Epidemiological and molecular assessment of a measles outbreak in a highly vaccinated population of northeast Italy

2011 ◽  
Vol 139 (11) ◽  
pp. 1727-1733 ◽  
Author(s):  
P. D'AGARO ◽  
G. DAL MOLIN ◽  
T. GALLO ◽  
T. ROSSI ◽  
D. SANTON ◽  
...  
Keyword(s):  
Measles Virus ◽  
Vaccine Coverage ◽  
Point Of View ◽  
Mmr Vaccine ◽  
Measles Outbreak ◽  
Northeastern Italy ◽  
Molecular Assessment ◽  
Measles Outbreaks ◽  
The City ◽  
Target Children

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.

scholarly journals Interruption of measles transmission in Gipuzkoa (Basque Country), Spain

2004 ◽  
Vol 9 (5) ◽  
pp. 7-8 ◽  
Author(s):  
G Cilla ◽  
M Basterretxea ◽  
J Artieda ◽  
D Vicente ◽  
E Pérez-Trallero
Keyword(s):  
Vaccination Programme ◽  
Measles Virus ◽  
Vaccine Coverage ◽  
Basque Country ◽  
Measles Vaccine ◽  
Mmr Vaccine ◽  
High Coverage ◽  
Imported Cases ◽  
Measles Vaccination ◽  
Measles Outbreaks

Measles vaccine was introduced in Gipuzkoa (Basque country, Spain) in 1978 and was replaced by the measles, mumps, and rubella (MMR) vaccine for children aged 12-15 months in 1981. A second dose of the MMR vaccine was introduced in 1992. Both doses of the MMR vaccine were well accepted by the population and high coverage was achieved (95% and 91% for the first and second doses respectively for the period 1993-2002). Measles virus circulation was interrupted in the second half of the 1990s: no cases of indigenous measles were notified between 1998 and 2003, and only imported cases have been confirmed during this period. These data indicate that the measles vaccination programme implemented has been effective. Nevertheless, to avoid measles outbreaks following viral introduction, high MMR vaccine coverage levels for the two doses have to be maintained (>95%).

scholarly journals Characterisation of measles after the introduction of the combined measles-mumps-rubella (MMR) vaccine in 2004 with focus on the laboratory data, 2016 to 2019 outbreak, Romania

2019 ◽  
Vol 24 (29) ◽  
Author(s):  
Mihaela Lazar ◽  
Aurora Stănescu ◽  
Ana Raquel Penedos ◽  
Adriana Pistol
Keyword(s):  
Measles Virus ◽  
Vaccine Coverage ◽  
Laboratory Data ◽  
Molecular Data ◽  
Control Measures ◽  
Mmr Vaccine ◽  
Incidence And Mortality ◽  
Multiple Virus ◽  
Current Outbreak ◽  
Measles Outbreaks

Background Since January 2016, a resurgence of measles in Romania has led to the third measles epidemic in the past 12 years; 64 deaths have been confirmed so far–the highest number of measles-related deaths since the measles-mumps-rubella (MMR) vaccine was introduced in 2004. Aim To provide an overview on the characterisation on measles in Romania after the introduction of the MMR vaccine with focus on the current outbreak, laboratory and molecular analysis. Methods We performed an analysis of measles incidence and mortality after the introduction of MMR vaccination and a retrospective study using serological and molecular data in three consecutive outbreaks with focus on the current outbreak. Results In the current outbreak, 17,533 measles cases were notified to the national surveillance system, 93% were unvaccinated. Measles virus was isolated from 429 samples and 283 were genotyped. Genotype B3 was predominant (n = 269) and sporadic measles cases associated with D8 genotype (n = 9) were also observed; genotype D4 and D8 were identified in the previous two measles outbreaks. The detection of several distinct measles virus B3 genotypes suggests multiple virus importations to Romania. Conclusion The current outbreak is a consequence of insufficient vaccine coverage. Control measures were implemented to improve uptake of MMR vaccine, including administering the first MMR dose at a younger age (9–11 months) and offering catch-up vaccination to children that have not followed the recommended dosing schedule. More measures are needed to improve the surveillance performance and to achieve high routine MMR vaccination coverage.

