title: Surveillance and vaccination coverage of measles and rubella in Northern Italy.
abstract: Measles and rubella are infectious diseases and humans are the only reservoir of these infections. Effective vaccines are available with the potential for measles (MV) and rubella (RuV) virus eradication. According to the World Health Organisation guidelines, a national plan was approved in Italy in 2013 to achieve the MV/RuV elimination by 2015, and active MV/RuV integrated surveillance initiated. Towards this purpose, a regional laboratory centre was set up on 1 September 2013 in Lombardy, Northern Italy. This paper aimed at: (1) evaluating measles-mumps-rubella (MMR) vaccine coverage and MV/RuV notified cases retrospectively; and (2) presenting the results of MV/RuV integrated surveillance (laboratory confirmed and viral genetic profiles).   The 95% target for MMR vaccine coverage was achieved in 2001, and coverage increased until 2007 (96.6%), but then a decreasing trend was observed. Since 2000 to 2014, 3026 rubella cases were notified, with nearly 58% of them in the 2002 epidemic. From 2009, less than 45 RuV cases per year were reported. From 2000 to 2014, 5024 measles cases were notified. Since 2008, three large outbreaks (in 2008, 2011, and 2013) were observed. From data obtained during our surveillance activity, there were no rubella cases, and 57.5% (46/80) collected samples were MV-positive by real-time RT-PCR. A fragment of the MV N gene was sequenced from 37 MV-positive samples; D8, D9, and B3 genotypes were detected. Data obtained retrospectively and from active surveillance underline the necessity to achieve and maintain high vaccination coverage and to improve surveillance and the effectiveness of healthcare actions.
authors.affiliation: a Department of Biomedical Sciences for Health; University of Milan; Milan, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Amendola
authors.forename: Laura
authors.initials: L
authors.lastname: Bubba
authors.forename: Antonio
authors.initials: A
authors.lastname: Piralla
authors.forename: Sandro
authors.initials: S
authors.lastname: Binda
authors.forename: Alessandro
authors.initials: A
authors.lastname: Zanetti
authors.forename: Elena
authors.initials: E
authors.lastname: Pariani
authors.forename: Alberto
authors.initials: A
authors.lastname: Ranghiero
authors.forename: Marta
authors.initials: M
authors.lastname: Premoli
authors.forename: Laura
authors.initials: L
authors.lastname: Pellegrinelli
authors.forename: Liliana
authors.initials: L
authors.lastname: Coppola
authors.forename: Maria
authors.initials: M
authors.lastname: Gramegna
authors.forename: Fausto
authors.initials: F
authors.lastname: Baldanti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Zanetti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D060740:Disease Eradication; D018563:Disease Notification / Q000706:statistics & numerical data; D004196:Disease Outbreaks; D062665:Epidemiological Monitoring; D005260:Female; D005838:Genotype; D006291:Health Policy; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D008457:Measles / Q000453:epidemiology* / Q000517:prevention & control*; D008459:Measles virus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage* / Q000276:immunology*; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012409:Rubella / Q000453:epidemiology* / Q000517:prevention & control*; D017422:Sequence Analysis, DNA; D014611:Vaccination / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D022542:Measles-Mumps-Rubella Vaccine
keywords: MMR vaccine; Measles; epidemiology; measles and rubella integrated surveillance; phylogeny; rubella; vaccine coverage