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In 2005, countries in WHO Western Pacific Region, including China, resolved to eliminate measles by 2012 or as soon as feasible thereafter. (1) As of 2018, 9 (2) of the [...]

Objective To analyse the epidemiology of measles in China and determine the progress made towards the national elimination of the disease. Methods We analysed measles surveillance data--on the age, sex, residence and vaccination status of each case and the corresponding outcome, dates of onset and report and laboratory results--collected between January 2005 and October 2013. Findings Between 2005 and October 2013, 596 391 measles cases and 368 measles-related deaths were reported in China. Annual incidence, in cases per 100000 population, decreased from 9.95 in 2008 to 0.46 in 2012 but then rose to more than 1.96 in 2013. The number of provinces that reported an annual incidence of less than one case per million population increased from one in 2009 to 15 in 2012 but fell back to one in 2013. Median case age decreased from 83 months in 2005 to 14 months in 2012 and 11 months in January to October 2013. Between 2008 and 2012, the incidence of measles in all age groups, including those not targeted for vaccination, decreased by at least 93.6%. However, resurgence started in late 2012 and continued into 2013. Of the cases reported in January to October 2013, 40% were aged 8 months to 6 years. Conclusion Although there is evidence of progress towards the elimination of measles from China, resurgence in 2013 indicated that many children were still not being vaccinated on time. Routine immunization must be strengthened and the remaining immunity gaps need to be identified and filled. [TEXT NOT REPRODUCIBLE IN ASCII] [TEXT NOT REPRODUCIBLE IN ASCII] Objectif Analyser repidemiologie de la rougeole en Chine et determiner les progres realises sur la vole de l'elimination nationale de la maladie. Methodes Nous avons analyse les donnees de surveillance de la rougeole--concernant l'age, le sexe, le lieu de residence et le statut vaccinal de chaque cas et les resultats correspondants, les dates de l'apparition et de slgnalement de la maladie, et les resultats de laboratoire --collectees entre janvler 2005 et octobre 2013 Resultats Entre 2005 et octobre 2013, 596 391 cas de rougeole et 368 deces lies a la rougeole ont ete signales en Chine. L'incidence annuelle exprimee en cas pour 100 000 habitants a diminue de 9,95 en 2008 a 0,46 en 2012, mais a ensuite augmente a plus de 1,96 en 2013. Le nombre de provinces ayantsignale une Incidence annuelle inferieure a un cas pour un million d'habitants a augmente de 1 en 2009 a 15 en 2012, mais est retombe a 1 en 2013. L'age median des cas a diminue de 83 moisen 2005 a 14 moisen 2012 et a 11 mois pendant la periode allant de janvier a octobre 2013. Entre 2008 et 2012, l'incidence de la rougeole dans tous les groupes d'age, y compris ceux qul ne sont pas cibles pour la vaccination, a diminue d'au moins 93,6%. Cependant, la resurgence a commence a la fin de l'annee 2012 et s'est poursuivie en 2013. Parmi les cas signales de janvier a octobre 2013, 40% etaient ages de 8 mois a 6 ans. Conclusion Bien qu'il y ait des preuves de progres vers l'objectif d'elimination de la rougeole en Chine, la resurgence de 2013 indique que de nombreux enfants netaient toujours pas vaccines a temps. La vaccination de routine doit etre renforcee et les lacunes immunitaires restantes doivent etre identifiees et comblees. [TEXT NOT REPRODUCIBLE IN ASCII] Objetivo Analizar la epidemiologia del sarampion en China y determinar el progreso hecho hacia la erradicacion nacional de la enfermedad. Metodos Hemos analizado los datos de vigilancia del sarampion recogidos entre enero de 2005 y octubre de 2013 en base a la edad, el sexo, la residencia y el estado de vacunacion de cada caso y el resultado correspondiente, las fechas de inicio de la enfermedad y de su comunicacion, y los resultados de laboratorio. Resultados Entre 2005 y octubre de 2013, se registraron 596 391 casos de sarampion y 368 muertes relacionadas con el sarampion en China. La incidencia anual, en casos por 100 000 habitantes, descendio del 9,95 en 2008 al 0,46 en 2012, pero volvio a aumentar en el 2013 hasta mas del 1,96. El numero de provincias que informo acerca de una incidencia anual de menos de un caso por millon de habitantes aumento de una en 2009 a 15 en 2012, pero volvio a caer a una en 2013. La edad media de los casos disminuyo de 83 a 14 meses en 2012, y a 11 meses de enero a octubre de 2013. Entre 2008 y 2012, la Incidencia del sarampion en todos los grupos de edad, incluidos los que no estaban incluidos en la vacunacion, se redujo en al menos un 93,6 %. Sin embargo, un resurgimiento comenzo a finales de 2012 y continuo en 2013. De los casos comunicados de enero a octubre de 2013, el 40 % tenia entre 8 meses y 6 anos. Conclusion Aunque hay pruebas de los progresos hacia la erradicacion del sarampion en China, el resurgimiento en el ano 2013 mostro que todavia hay muchos ninos que no reciben la vacuna a tiempo. Es necesario reforzar la vacunacion sistematica e identificar y completar las lagunas restantes en la inmunizacion., Introduction Measles is a highly infectious disease that causes enormous morbidity and mortality among children in many parts of the world. For example, it has been estimated that measles and [...]

