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 <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.

scholarly journals 1617. Mumps in Detention Facilities that House Detained Migrants—United States, September 2018–April 2019

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S589-S590 ◽  
Author(s):  
Jessica Leung ◽  
Diana Elson ◽  
Brandy Cloud ◽  
Dakota (Cody) McMurray ◽  
Rebecca J McNall ◽  
...  
Keyword(s):  
Public Health ◽  
Close Contact ◽  
Laboratory Data ◽  
Case Definition ◽  
Mmr Vaccine ◽  
Public Health Response ◽  
Health Response ◽  
Increased Risk ◽  
Immigration And Customs Enforcement ◽  
Detention Facilities

Abstract Background Starting in September 2018, an unusually high number of mumps cases were reported in US adult detention facilities. Detention facilities usually involve close contact among detainees, facilitating transmission of mumps. Detainees in close contact with a mumps patient are at increased risk for acquiring mumps and should be offered a dose of MMR vaccine. We summarize the epidemiologic, clinical, and laboratory data for mumps cases in adult detention facilities during September 2018-April 2019. Methods Data were collected by health departments and US Immigration and Customs Enforcement (ICE) Health Services Corps and reported to CDC. Cases were classified according to the CSTE case definition for mumps and confirmed by RT-qPCR; molecular sequencing was performed on mumps-positive specimens. Results From September 2018-April 2019, 389 confirmed and probable mumps cases in adult migrants detained by ICE in 44 detention facilities were reported in 16 states (figure). The median age of patients was 24 years (range: 18–66); 94% were male. Vaccination status was unknown for all patients. Most (80%) patients were exposed while in custody of ICE or other US legal agency, 7% were exposed before apprehension, and custody status at exposure was unknown for 13%. Among 265 patients with data on complications, 15% had orchitis; at least 3 were hospitalized. Mumps genotype G, the most common genotype in US, was identified in specimens from 70 patients. This mumps response included >7,000 MMR vaccine doses distributed to affected facilities, and hundreds of exposed detainees placed under restricted movement in their facility each week. The response is ongoing as new cases continue to be reported. Conclusion This is the first report of mumps outbreaks occurring in multiple states and detention facilities during the same period. These outbreaks are costly and challenging to control. Identifying target groups for vaccination is challenging since detainees are frequently transferred and MMR vaccine does not prevent mumps in persons already exposed and infected. Effective public health interventions require an understanding of detention settings. Development of national guidance and resources for public health response to mumps and other infectious diseases in detention facilities would be beneficial. Disclosures All authors: No reported disclosures.

Predicting Measles Susceptibility

PEDIATRICS ◽  
1984 ◽  
Vol 73 (6) ◽  
pp. 871-873
Author(s):  
LORING G. DALES ◽  
JAMES CHIN
Keyword(s):  
Public Health ◽  
Health Service ◽  
Advisory Committee ◽  
Virus Vaccine ◽  
Measles Virus ◽  
Public Health Service ◽  
Measles Vaccine ◽  
Measles Outbreak ◽  
The Us ◽  
History Of

Elsewhere in this issue, Scott et al1 present results of their study which found that the historical criteria developed by the US Public Health Service Immunization Practices Advisory Committee (ACIP) for detecting students who were susceptible to measles performed very poorly in a school measles outbreak. The ACIP criteria designate as susceptible persons born since 1956 who have no documentation of immunization, who have no physician-Venified history of measles infection, who last received measles vaccine before their first birthday, or who were last immunized (at age 12 months or older) before 1968 with measles virus vaccine that could have been either live or inactivated.

Measles

2016 ◽  
Author(s):  
David Baxter ◽  
Gill Marsh ◽  
Sam Ghebrehewet
Keyword(s):  
Public Health ◽  
Single Case ◽  
Background Information ◽  
Post Exposure Prophylaxis ◽  
Mmr Vaccine ◽  
Case Definitions ◽  
Risk Area ◽  
Public Health Response ◽  
High Risk Area ◽  
The Public

This chapter describes a case of measles in a school child who contracted measles following travel to a high-risk area. The case resulted in a measles outbreak in the school and further cases in the community. Background information on the epidemiology and clinical features of measles and the public health response to a single case, an outbreak of measles in a school, and measles exposure in a healthcare setting are discussed. Case definitions risk assessment, identification of close contacts including priority groups and the required public health actions including post exposure prophylaxis (PEP) with Human Normal Immunoglobulin (HNIG) and/or MMR vaccine, are described in detail. ‘Top tips’ are given to provide practical tips for the reader to think through the public health management of the case study, and ‘tools of the trade’ list the laboratory and epidemiological components of the investigation. Finally, the chapter encourages exploration of other potential scenarios, including the possibility of measles transmission in a nursery.

