Control of a nosocomial measles outbreak among previously vaccinated adults in a population with high vaccine coverage: Korea, 2019

Author(s):  
Kyunghyun Song ◽  
Ju Mi Lee ◽  
Eun Ju Lee ◽  
Bo Ram Lee ◽  
Ji Young Choi ◽  
...  
2019 ◽  
Vol 24 (2) ◽  
Author(s):  
Guilherme Almeida Elidio ◽  
Giovanny Vinícius Araújo de França ◽  
Flávia Caselli Pacheco ◽  
Marinélia Martins Ferreira ◽  
Jair dos Santos Pinheiro ◽  
...  

We report an ongoing measles outbreak in Manaus, Amazonas state, Brazil. As at 3 November 2018, 1,631 cases were confirmed corresponding to an incidence of 75.3 per 100,000 inhabitants; all five sanitary districts presented confirmed cases. Reintroduction of measles virus in Manaus is likely related to the current outbreak in Venezuela and due to recent decline in measles vaccine coverage. Given the current scenario, prevention and control measures should target individuals aged 15–29 years.


2019 ◽  
Vol 8 (4) ◽  
pp. 190-196
Author(s):  
Muhammad Wasif Malik ◽  
Mumtaz Ali Khan ◽  
Muhammad Salman ◽  
Muazam Abbas Ranjha ◽  
Tayyab Razi Rathore ◽  
...  

Background: On 13th April 2017, 3 measles cases were reported in Dhok Kazin, Islamabad to National Institute of Health, Islamabad. Federal Disease Surveillance & Response Unit on request of Islamabad Capital Territory (ICT) health administration started disease outbreak investigation and active case finding. The study was aimed to identify risk factors associated with disease outbreak, to assess vaccine coverage and vaccine efficacy in the outbreak area, and to suggest control measures. Methods: To determine possible risk factors age and sex matched case-control study was conducted in April, 2017. A case was defined as "Any resident of Dhok Kazin, presented with fever and maculopapular rash with any of signs/symptoms like coryza, conjunctivitis, cough, otitis media or pneumonia after March 20 to April 30, 2017". For each case 04 matched controls were selected. A structured questionnaire prepared to collect data. Vaccine coverage survey was conducted. Uni and multivariate analyses and vaccine efficacy were calculated. Results: A total of 14 cases identified including 11 cases found on active search. Cases were compared with 57 matched controls. Mean age was 39 months (range 08- 132 months). Among cases male to female ratio observed was 1:2.5. Overall attack rate was 1.2%, while most severely affected age-group was <12 months (AR=10.3%). The most common complications were diarrhea n=8 (57.1%) and pneumonia n=1 (7.1%). On vaccine coverage survey in 230 households, 31(70.5%) out of 44 children checked were vaccinated. The un-vaccinated children had attack rate of 14.3% while vaccinated had attack rate of 6.7%. The vaccine efficacy calculated was 53%. Significant association found in risk factors were; contact with positive case [OR 19.5, 95% CI; 4.5-84, P=0.00], unvaccinated children [OR=10.0, 95%, CI;1.2.0-49.3, P= 0.003], Mother illiteracy [OR 10.2, 95% CI; 2.5-41, P=0.00], Misconception about vaccination [OR 13.2, 95%, CI;3.1-57.1, P=0.00), vaccinator not visited home as a part of outreach activity [OR=6.4, 95%CI;1.7-23.4, P=0.00]. Reasons for non-vaccination were found to be misconception about vaccination (OR=34.8, 95%CI=5.5-219.7) and mother's illiteracy (OR=6.4, 95%CI=1.2-34.8). Conclusion: Most severely affected age group was 12 months and below. Low immunization rates were the most probable cause of outbreak. Case contacts, partial vaccination, misconception of vaccination, no visit of vaccinator to home, and mother's education were risk factors significantly associated with Measles outbreak. Findings were shared with the district health authorities for implementation of control measures.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
E Brottet ◽  
A S Ronnaux-Baron ◽  
N Grangeret ◽  
M Deher ◽  
B Andrivot ◽  
...  