Background Industrialization and demographic transition generate nonstationary dynamics in human populations that can affect the transmission and persistence of infectious diseases. Decades of increasing vaccination and development have led to dramatic declines in the global burden of measles, but the virus remains persistent in much of the world. Here we show that a combination of demographic transition, as a result of declining birth rates, and reduced measles prevalence, due to improved vaccination, has shifted the age distribution of susceptibility to measles throughout China. Methods and findings We fit a novel time-varying catalytic model to three decades of age-specific measles case reporting in six provinces in China to quantify the change in the age-specific force of infection for measles virus over time. We further quantified the impact of supplemental vaccination campaigns on the reduction of susceptible individuals. The force of infection of measles has declined dramatically (90%-97% reduction in transmission rate) in three industrialized eastern provinces during the last decade, driving a concomitant increase in both the relative proportion and absolute number of adult cases, while three central and western provinces exhibited dynamics consistent with endemic persistence (24%-73% reduction in transmission rate). The reduction in susceptible individuals due to supplemental vaccination campaigns is frequently below the nominal campaign coverage, likely because campaigns necessarily vaccinate those who may already be immune. The impact of these campaigns has significantly improved over time: campaigns prior to 2005 were estimated to have achieved less than 50% reductions in the proportion susceptible in the target age classes, but campaigns from 2005 onwards reduced the susceptible proportion by 32%-87%. A limitation of this study is that it relies on case surveillance, and thus inference may be biased by age-specific variation in measles reporting. Conclusions The age distribution of measles cases changes in response to both demographic and vaccination processes. Combining both processes in a novel catalytic model, we illustrate that age-specific incidence patterns reveal regional differences in the progress to measles elimination and the impact of vaccination controls in China. The shift in the age distribution of measles susceptibility in response to demographic and vaccination processes emphasizes the importance of progressive control strategies and measures to evaluate program success that anticipate and react to this transition in observed incidence., Author(s): Sheng Li 1, Chao Ma 2, Lixin Hao 2, Qiru Su 2, Zhijie An 2, Fubao Ma 3, Shuyun Xie 4, Aiqiang Xu 5, Yanyang Zhang 6, Zhengrong Ding [...]

