2014.ISDS.Abstracts.Final.pdf


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ISDS 2014 Conference Abstracts

Effect of the Ukrainian Crisis on the Current Measles 
Situation and ways of Improving Surveillance

Tetyana Chumachenko*1, Dmytro Chumachenko3 and Tetyana Karlova2

1Epidemiology Department, Kharkiv National Medical University, Kharkiv, Ukraine; 2Kharkiv Region Laboratory Center of the State 
Sanitary Epidemiological Service of Ukraine, Kharkiv, Ukraine; 3National Aerospace University, Kharkiv, Ukraine

Objective
To estimate the current measles situation in the Kharkiv oblast 

(eastern region of Ukraine) and to develop ways of improving the 
surveillance and control of measles in elimination phase during the 
crisis in Ukraine.

Introduction
Deterioration of socio-economic conditions in Ukraine created 

a threat of the spread of communicable diseases, including vaccine 
preventable diseases [1]. Children in Ukraine routinely receive two 
doses of the measles-mumps-rubella (MMR) vaccine according to the 
national immunization schedule. Measles is targeted for elimination 
in Ukraine [2]. But now Ukraine crisis carries significant public health 
risk and requires changing tactics of surveillance and epidemiological 
control against measles.

Methods
We used the data about reported cases of measles in the region and 

vaccination of sick people; the results of laboratory tests (ELISA), 
which confirmed the cases of measles, data about the level of measles 
immunity among the Kharkiv region population.

Results
In Ukraine, there is a mandatory registration of cases of measles. 

Doctor who identified patients with measles or suspected it necessarily 
informs the surveillance authorities of suspected cases. In 2013 there 
were 18 cases of measles (incidence was 0.66 per 100000 population) 
in the Kharkiv oblast. As of August 1, 2014 the incidence was 4.54 
per 100000 people (124 cases). As of 01.09.2014, there were 163 
probable cases and 128 confirmed cases of measles in the Kharkiv 
oblast, the cases were distributed equally among the children and 
adults - 64 cases of measles per each group. It should be noted that 
among these cases, 48 people were gypsies, who moved from the 
combat zone (Slavyansk, Donetsk oblast, Lugansk oblast, Ukraine), 
among them 38 (29.7%) were children, 10 (7.8%) – adults. Gypsies 
often avoid preventive vaccinations. Most cases have been reported in 
Kharkiv region which was the main place of resettlement of refugees 
and in Lozovaya region which was their entrepot (Fig.1). The largest 
number of cases were reported in May and June, 2014, when the flow 
of refugees from the area of anti-terrorist operation (ATO) increased.
Given the fact that at the beginning of the school year (September 
1), the flow of refugees from the area of ATO in Kharkiv region 
grew by people with school-age children and students, a worsening 
of the measles situation in the area should be expected. In the period 
before the crisis in Ukraine, an effective syndromic surveillance 
was implemented in the Kharkiv oblast. Suspected clinical cases 
of measles (people with maculapapular rash and temperature above 
38°C) were laboratory confermed. This approach allowed to identify 
sick people with measles more fully and to distinguish measles 
cases from other infections with rash. In Kharkiv oblast laboratory 
confirmation of cases was noted in 66.4 - 68.15% of cases.

Conclusions
The crisis in Ukraine led to a deterioration of the current measles 

situation due to refugees from the area of ATO, especially gypsies.
In host territories unvaccinated people need to be vaccinated 

and people with unknown vaccination status should be laboratory 
tested and if necessary vaccinated too. For that we should provide 
opportunities for vaccination of unaccounted population (allocation 
of vaccines, medical staff etc.)

To achieve the goals of eliminating measles in spite of the crisis 
in Ukraine implementation of the syndromic surveillance of measles 
should be continued in order to identify all the cases fully. Laboratories 
for serological investigation and conformation of suspected cases in 
Kharkiv should be empowered.

Fig.1. Map of number of measles cases in Kharkiv oblast from 01/01/2014 to 
09/01/2014

Keywords
Ukraine; vaccine preventable diseases; a treat of the spread of 
communicable diseases

References

1. World Health Organization (WHO). Ukraine crisis. Donor Alert. 15
August 2014.

http://www.who.int/hac/donorinfo/donoralert_ukraine_15aug.pdf?ua=1
2. World Health Organization (WHO). Surveillance Guidelines for

measles, Rubella and Congenital Rubella Syndrome in the WHO 
European Regional Office for Europe: 2012.

*Tetyana Chumachenko

E-mail: tatalchum@gmail.com    

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * (1):e188, 201