scholarly journals Progress towards Rapid Detection of Measles Vaccine Strains: a Tool To Inform Public Health Interventions

2016 ◽  
Vol 55 (3) ◽  
pp. 686-689 ◽  
Author(s):  
Jill K. Hacker
Keyword(s):  
Public Health ◽  
Measles Virus ◽  
Measles Vaccine ◽  
Wild Type ◽  
Pcr Assay ◽  
Public Health Response ◽  
The Public ◽  
Health Response ◽  
Epidemiological Tool ◽  
Type Strains

ABSTRACT Rapid differentiation of vaccine from wild-type strains in suspect measles cases is a valuable epidemiological tool that informs the public health response to this highly infectious disease. Few public health laboratories sequence measles virus-positive specimens to determine genotype, and the vaccine-specific real-time reverse transcriptase PCR (rRT-PCR) assay described by F. Roy et al. (J. Clin. Microbiol. 55:735–743, 2017, https://doi.org/10.1128/JCM.01879-16 ) offers a rapid, easily adoptable method to identify measles vaccine strains in suspect cases.

Concurrent Summer Influenza and Pertussis Outbreaks in a Nursing Home in Sydney, Australia

2004 ◽  
Vol 25 (11) ◽  
pp. 962-966 ◽  
Author(s):  
Mark J. Ferson ◽  
Keira Morgan ◽  
Peter W. Robertson ◽  
Alan W. Hampson ◽  
Ian Carter ◽  
...  
Keyword(s):  
Public Health ◽  
Nursing Home ◽  
Influenza A ◽  
Respiratory Illness ◽  
Case Definition ◽  
Acute Respiratory Illness ◽  
Public Health Response ◽  
Pertussis Infection ◽  
Eastern Australia ◽  
Sydney Australia

AbstractObjective:To report on the investigation of a summer outbreak of acute respiratory illness among residents of a Sydney nursing home.Design:An epidemiologic and microbiological investigation of the resident cohort at the time of the outbreak and medical record review 5 months later.Setting:A nursing home located in Sydney, Australia, during February to July 1999.Patients:The cohort of residents present in the nursing home at the time of the outbreak.Interventions:Public health interventions included recommendations regarding hygiene, cohorting of residents and staff, closure to further admissions, and prompt reporting of illness; and virologic and serologic studies of residents.Results:Of the 69 residents (mean age, 85.1 years), 35 fulfilled the case definition of acute respiratory illness. Influenza A infection was confirmed in 19 residents, and phylogenetic analysis of the resulting isolate, designated H3N2 A/Sydney/203/99, showed that it differed from strains isolated in eastern Australia during the same period. Serologic evidence ofBordetellainfection was also found in 10 residents; however, stratified epidemiologic analysis pointed to influenza A as the cause of illness.Conclusions:The investigation revealed an unusual summer outbreak of influenza A concurrent with subclinical pertussis infection. Surveillance of acute respiratory illness in nursing homes throughout the year, rather than solely during epidemic periods, in combination with appropriate public health laboratory support, would allow initiation of a timely public health response to outbreaks of acute respiratory illness in this setting.

scholarly journals Measles outbreak linked to a minority group in Austria, 2008

2009 ◽  
Vol 138 (3) ◽  
pp. 415-425 ◽  
Author(s):  
D. SCHMID ◽  
H. HOLZMANN ◽  
K. SCHWARZ ◽  
S. KASPER ◽  
H-W. KUO ◽  
...  
Keyword(s):  
Vaccination Coverage ◽  
Measles Virus ◽  
Minority Group ◽  
Age Groups ◽  
Case Definition ◽  
Outbreak Strain ◽  
School Based ◽  
Measles Outbreak ◽  
Source Case ◽  
2010 Target