Background: Measles is among the most highly infectious human diseases. By virtue of increasingly effective childhood vaccination, together with targeted supplemental immunization activities (SIAs), health authorities in the People's Republic of China have reduced measles' reproduction number from about 18 to 2.3. Despite substantial residual susceptibility among young adults, more in some locales than others, sustained routine childhood immunization likely would eliminate measles eventually. To support global eradication efforts, as well as expedite morbidity and mortality reductions in China, we evaluated alternative SIAs via mechanistic mathematical modelling.Methods: Our model Chinese population is stratified by immune status (susceptible to measles infection; infected, but not yet infectious; infectious; and recovered or immunized), age (0, 1-4, 5-9, …, 65+ years) and location (31 provinces). Contacts between sub-populations are either empirical or a mixture of preferential and proportionate with respect to age and decline exponentially with distance between locations at age-dependent rates. We estimated initial conditions and most parameters from recent cross-sectional serological surveys, disease surveillance and demographic observations. Then we calculated the reproduction numbers and gradient of the effective number with respect to age- and location-specific immunization rates. We corroborated these analytical results by simulating adolescent and young adult SIAs using a version of our model in which the age-specific contact rates vary seasonally.Results: Whereas the gradient indicates that vaccinating young adults generally is the optimal strategy, simulations indicate that a catch-up campaign among susceptible adolescent schoolchildren would accelerate elimination, with timing dependent on uptake.Conclusions: These results are largely due to indirect effects (i.e. fewer infections than immunized people might otherwise cause), which meta-population models with realistic mixing are uniquely capable of reproducing accurately. [ABSTRACT FROM AUTHOR]

What Is Already Known About This Topic?: The incidences of vaccine-preventable diseases (VPDs) included in the Expanded Program on Immunization in China have decreased significantly in recent decades., What Is Added by This Report?: This study summarizes the national incidences of nine VPDs and the seroprevalence of hepatitis B surface antigen (HBsAg) under different immunization strategies from 1950 through 2021 in China. The sharpest decreases in VPD incidence and under-5-year HBsAg seroprevalence occurred during the latest stage of the National Immunization Program. The decreases in VPD incidence were most prominent among children under five years of age., What Are the Implications for Public Health Practice?: These findings provide valuable insights for vaccine value assessment and emphasize the importance of implementing immunization strategies in targeted populations., Competing Interests: No conflicts of interest., (Copyright and License information: Editorial Office of CCDCW, Chinese Center for Disease Control and Prevention 2024.)

Introduction: Detecting poliovirus infections proves to be highly challenging due to their asymptomatic nature and infectious potential, highlighting the crucial importance of effective detection methods in the context of polio eradication efforts. In many countries, including China, the primary approach for identifying polio outbreaks has been through acute flaccid paralysis (AFP) surveillance. In this study, we conducted an evaluation spanning three decades (1993-2022) to assess the effectiveness of AFP surveillance in China., Methods: Data on all AFP cases identified since 1993 and national-level AFP surveillance system quality indicators aligned with the World Health Organization (WHO) standards were collected for analysis. The quality indicators assess surveillance sensitivity, completeness, timeliness of detection notification, case investigation, and laboratory workup. Surveillance sensitivity is determined by the non-polio AFP (NPAFP) detection rate among children under 15 years of age., Results: Between 1993 and 2022, a total of 150,779 AFP cases were identified and reported. Within this pool, surveillance identified 95 cases of wild poliovirus (WPV) and 24 cases due to vaccine-derived poliovirus. From 1995 onwards, the detection rate of NPAFP cases consistently adhered to the WHO and national standards of ≥1 case per 100,000, falling between 1.38 and 2.76. Starting in 1997, all timeliness indicators consistently achieved the criteria of 80%, apart from the consistency in meeting standards set for the rate of positive specimens sent to the national laboratory., Conclusions: AFP surveillance has been instrumental in China's accomplishment of maintaining a polio-free status. The ongoing adherence to key performance indicators, ensuring sensitivity and prompt specimen collection, demonstrates that AFP surveillance is proficient in detecting poliovirus in China. As we move into the post-eradication phase, AFP surveillance remains crucial for the sustained absence of polioviruses in the long term., Competing Interests: No conflicts of interest., (Copyright and License information: Editorial Office of CCDCW, Chinese Center for Disease Control and Prevention 2024.)

