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Original article Epidemic characteristics of measles and efforts to control measles infections in Zhejiang Province, China
Rui Yan1,2orcid , Mengya Yang3orcid , He Hanqing1orcid , Feng Yan1orcid , Zhou Yang1orcid , Tang Xuewen1orcid , Deng Xuan1orcid , Zhu Yao1orcid , Yuxia Du2orcid , Can Chen2orcid , Cao Kexin2orcid , Shigui Yang2orcid
Epidemiol Health 2024;e2024075
DOI: https://doi.org/10.4178/epih.e2024075 [Accepted]
Published online: September 11, 2024
1Zhejiang Provincial Center for Disease Control and Prevention , Hangzhou, China
2Department of Epidemiology and Biostatistics, School of Public Health, Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
3Quzhou People's Hospital, Quzhou, China
Corresponding author:  Shigui Yang,
Email: yangshigui@zju.edu.cn
Received: 19 February 2024   • Revised: 8 July 2024   • Accepted: 25 August 2024
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Abstract

OBJECTIVES
Several countries have successfully eliminated measles, and China is making significant strides toward achieving this goal. This study focused on investigating the patterns of measles infections in Zhejiang Province, China, as well as control measures. The objective was to provide valuable insights that could contribute to the development of nationwide elimination strategies.
METHODS
We analyzed measles surveillance data from 2005 to 2022 in Zhejiang Province. We utilized a joinpoint regression model to examine trends in measles. Additionally, we employed SaTScan software (version 9.5) to identify spatial-temporal clusters. Finally, we used an age-period-cohort model to assess the effects of age, period, and cohort.
RESULTS
The age-standardized incidence rate (ASIR) of measles infection in Zhejiang Province from 2005 to 2022 was 5.24 per 100,000, showing a consistent and significant downward trend with an annual percentage change of -24.93% (p<0.05). After 2020, the ASIR for measles infection fell to below 0.1 per 100,000. The majority of measles cases occurred in individuals either without an immunization history or with an unknown immunization status, representing 41.06% and 41.40% of the cases from 2010 to 2022, respectively. According to data from the National Measles Surveillance System, the annual rate of discarded measles cases from 2009 to 2014, and the annual rate of discarded measles and rubella cases from 2015 to 2022, were both above 2 per 100,000, indicating the high sensitivity of the measles surveillance system.
CONCLUSIONS
The significant reduction in measles incidence from 2005 to 2022 demonstrates substantial progress in Zhejiang Province towards the elimination of measles.

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