SUMMARYWe report on a measles outbreak originating in an anthroposophic community in Austria, 2008. A total of 394 (94·9%) cases fulfilled the outbreak case definition including 168 cases affiliated to the anthroposophic community. The source case was a school pupil from Switzerland. The Austrian outbreak strain was genotype D5, indistinguishable from the Swiss outbreak strain. A school-based retrospective cohort study in the anthroposophic school demonstrated a vaccine effectiveness of 97·3% in pupils who had received a single dose of measles-containing vaccine and 100% in those who had received two doses. The vaccination coverage of the cases in the anthroposophic community was 0·6%. Of the 226 outbreak cases not belonging to the anthroposophic community, the 10–24 years age group was the most affected. Our findings underline the epidemiological significance of suboptimal vaccination coverage in anthroposophic communities and in older age groups of the general population in facilitating measles virus circulation. The findings of this outbreak investigation suggest that the WHO European Region is unlikely to achieve its 2010 target for measles and rubella elimination.

scholarly journals Cost of Public Health Response and Outbreak Control With a Third Dose of Measles-Mumps-Rubella Vaccine During a University Mumps Outbreak—Iowa, 2015–2016

2018 ◽  
Vol 5 (10) ◽  
Author(s):  
Mona Marin ◽  
Tricia L Kitzmann ◽  
Lisa James ◽  
Patricia Quinlisk ◽  
Wade K Aldous ◽  
...  
Keyword(s):  
Public Health ◽  
Vaccine Coverage ◽  
The United States ◽  
Mmr Vaccine ◽  
Public Health Response ◽  
University Of Iowa ◽  
Outbreak Control ◽  
Response Planning ◽  
Health Response ◽  
The University

Abstract Background The United States is experiencing mumps outbreaks in settings with high 2-dose measles-mumps-rubella (MMR) vaccine coverage, mainly universities. The economic impact of mumps outbreaks on public health systems is largely unknown. During a 2015–2016 mumps outbreak at the University of Iowa, we estimated the cost of public health response that included a third dose of MMR vaccine. Methods Data on activities performed, personnel hours spent, MMR vaccine doses administered, miles traveled, hourly earnings, and unitary costs were collected using a customized data tool. These data were then used to calculate associated costs. Results Approximately 6300 hours of personnel time were required from state and local public health institutions and the university, including for vaccination and laboratory work. Among activities demanding time were case/contact investigation (36%), response planning/coordination (20%), and specimen testing and report preparation (13% each). A total of 4736 MMR doses were administered and 1920 miles traveled. The total cost was >$649 000, roughly equally distributed between standard outbreak control activities and third-dose MMR vaccination (55% and 45%, respectively). Conclusions Public health response to the mumps outbreak at the University of Iowa required important amounts of personnel time and other resources. Associated costs were sizable enough to affect other public health activities.

scholarly journals Vaccination Coverage Increase among Adolescent and Young Adults of the Palermo District (Italy) as a Result of a Public Health Strategy to Contrast an “Epidemic of Panic”

2018 ◽  
Author(s):  
Claudio Costantino ◽  
Vincenzo Restivo ◽  
Gianmarco Ventura ◽  
Claudio D'Angelo ◽  
Maria Angela Randazzo ◽  
...  
Keyword(s):  
Public Health ◽  
Young Adults ◽  
General Population ◽  
Mass Media ◽  
Local Public Health ◽  
Health Authorities ◽  
Health Strategy ◽  
Public Health Authorities ◽  
Adolescent And Young Adults ◽  
Catch Up

During summer 2016 in the District of Palermo, Italy, the rapid succession of four cases of invasive meningococcal disease among young adults, with one death, have had an extraordinary emphasis by Local and National mass media. The resultant “epidemic of panic” among general population overloaded vaccination Units of the Palermo District during following months. Strategies implemented by Sicilian and Local Public Health Authorities to counteract “meningitis fear” were: a) extension of active and free of charge anti-meningococcal tetravalent vaccination from age class 12–18 to 12–30 years old; b) implementation of vaccination units usual opening hours and rooms tailored for vaccine administration; c) development of informative institutional tools and timely communications throughout local mass media to reassure general population. In 2016, was observed an increase of anti-meningococcal coverage in Palermo District (+18% for 16th y.o. and + 14% for 18th y.o. cohorts) and at Regional Level (+11.2% and +13.5% respectively). Concurrent catch-up of other recommended vaccination for age (diphtheria-tetanus-pertussis-poliomyelitis and papillomavirus), resulted in further increase of doses administered. The fear for meningitis, managed by Sicilian Public Health Authorities, had positive reverberations in terms of prevention. In particular, informative strategies adopted sensibly contributed to get Sicilian young adults closer to vaccination issues.

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 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.

Sign in / Sign up

Export Citation Format

Share Document