Objective: To analyze the current situation and long term trends in minerals intakes from 1989 to 2018 in adults aged 18 to 35 years in 15 provinces(autonomous regions, municipalities) of China., Methods: Based on the data of China Health and Nutrition Survey from 1989 to 2018. Adults aged 18 to 35 were selected as study subjects. According to the dietary survey result of 3-day 24-hour dietary review method and weighing accounting method, the mineral intake was calculated and analyzed. Nonparametric statistical method was used to analyze the trend of dietary minerals intake with years. Comparing the dietary minerals intake with the dietary reference intakes, the trend of the proportion of people at risk of insufficient dietary minerals intake was analyzed by Cochran-Armitage trend test. According to the different demographic characteristics in 2018, the minerals intake status and the proportion of people with insufficient dietary minerals intake were analyzed., Results: In 2018, the median intakes of dietary minerals of adults were 302.96 mg/d of calcium, 887.91 mg/d of phosphorus, 1451.69 mg/d of potassium, 3760.09 mg/d of sodium, 238.50 mg/d of magnesium, 19.40 mg/d of iron, 9.91 mg/d of zinc, 43.54 μg/d of selenium, 1.41 mg/d of copper and 4.59 mg/d of manganese, respectively, with significant gender differences(P<0.05). The intakes of dietary calcium, phosphorus, magnesium, potassium, selenium and copper in urban areas were significantly higher than those in rural areas(Z values were 3.00, 2.04 and 3.10, respectively, P<0.05). The dietary intakes of calcium, phosphorus, magnesium, potassium, selenium and copper showed significant differences among regions, education levels and income levels. From 1989 to 2018, the dietary mineral intake of calcium, phosphorus, potassium, sodium, magnesium, iron, zinc, copper and manganese of adults aged 18-35 in 15 provinces(autonomous regions and municipalities) of China showed a downward trend, only selenium intake showed an upward trend, and the intake of men was higher than that of women. The proportion of people at risk of inadequate intake of dietary phosphorus, magnesium, iron, zinc and copper showed an increasing trend year by year. In each survey year, the proportion of people at risk of insufficient calcium intake was more than 90%., Conclusion: From 1989 to 2018, there was a risk of insufficient intake of minerals in adults aged 18-35 in 15 provinces(autonomous regions, municipalities) in China, and the problem of inadequate calcium intake was serious.

Objective: To analyze the knowledge level and related factors related to dietary recommendations for Chinese residents aged 18-64 years in 2021., Methods: A multi-stage cluster random sampling was used to select 302 survey sites across the country, there were 102 398 people surveyed, with 98 567 valid questionnaires, 49.4% male and 41.9% urban, and an average age of(38.5±12.2) years. A standardized questionnaire certified by experts and evaluated for reliability and validity was used to conduct the face-to-face survey. The questionnaire was scored out of 100 points; dietary recommendation-related knowledge was scored out of 30 points, and a score of 22.5 points or above was judged as acquiring relevant knowledge. Descriptive statistics were used to report the values of relevant knowledge level of respondents with different characteristics, and univariate and multi-variate Logistic regression models were used to analyze the factors influencing relevant knowledge level., Results: The average score of dietary recommendation-related knowledge was(17.9±4.2), and the knowledge awareness rate was 14.7%. The five knowledge points with the lowest correct rates were the recommended intakes of soybeans and products(21.1%), added sugars(22.6%), milk(25.5%), food groups(27.6%), and cooking oils(31.4%) and the recommended intakes of fruits and salt were also less correct(56.9% and 58.5%). Multi-variate analysis revealed that the knowledge of dietary recommendations was lower among residents in rural(OR=0.945, 95%CI 0.944-0.945), central(OR=0.863, 95%CI 0.863-0.864) and western(OR=0.983, 95%CI 0.982-0.983) areas, those with chronic diseases(OR=0.784, 95%CI 0.783-0.784) and those who did not know about chronic diseases(OR=0.694, 95%CI 0.694-0.694) compared to the counterparts; female(OR=1.090, 95%CI 1.090-1.091) had a higher knowledge rate compared to male. The awareness rate of residents increased with the level of education, and the trend was statistically significant(P<0.001)., Conclusion: The level of knowledge related to dietary recommendations for the adult population in China in 2021 is low, especially for the recommended intake of dairy, soybeans and products, and cooking oils, and the knowledge level of men, rural, central and western, and less educated populations is even lower.