scholarly journals Measles outbreak: preliminary report on a case series of the first 8,070 suspected cases, Manaus, Amazonas state, Brazil, February to November 2018

2019 ◽  
Vol 24 (2) ◽  
Author(s):  
Guilherme Almeida Elidio ◽  
Giovanny Vinícius Araújo de França ◽  
Flávia Caselli Pacheco ◽  
Marinélia Martins Ferreira ◽  
Jair dos Santos Pinheiro ◽  
...  
Keyword(s):  
Measles Virus ◽  
Vaccine Coverage ◽  
Case Series ◽  
Control Measures ◽  
Measles Outbreak ◽  
Current Scenario ◽  
Current Outbreak ◽  
Prevention And Control Measures ◽  
Amazonas State ◽  
And Control

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.

scholarly journals Phylogenetic and epidemiological analysis of measles outbreaks in Denmark, 2013 to 2014

2015 ◽  
Vol 20 (39) ◽  
Author(s):  
Lasse Dam Rasmussen ◽  
Jannik Fonager ◽  
Lisbet Krause Knudsen ◽  
Peter Henrik Senten Andersen ◽  
Jesper Rønn ◽  
...  
Keyword(s):  
Measles Virus ◽  
Virus Genome ◽  
Vaccine Preventable Disease ◽  
Global Public Health ◽  
Rt Pcr ◽  
Mmr Vaccine ◽  
Epidemiological Analysis ◽  
Clinical Specimens ◽  
Vaccination Coverage Rate ◽  
Measles Outbreaks

Despite the introduction of safe, effective vaccines decades ago and joint global public health efforts to eliminate measles, this vaccine-preventable disease continues to pose threats to children’s health worldwide. During 2013 and 2014, measles virus was introduced into Denmark through several independent importations. This resulted in a number of secondary cases (n = 7), with two clusters in 2013 and one in 2014. In total, there were 44 cases of measles. Most cases (n = 41) were laboratory confirmed by detection of measles virus genome by real-time reverse transcription (RT)-PCR and IgM antibodies. The viruses from confirmed cases were genotyped by sequencing. Only one genotype circulated each year, i.e. D8 and B3, respectively. Sequencing of measles virus from different clinical specimens from the same patients revealed that sequence variants of measles viruses might co-exist and co-transmit during an outbreak. The majority of the cases were unvaccinated (n = 27) or recipients of one dose of measles-mumps-rubella (MMR) vaccine (n = 7). In addition, two fully vaccinated adult cases were reported in 2014. We demonstrate the transmission of measles virus in a population in which the two-dose MMR vaccination coverage rate was 80% and how even vaccinated individuals may be at risk of contracting measles once transmission has been established.

Spatial Clustering of Vaccine Exemptions on the Risk of a Measles Outbreak

PEDIATRICS ◽  
2021 ◽  
Vol 149 (1) ◽  
Author(s):  
Ashley Gromis ◽  
Ka-Yuet Liu
Keyword(s):  
Large Scale ◽  
Spatial Clustering ◽  
Vaccine Coverage ◽  
Herd Immunity ◽  
The United States ◽  
Vaccine Preventable Diseases ◽  
Measles Outbreak ◽  
Measles Outbreaks ◽  
Lower Population ◽  
Local Herd

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 >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.

scholarly journals Measles Outbreak in Unvaccinated and Partially Vaccinated Children and Adults in the United States and Canada (2018-2019): A Narrative Review of Cases

2019 ◽  
Vol 56 ◽  
pp. 004695801989409 ◽  
Author(s):  
Adekunle Sanyaolu ◽  
Chuku Okorie ◽  
Aleksandra Marinkovic ◽  
Oladapo Ayodele ◽  
Abu Fahad Abbasi ◽  
...  
Keyword(s):  
United States ◽  
Measles Virus ◽  
The United States ◽  
Narrative Review ◽  
World Health ◽  
Health Concern ◽  
Mmr Vaccine ◽  
Measles Outbreak ◽  
Major Outbreak ◽  
Health Organization

