Measles - possibilities of managing unsatisfactory epidemiological situation in Europe

This thesis focuses on the epidemiological situation in the incidence of measles in the Czech Republic and possibilities of influencing their unfavourable situation in Europe. Measles is a highly contagious disease of viral origin, which has a significant impact on the health of the child population in particular. The most effective protection against the measles is vaccination. The introduction of measles vaccination positively affected the epidemiological situation in the world. Priority of the WHO (World Health Organization, WHO, hereinafter) is elimination of the measles. The long term goal of the WHO and the European Centre for Disease Prevention and Control (ECDC hereinafter) was the elimination of measles in the European region by 2010. This goal was not achieved. The cause was low immunization coverage of certain population groups in several European countries. The prerequisite of achieving elimination of measles is that the vaccination coverage in the population is high. Many countries, thanks to effective vaccination strategy, succeeded in reducing the incidence of measles. In the years 2007- 2009 the historically lowest incidence, of less than 10 measles cases per million inhabitants, in the European region was achieved. In subsequent years, there was again a rise in measles morbidity. A repeated rise in cases of the disease is attributed to the expansion of social groups where vaccination coverage was inadequate in terms of achieving herd immunity. The thesis is divided into theoretical and practical part. The theoretical part is divided into four main chapters. The first chapter describes the history of measles, the origin of the name of the disease and the first mention of it. The second theoretical chapter is devoted to the clinical characteristics of measles. In subchapters it describes the clinical picture of the disease, possible complications of the disease, how the infection is diagnosed and what treatment options there are. The third chapter defines the epidemiological characteristics of the disease. The subheads are aimed at the cause of the disease, possible ways of transmission, incubation period, period of communicability, susceptibility and incidence of this disease. At last, the fourth chapter of the theoretical part desribes possible epidemiological measures, which include measles surveillance, preventive and repressive measures and vaccination. The practical part of the thesis was elaborated through quantitative research - secondary data analysis. Analysed data were obtained from the information system for reporting and recording infectious diseases EPIDAT on Regional Hygiene Station of South Bohemian Region, based in Budweis and the European Centre for Disease Prevention and Control. The data on population, in terms of age groups and individual regions, were drawn from the demographic yearbooks, which are available on the website of the Czech Statistical Office. The resulting data were subsequently processed in tabular and graphical forms in Microsoft Excel. The research objectives were: 1) to set charting trends in the incidence of measles in the Czech Republic and Central Europe over the period 2004-2013, 2) to compare the incidence of measles in the individual regions of the Czech Republic, and 3) to identify the reasons for gaps in vaccination coverage against measles in the South Bohemian Region. Based on the above stated objectives, the five research questions were defined. The results are intended to highlight the issues of possible adverse influence on the epidemiological situation in the incidence of measles in Europe. This thesis can be used as a source of information on trends in incidence, vaccine development and immunization status for measles