were detected in the Kantemirovsky district. The doctor was infected from a patient with measles, which led to further spread of the infection among other healthcare workers. Cases were registered from April 28 to May 13, inclusive: the interval between the first and the last was 16 days. Infection in the outbreak could have occurred either simultaneously from the first identified case, or first from the first and then from the second patient. It is noted that 50.0% of those infected were vaccinated against measles. The other two outbreaks of measles infection were registered in 2023 and 2024. In 2023, a single case of measles was detected in a nurse in Ramonsky District without further spread of the infection. The primary source of infection was not identified. It was established that the infected woman had not been vaccinated against measles. In 2024, measles was registered in a nurse of Voronezh Regional Clinical Hospital No. 1 in Voronezh. The primary source of infection was also not identified; the case did not spread further among patients and hospital staff. It should be noted that the man was vaccinated against measles. Discussion. In the context of an increase in the incidence of vaccine-preventable infections, such as measles, whooping cough, diphtheria, etc., immunoprophylaxis is becoming a key tool in preventing their spread. Despite the achievements in the field of vaccination, the decrease in vaccination coverage in a number of regions leads to the formation of susceptible groups of the population, which contributes to outbreaks of diseases. Cases of measles infection among health care workers require special attention. Measles, being a highly contagious disease, can spread quickly in health care settings, especially with insufficient herd immunity. Numerous studies on immunity to the measles virus have found that from 3.9 to 12.5% of health care personnel do not have a protective level of antibodies to the virus. This is due to both the lack of vaccinations among workers and the characteristics of their humoral immunity. It should be noted that post-vaccination immunity to infection decreases by 1.5 times every 5 years [4-5]. According to the results of our study, cases of measles among health care personnel were observed both in the absence of vaccination and timely revaccination (57.14%), and in the presence of documented vaccination (42.86%). This highlights the need for regular serological monitoring of healthcare workers to guide vaccination/revaccination of seronegative or low measles antibody individuals. Conclusion. An integrated approach to measles prevention among healthcare personnel, including vaccination, training and seromonitoring, is essential to reduce the risk of infection and protect the health of both staff and patients. <ol> <li>Measles incidence among healthcare personnel in the Voronezh Region was unevenly distributed and was recorded in 2012 - 2.51 cases (CI -2.41-7.44), 2014 - 9.42 cases (CI 0.19-18.65), 2023 - 3.94 cases (CI -3.78-11.67) and 2024 - 2.60 cases per 100 thousand contingent (CI -2.50-7.70).</li> <li>When analyzing the prevalence of measles infection among healthcare workers over a 12-year period, 4 foci of measles infection were identified in the Kantemirovsky, Ramonsky districts and the city of Voronezh.</li> <li>Measles was registered both in unvaccinated individuals (57.14%) and in individuals who had been immunized (42.86%). The presence of those vaccinated against measles in the structure of cases requires further study.</li> </ol>

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