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A new case of measles and a lack of vaccine reopen the debate on the return of controlled diseases



The National Epidemiology and Health Department's Health Department issued an epidemiological warning after confirming a new case of measles in the country.

With the latest 36-year-old from Rosaria, who would have been contacted on a commercial air flight on March 16 with a tourist who was later confirmed to have measles – four have so far been notified in 2019 in Argentina. Three previous ones have been implemented, and the present is being investigated.

In Argentina, the last endemic case of measles was recorded in 2000, and the last one died because of that cause in 1998, The North and South America region was the first and only worldwide to be named without measles in 2016. However, the epidemiological situation reported globally, and in particular in some countries in the region, warns disease specialists who believed it was being controlled.

"The only reservoir of measles virus is a human being, and given that we have a vaccine that is highly immunogenic, safe and effective can be eradicated if we are all vaccinated." The infectious physician Carla Vizzotti analyzed with concern the increase in cases of this disease recorded in recent years.

The president of the Argentine Society for Vaccinology and Epidemiology (SAVE) warned that "The measles are very portable, as nine out of ten people have contact with the virus and stays in the air for two hours so that someone can get it even without coming into contact with the infected person. "

At that time, Pablo Bonvehí, a member of the Argentine Society of Infectious Disease Advisory Board (SADI), said the disease was still deadly in children under five years (especially in infant and developing countries).

"The main challenge is to maintain very good surveillance, prompt and effective response to imported cases, so you must have a low threshold for detecting reported cases and be the subject of isolation and blocking that suits. it is necessary to maintain coverage over 95%He said.

After pointing out that "between 2000 and 2016, the measles vaccine prevented more than 20 million deaths, making it one of the best public health investments," the expert said "it is unacceptable that there are cases of very effective preventive tool. "

"The perception of severity of the disease is lost; people take it as true concepts that spread to various social networks that talk against the vaccine – such as association of autism vaccine, which is not the case – and how they do not experience the disease as serious, suspects that the vaccine misdirected not to vaccinate their children, "he said Bonvehí, who described in detail: "In America, there were 1052 cases in 2005 in 38 cities in the state of Ceará, after 13 years without the onset of illness, and this lasted for 20 months, including a lack of rapid response."

More recently, in 2018, Brazil was the country with the highest number of cases (10,262) followed by Venezuela (5,643), the United States (349), Colombia (188), Peru (38), Canada (28) Chile (23), Ecuador (19), Argentina (14), Mexico (5), Antigua and Barbuda (1) and Guatemala (1). "Until the epidemic week of 52 last year there were 16,514 illnesses eliminated from the region and with effective vaccine in place, it's hard to understand that this is happening," he said.

In this regard, Bonvehí recalled the recommendation of the Pan American Health Organization (PAHO) in order to prevent the progression of this disease:
– Maintain 95% coverage by vaccination
– Vaccinations of risky populations without evidence of immunity or vaccination against measles and rubella
Keep vaccination against measles and rubella
– Control imported cases
– Enhance surveillance (it is necessary to quickly detect cases, isolate them and establish an appropriate blockage)
– Provide a quick response to the imported case
– Identify internal and external migration flows in order to facilitate access to vaccinations, in accordance with the national program

Also, in 2010, the World Health Assembly found three milestones in the way of measles extermination, which should be completed by 2015:
– Increase systemic coverage of the first dose of measles vaccine in more than 90% nationally and more than 80% at the municipal level
– Reduce and maintain the annual incidence of measles in less than five cases per million; and
– Reduce measurable measles mortality by more than 95% compared with 2000 estimates

In 2012, the World Health Assembly approved the Global Action Plan for Vaccines to Remove Missiles in Four World Health Organization (WHO) by 2015 and five by 2020.

At that point, Vizzotti pointed out "There are countries that still have only one dose in the calendar so the possibility of eradicating the disease in the world far" and ceased to consider the importance of compulsory vaccination "as a social good that is above individual benefit". "In Europe, for example, people may decide not to vaccinate and which have a very high impact on public health and actually assess the mandatory nature of children before entering school in several countries, and in the United States they are not allowed to go public place, if not vaccinated, "said an expert who stressed that" in Argentina, vaccination is mandatory, because it is considered to be individual benefit, first and foremost, but to social good beyond the individual decision ".

Bonvehí remembered this The full vaccination schedule for the age according to the National vaccination schedule shows that children aged 12 months to 5 years must have a triple vaccine (measles, rubella and mumps) and those older than five years (including adults). They have to accredit two doses of triple viral vaccine. While people born before 1965 do not have to be vaccinated because they are considered to be protected because they have been in contact with the virus.

Inside, they criticize missing vaccines

At the end of the delivery of meningococcal vaccine doses for 11 years since last August, Vizzotti has assured that "there is a lack of meningococcal vaccine for children of 3, 5 and 15 months and other vaccines that are delivered irregularly and in smaller amounts against HPV, smallpox, triple viruses, rotaviruses, Sabina and Salka. "

"The provinces reported receiving less than planned and irregularly, and this really has a very impressive impact on the planning of vaccination actions in the provinces, which must carry out vaccination," said the experts who "put this much out to the health care team , as well as the confidence of the population in the health care system because, although there are many factors that can reduce coverage, the truth that someone gets vaccinated, and vaccines are not available, which must be provided by the national state, an inadmissible missed opportunity in our country".


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