Since 2018 and currently in 2019, the United States and Canada experienced a rapidly spreading measles virus outbreak. The developing outbreak may be due to a lack of vaccination, an inadequate dosage of measles (MMR) vaccine, clusters of intentionally under-vaccinated children, imported measles from global travel, and from those who are immunocompromised or have other life-threatening diseases. The infection originated mainly from travelers who acquired measles abroad and has thus led to a major outbreak and health concern not only in the United States and Canada but also in other parts of the world. According to World Health Organization, from January 2019 through September 2019, 1234 cases of measles have been reported in the United States and 91 reported cases in Canada, while in 2018, 372 and 28 cases were reported in the United States and Canada, respectively. A potential driving factor to the increased cases maybe because fewer children have been vaccinated over the last number of years in both countries. This article is a narrative review of cases discussing the measles outbreak among partially vaccinated and unvaccinated children and adults in the United States and Canada in 2018 and 2019.

scholarly journals Design of a Small-Molecule Entry Inhibitor with Activity against Primary Measles Virus Strains

2005 ◽  
Vol 49 (9) ◽  
pp. 3755-3761 ◽  
Author(s):  
Richard K. Plemper ◽  
Joshua Doyle ◽  
Aiming Sun ◽  
Andrew Prussia ◽  
Li-Ting Cheng ◽  
...  
Keyword(s):  
Small Molecule ◽  
Viral Entry ◽  
Half Life ◽  
Measles Virus ◽  
Vaccine Coverage ◽  
Developed Countries ◽  
Structural Basis ◽  
Strong Activity ◽  
Coverage Rates ◽  
Measles Outbreaks

ABSTRACT The incidence of measles virus (MV) infection has been significantly reduced in many nations through extensive vaccination; however, the virus still causes significant morbidity and mortality in developing countries. Measles outbreaks also occur in some developed countries that have failed to maintain high vaccine coverage rates. While vaccination is essential in preventing the spread of measles, case management would greatly benefit from the use of therapeutic agents to lower morbidity. Thus, the development of new therapeutic strategies is desirable. We previously reported the generation of a panel of small-molecule MV entry inhibitors. Here we show that our initial lead compound, although providing proof of concept for our approach, has a short half-life (<16 h) under physiological conditions. In order to combine potent antiviral activity with increased compound stability, a targeted library of candidate molecules designed on the structural basis of the first lead has been synthesized and tested against MV. We have identified an improved lead with low toxicity and high stability (half-life ≫ 16 h) that prevents viral entry and hence infection. This compound shows high MV specificity and strong activity (50% inhibitory concentration = 0.6 to 3.0 μM, depending on the MV genotype) against a panel of wild-type MV strains representative of viruses that are currently endemic in the field.

scholarly journals Measles outbreaks affecting children in Jewish ultra-orthodox communities in Jerusalem

2007 ◽  
Vol 136 (2) ◽  
pp. 207-214 ◽  
Author(s):  
C. STEIN-ZAMIR ◽  
G. ZENTNER ◽  
N. ABRAMSON ◽  
H. SHOOB ◽  
Y. ABOUDY ◽  
...  
Keyword(s):  
Index Case ◽  
Vaccine Coverage ◽  
Immunization Coverage ◽  
Mmr Vaccine ◽  
National Immunization ◽  
Unvaccinated Child ◽  
Virus Genotypes ◽  
Measles Outbreaks

SUMMARYIn 2003 and 2004 two measles outbreaks occurred in Jewish ultra-orthodox communities in Jerusalem. The index case of the first outbreak (March 2003) was a 2-year-old unvaccinated child from Switzerland. Within 5 months, 107 cases (mean age 8·3±7·5 years) emerged in three crowded neighbourhoods. The first cases of the second outbreak (June 2004) were in three girls aged 4–5 years in one kindergarten in another community. By November 2004, 117 cases (mean age 7·3±6·5 years) occurred. The virus genotypes were D8 and D4 respectively. Altogether, 96 households accounted for the two outbreaks, with two or more patients per family in 79% of cases. Most cases (91·5%) were unvaccinated. Immunization coverage was lower in outbreak than in non-outbreak neighbourhoods (88·3% vs. 90·3%, P=0·001). Controlling the outbreaks necessitated a culture-sensitive approach, and targeted efforts increased MMR vaccine coverage (first dose) to 95·2%. Despite high national immunization coverage (94–95%), special attention to specific sub-populations is essential.

