A brief overview of the epidemiological situation with measles in Macedonia
This week, a total of 82 suspected cases have been reported, of which 74 are classified as measles (laboratory confirmed or with an epidemiological link).
44 cases of measles have been reported from Skopje, while the other 30 are from 9 other cities in Macedonia.
A total of 412 cases of measles have been registered in Macedonia since the beginning of the epidemic in Skopje since December 2018, of which 362 have been linked to the epidemic in Skopje.
According to the place of permanent living, measles cases were registered in 16 towns in Macedonia, of which 321 cases were from Skopje, 33 from Tetovo, 17 from Kumanovo, 9 from Gevgelija, 6 from Debar, 5 from Gostivar, 4 from Kichevo, and the other 9 cities are sporadic cases (chart 1).
This week’s epidemic of measles reported CPH Kumanovo, which is currently active in measles epidemics in three regions (Skopje, Tetovo and Kumanovo).
Chart 1. Geographical distribution of cases of measles in Macedonia, December 2018-February 2019
The largest number of cases are from the age group 1-4, 113 or 27.4% of the total number, children under the age of one year participate with 20.4% (n = 84), a high percentage of patients are also registered in the elderly groups, the people of 20-29 years participate with 10% (n = 41), and persons older than 30 with 34% (n = 140) (Chart 2).
Chart 2. Distribution of measles patients in Macedonia by age, December 2018-February 2019
A total of 113 cases in children aged 1-4 years, 104 or 92% have been unvaccinated, out of 181 cases in people over 20 years of age, 72.3% (n = 131) have been unvaccinated, incomplete vaccinated or with unknown vaccine status.
So far, due to a more severe clinical picture, 175 patients or 42.5% of the total number of cases have been hospitalized. Complications were reported in 17.5% of cases (n = 72), the most common complications being pneumonia (33) and diarrhea (33).
Three deaths associated with measles in children aged 5.5 to 13 months have been reported, all non-vaccinated with MRI vaccine. In two of the children there was co-morbidity, and all three children died of bronchopneumonia as a complication of measles disease.
During the eighth week, 1,789 children under the age of 14 were vaccinated, 1,123 in Skopje and 666 children in other cities.
A total of 13,838 children have been vaccinated since the onset of the epidemic.
In Skopje, 9,216 children from 16,361 unvaccinated children at pre-school and school age have been vaccinated since the beginning of the epidemic.
Out of Skopje, 4,622 children out of 25,955 vaccinated or incomplete vaccinated children aged 14 years have been vaccinated.