In the period from 13.04.19.04.2019, a total of 121 cases of measles were reported. From the total number of newly reported cases, 79 cases are from Skopje, while the remaining 42 are from 8 other cities in Macedonia – Tetovo (14), Kumanovo (10), Veles (8), Gostivar (4), Ohrid (3) , Strumica (1), Sveti Nikole (1) and Resen (1). During this week, the highest number of cases (52) are over the age of 30, followed by children aged 0-4 years with 44 registered cases. According to the vaccine status, 90 or 70% of the registered cases are unvaccinated, incomplete vaccinated or with unknown vaccine status.
In total, since the onset of the epidemic in December 2018 as of April 19, 2019, 1,081 cases of measles have been registered in the Republic of Northern Macedonia with a disease rate of 52.2 per 100,000 inhabitants, the highest number of registered cases in the last 10 years. Due to the epidemiological criteria, a measles epidemic has been declared on the entire territory of the Republic of Northern Macedonia.
According to the place of permanent living, measles cases are registered in 21 towns, of which 692 cases are from Skopje, Kumanovo – 103, Tetovo – 93, Struga – 50, Kicevo – 30, Veles – 24, Gostivar – 20, Gevgelija -18, Debar -17, and in other cities less than 10 cases were registered (Chart 1).
Chart 1. Geographic distribution of measles in N. Macedonia, December 2018 – April 2019
The largest number of cases are from the age group over 30 years -463, and the overall disease rate in this age group is 36.4 per 100,000 inhabitants. 184 children under the age of one year were registered and a disease rate of 787.2 per 100,000 inhabitants. Children aged 1-4 years are registered with 189 cases and the second highest incidence of 203.6 per 100,000 inhabitants (Chart 2).
Chart 2. Distribution of measles patients in N.Macedonia by age, December 2018-April 2019 (n = 1081)
According to the vaccine status, 810 or 75% of diseased people are unvaccinated, incompletely vaccinated or with unknown vaccine status. From the non-vaccinated persons, 184 (17.0%) are under the age of 12 months and are not subject to vaccination, according to the Immunization Calendar.
Out of 189 children aged 1-4 years, 89.4% were unvaccinated or with unknown vaccine status, and from 613 patients over 20 years of age, 66.4% (n = 407) were unvaccinated, incomplete vaccinated or with unknown vaccine status.
From the reported cases, 442 or 41% were hospitalized, and 188 (17.4%) had complications. Of these, the highest number of complications – 52 or 27.7% were in children under the age of one year and 39 (20.7%) in children aged 1-4 years, suggesting that this age group is the most affected and susceptible to complications.
In Skopje from the beginning of the epidemic, a total of 12,468 children were vaccinated to 14 years of age.
In the rest of the country, a total of 7,776 children under the age of 14 were vaccinated with a first or second dose.
The total number of immunized people aged 14 years with MRP vaccine since the start of the epidemic in the republic is 20,244.