scholarly journals Measles outbreak in Andalusia, Spain, January to August 2011

2012 ◽  
Vol 17 (42) ◽  
Author(s):  
J M Mayoral Cortés ◽  
E Pérez Morilla ◽  
V Gallardo García ◽  
J M Navarro Marí ◽  
M Pérez Ruiz ◽  
...  
Keyword(s):  
Measles Virus ◽  
Index Case ◽  
Southern Spain ◽  
Contact Tracing ◽  
Age Group ◽  
Wide Spread ◽  
Measles Outbreak ◽  
The City

On 7 January 2011, a six year-old child living in a Roma community near Seville, southern Spain, was hospitalised with measles. Contact tracing identified a probable index case with onset of symptoms on 20 December 2011 and several unreported cases among children under the age of 15 years in the same town. The outbreak initially spread in districts in the city of Seville with a high proportion of Roma residents, and later to other cities and towns in Andalusia. While some towns experienced wide spread of the disease with significant clusters of cases, most of the affected locations saw non-clustered cases or very few secondary cases. The outbreak resulted in 1,759 confirmed or probable cases of which 393 (19%) required hospitalisation. Measles virus of genotype D4 was diagnosed in more than half of the cases. Significant differences (p<0.0001) by age group were found between clustered and non-clustered cases. The highest proportion of clustered cases occurred in the age group of 5-14 year-olds, while the highest proportion of non-clustered cases was seen in those older than 29 years. The last confirmed case related to this outbreak was reported on 20 August 2011.

scholarly journals 1724. Characteristics of the Ongoing Measles Outbreak in Greece in the Context of the Recent European-wide Epidemic and Public Health Measures

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S54-S54
Author(s):  
Theano Georgakopoulou ◽  
Elina Horefti ◽  
Helena Maltezou ◽  
Kassiani Gkolfinopoulou ◽  
Alexandra Vernardaki ◽  
...  
Keyword(s):  
Public Health ◽  
Young Adults ◽  
General Population ◽  
Measles Virus ◽  
Case Definition ◽  
Molecular Testing ◽  
Mmr Vaccine ◽  
Public Health Response ◽  
Roma Population ◽  
Measles Outbreak

Abstract Background Measles is a highly contagious disease which still remains a cause of severe complications, including deaths worldwide, despite the existence of safe and effective vaccines. In the last 3 decades, the incidence of measles in Greece has constantly declined with only sporadic clusters or outbreaks (last outbreak in 2010–2011). We describe the characteristics of the ongoing measles outbreak and the Public Health response. Methods All measles cases are reported through the mandatory notification system (EU case definition 2012) to the Department of Surveillance and Intervention of the Hellenic Centre for Disease Control and Prevention. For laboratory confirmation patient sera were tested for IgM antibodies and pharyngeal swabs for the presence of measles virus RNA with RT-PCR. Sequencing of the measles nucleoprotein gene was applied in positively tested serological samples. Results From 9 May 2017 to 26 April 2018, 2,659 cases were reported in all 13 regions in Greece; 1,605 (60.4%) were laboratory confirmed. Most cases (n = 1,595; 60%) were Roma (73% children &lt;10 years) followed by nonminority Greek nationals (n = 781; 29.4%, of whom 57% young adults 25–44 years), highlighting the immunity gap in Roma population. The vast majority of cases (80.5%) were unvaccinated. Ninety-four (3.5%) cases were healthcare workers (HCW); all were partially or not vaccinated. Genotype B3 was identified by molecular testing in all 88 cases tested. Severe complications were reported in 429 (16.1%) patients, most frequently pneumonia (43.8%) and hepatitis (21.2%). Three deaths were recorded in an 11-month-old immunocompromised Roma infant, a 17-year-old unvaccinated Roma, and a 35 year olds partially vaccinated individual from the general population. Extensive vaccination in refugee/migrant hosting sites prevented the emergence of a large number of cases. Mitigation efforts focused on closing the immunization gap in Roma population through emergency vaccination and raising awareness among HCWs to prevent further spread. Conclusion The current outbreak highlights the need to achieve high vaccination coverage with 2 doses of MMR vaccine in the general population (children, adolescents, and young adults) and in hard-to-reach vulnerable populations like Roma and refugees. Disclosures All authors: No reported disclosures.

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