Abstract During the 2019 winter season, a measles outbreak occurred at the Val Thorens ski station in France, in an area frequented by over 300,000 holiday-makers (70% foreigners) and 2,500 seasonal workers. Between 24/01/2019 and 15/04/2019, 55 cases were reported (18 confirmed and 37 clinical). Apart from 5 infected children under 2 years old attending the same nursery, cases were mainly seasonal workers between 19 and 41 years old. Five cases were hospitalised, one with severe pneumonia. Of the 36 cases with known vaccination status, 25 (69%) had not completed 2-dose vaccination. Other confirmed cases in visitors to Val Thorens were reported in neighbouring valleys (n = 3), and in other French regions. One case was reported the French overseas territory Guadeloupe (WHO ‘Americas’ region where measles has been eradicated). British, Belgian, Danish, Dutch and Irish authorities reported 7 cases in people who had stayed in the area. The list of exported cases is non-exhaustive. The regional health agency (ARS) provided increased information on epidemic risk and vaccination recommendations, particularly to health professionals and the town council. Identifying all contacts was difficult because many had occurred with seasonal workers. In addition to the approximately 150 vaccinations carried out by the Val Thorens medical centre from the start of the outbreak, only 41 other people were vaccinated in 5 free vaccination sessions organized in situ by the ARS, and the local medical and immunization centres. The large attendance at the station favoured the outbreak and its extension in France and abroad. Due to low measles vaccine coverage in France (80.3% for 2-dose cover in 2 years in 2017), outbreaks in non-vaccinated and not fully vaccinated populations are increasing, as seen in Val Thorens. Key messages A major measles epidemic occurring in an undervaccinated population in frequent contact with tourists, led to the extension of cases in France and Europe. Despite 5 free in situ vaccination sessions, with the mobilisation of local health professionals, few seasonal workers came to be vaccinated.


2018 ◽  
Vol 23 (25) ◽  
Author(s):  
Guillaume Béraud ◽  
Steven Abrams ◽  
Philippe Beutels ◽  
Benoit Dervaux ◽  
Niel Hens

Background Large measles and mumps outbreaks recently occurred throughout Europe and the United States. Aim: Our aim was to estimate and map the risk of resurgence for measles, mumps and rubella in France. Methods: We used a multi-cohort model combining seroprevalence information, vaccine coverage and social contact data. Results: The overall outbreak risk for France in 2018 was highest for mumps, remained significant for measles despite a recent measles outbreak and was low for rubella. Outbreak risks were heterogeneous between departments, as the effective reproduction numbers for 2018 ranged from 1.08 to 3.66. The seroprevalence, and therefore the risk of measles and rubella infection, differed significantly between males and females. There was a lower seroprevalence, and therefore a higher risk, for males. Infants of less than 1 year would be seriously affected in a future outbreak of measles, mumps or rubella, but the highest overall caseload contribution would come from teenagers and young adults (10–25 years old). Conclusions: The high risk for teenagers and young adults is of concern in view of their vulnerability to more severe measles, mumps and rubella disease and complications.


PEDIATRICS ◽  
2021 ◽  
Vol 149 (1) ◽  
Author(s):  
Ashley Gromis ◽  
Ka-Yuet Liu

OBJECTIVES Areas of increased school-entry vaccination exemptions play a key role in epidemics of vaccine-preventable diseases in the United States. California eliminated nonmedical exemptions in 2016, which increased overall vaccine coverage but also rates of medical exemptions. We examine how spatial clustering of exemptions contributed to measles outbreak potential pre- and postpolicy change. METHODS We modeled measles transmission in an empirically calibrated hypothetical population of youth aged 0 to 17 years in California and compared outbreak sizes under the observed spatial clustering of exemptions in schools pre- and postpolicy change with counterfactual scenarios of no postpolicy change increase in medical exemptions, no clustering of exemptions, and lower population immunization levels. RESULTS The elimination of nonmedical exemptions significantly reduced both average and maximal outbreak sizes, although increases in medical exemptions resulted in more than twice as many infections, on average, than if medical exemptions were maintained at prepolicy change levels. Spatial clustering of nonmedical exemptions provided some initial protection against random introduction of measles infections; however, it ultimately allowed outbreaks with thousands more infections than when exemptions were randomly distributed. The large-scale outbreaks produced by exemption clusters could not be reproduced when exemptions were distributed randomly until population vaccination was lowered by &gt;6 percentage points. CONCLUSIONS Despite the high overall vaccinate rate, the spatial clustering of exemptions in schools was sufficient to threaten local herd immunity and reduce protection from measles outbreaks. Policies strengthening vaccine requirements may be less effective if alternative forms of exemptions (eg, medical) are concentrated in existing low-immunization areas.


2011 ◽  
Vol 139 (11) ◽  
pp. 1727-1733 ◽  
Author(s):  
P. D'AGARO ◽  
G. DAL MOLIN ◽  
T. GALLO ◽  
T. ROSSI ◽  
D. SANTON ◽  
...  

SUMMARYTwo distinct measles outbreaks, unrelated from the epidemiological point of view but caused by genetically related strains, occurred in the Friuli Venezia Giulia region of northeastern Italy. Forty-two cases were reported during the period April–May 2008. In the first outbreak the index case was a teacher who introduced the virus into the Pordenone area, involving eight adolescents and young adults. The other concomitant outbreak occurred in the city of Trieste with 33 cases. The containment of the epidemics can be explained by the high MMR vaccine coverage in an area where the first dose was delivered to 93·4% and the second dose to 88·3% of the target children. Phylogenetic analysis of 14 measles virus strains showed that they belonged to a unique D4 genotype indistinguishable from the MVs/Enfield.GBR/14.07 strain, probably introduced from areas (i.e. Piedmont and Germany) where this genotype was present or had recently caused a large epidemic.


2010 ◽  
Vol 15 (36) ◽  
Author(s):  
I Parent du Châtelet ◽  
D Antona ◽  
F Freymuth ◽  
M Muscat ◽  
F Halftermeyer-Zhou ◽  
...  

Since early 2008, France has been experiencing a measles outbreak with almost 5,000 notified cases as of 30 June 2010, including three measles-related deaths. The proportion of cases 20 years or older reached 38% during the first half of 2010. This situation is the consequence of insufficient vaccine coverage (90% at age 24 months in 2007) that led to the accumulation of susceptibles over the last years. It underlines the need for additional measures targeting susceptible children and young adults.


1995 ◽  
Vol 37 (5) ◽  
pp. 421-425 ◽  
Author(s):  
Solange A. Oliveira ◽  
Marilda M. Siqueira ◽  
Antonio J.L. Costa ◽  
Maria T.C. Almeida ◽  
Jussara P. Nascimento

From March 1991 to April 1992, serum samples for IgM detection were collected from 112 clinical measles cases reported to the Health Department of Niterói, State of Rio de Janeiro. The positivity exceeded 90% for specimens collected from the 5th to the 29th day after the onset of the disease. After day 30 a decline in IgM detection was observed, although positivity has been detected up to 90 days after the onset of the symptoms. Forty-four patients (48.9%) with an IgM response had a history of prior measles vaccination. In 5 of the 22 measles-IgM negative cases the infection was due to other agents (rubella: 4 cases, dengue: 1 case). These results show that sensitivity of the test employed for confirming suspected measles cases is high, even in vaccinated patients.


2002 ◽  
Vol 69 (1) ◽  
pp. 33-37 ◽  
Author(s):  
J. S. Thakur ◽  
R. K. Ratho ◽  
S. P. S. Bhatia ◽  
Raminder Grover ◽  
M. Issaivanan ◽  
...  

2000 ◽  
Vol 124 (2) ◽  
pp. 273-278 ◽  
Author(s):  
J. MOSSONG ◽  
C. P. MULLER

From March to July 1996 a measles outbreak occurred in northern Luxembourg with 110 reported cases centered around two primary schools (85 cases) and the surrounding community (25 cases). Eighty four suspected cases were confirmed serologically. Vaccine coverage was estimated from questionnaire-based surveys at the two primary schools to be 70 and 76%, respectively. Vaccine efficacy during the outbreak was estimated to be 94.6% [95% confidence interval (CI) 90·4–97·0]. Using the information from the school surveys, we obtained estimates of the basic reproduction number of measles of 7·7 (95% CI 4·4–11·0) and 6·2 (95% CI 3·5–8·9), respectively. Assuming a 95% vaccine efficacy, these estimates correspond to minimal vaccine coverages of 91·6% (95% CI 81·4–95·7) and 88·3% (95% CI 75·5–93·4) which would have been necessary to minimize the chances of a major outbreak occurring. We can confirm that major outbreaks in similar school settings can only be prevented if vaccination coverage exceeds 90%.


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