Measles and rubella in the North-West of Russia in period of elimination

Aim: To evaluate the epidemic situation on measles and rubella and to carry out the laboratory diagnostics of these infections in the North-West of Russia in the period of elimination.Materials and Methods. In 2016-2019 a total of 534 blood serum samples from patients with measles diagnosis, 210 – from patients with rubella diagnosis and 1251 – from patients with exanthema were studied by ELISA using “VectoMeasles-IgM” and “EIA-Rubella-IgM” test-systems.Results. Measles incidence in NWR varied from 0 to 0.96 per 100,000 in 2016 and 2019, respectively. Among measles patients the proportion of children and adults changed in 2018-2019, adults constituted 65.9%. Patients not vaccinated against measles and those with the unknown vaccination status were mainly involved in epidemic process (85%). High level of patients with revaccination status was revealed in 2018 (18.4%). These patients demonstrated high levels of IgG (>3.0 IU/ml) as well as high percentage of IgG avidity (>94.3%) on 4-7th day of rash onset thus evidencing secondary immune response. Molecular studies of the samples from patients revealed the circulation of D8 and B3 genotypes of measles virus. Strains of D8 and B3 genotypes were represented by 3 and 4 variants, respectively. Rubella incidence did not exceed 0.13 per 100,000. Strains of rubella virus of genotype 1E were detected.Conclusion. The data of annual measles incidence and molecular studies of circulating wild type measles viruses prove the on-going measles elimination process in the NorthWest of Russia. For rubella, the persistent phase of elimination was demonstrated in the region.

Comparative Study on Molecular Epidemiology of Measles H1a Outbreak and Sporadic Cases in Shandong Province, 2013-2019

Background: Measles caused by measles virus (MeV) is a highly contagious viral disease which has also been associated with complications including pneumonia, myocarditis, encephalitis, and subacute sclerosing panencephalitis. The current study collected33 strains from 2013 to 2019 in 13 cities of Shandong province and separate them into 2 group, outbreak cases and sporadic cases. Comparative of genetic characterization between 15 outbreak strains and 18 sporadic strains was made using nucleotide sequencing of the C-terminal region of the N protein gene(N-450). Results: The results showed that all 33 stains belonged to genotype H1a. The outbreak strains and sporadic strains distribute crossly in phylogenetic tree. Sequences alignment revealed some interesting G and A transversion, which change the amino acids, on sites 1317, 1422, 1543. The nucleotide sequence and amino acid homologies of 15 Shandong outbreak isolates were 98%–100% (0–10 nucleotide variation) and 97.7%–100%, for sporadic isolations, they are 97.3%–100% and 96.6%–100% respectively. The mean evolution rate of 15 outbreak isolations and 18 sporadic isolations was 4.73× 10-3 and 2.068× 10-3 substitutions per site per year separately, which is higher than the study made before 2002. Conclusions: This report compared epidemic and genetic characteristics of outbreak strains and sporadic strains, and raise evolutionary study of sporadic cases may be helpful for discovery of the possibility of outbreak, especially in the stage of measles elimination.

Re-verifying the elimination of measles, rubella and congenital rubella syndrome in Canada, 2016–2020

Elimination, in the context of measles, rubella and congenital rubella syndrome (CRS), refers to the absence of endemic measles/rubella virus transmission in a region or other defined geographic area for at least 12 months, in the presence of a high-quality surveillance system that meets targets of key performance indicators. In 1994, Canada and other countries of the World Health Organization (WHO) region of the Americas committed to the objectives of measles elimination by 2000 and rubella and CRS by 2010. Canada met these targets: eliminating measles transmission in 1998; rubella transmission in 2005; and endemically-acquired CRS in 2000. The WHO region of Americas was declared free of endemic rubella/CRS in 2015 and endemic measles in 2016. At the request of the Pan American Health Organization (PAHO), Canada’s elimination status of measles, rubella and CRS was verified in 2012 and again in 2017. Prior to submission to PAHO, the verification reports were reviewed, approved and endorsed by Canada’s National Certification Committee (NCC). The NCC is a group of experts who are not directly involved with the management of vaccine preventable diseases or immunization program implementation at the national level, but who have the expertise to assist in ensuring that Canada is meeting PAHO’S goals of elimination and eradication. Members are responsible for reviewing Canada’s current mechanisms of surveillance and progress towards elimination of targeted vaccine preventable diseases in Canada. Members have expertise in the fields of public health, infectious diseases and/or laboratory sciences.

Epidemiology of measles cases, vaccine effectiveness, and performance towards measles elimination in The Gambia

Introduction In 2011, member states of the World Health Organization (WHO) Africa Regional Office (AFRO) resolved to eliminate Measles by 2020. Our study aims to assess The Gambia’s progress towards the set AFRO measles elimination target and highlight surveillance and immunisation gaps to better inform future measles prevention strategies. Material and methods A retrospective review of measles surveillance data for the period 2011–2019, was extracted from The Gambia case-based measles surveillance database. WHO—UNICEF national coverage estimates were used for estimating national level MCV coverage. Measles post campaign coverage survey coverage estimates were used to estimate national measles campaign coverage. Results One hundred and twenty-five of the 863 reported suspected cases were laboratory confirmed as measles cases. More than half (53.6%) of the confirmed cases have unknown vaccination status, 24% of cases were vaccinated, 52.8% of cases occurred among males, and 72.8% cases were among urban residents. The incidence of measles cases per million population was lowest (0) in 2011–2012 and highest in 2015 and 2016 (31 and 23 respectively). The indicator for surveillance sensitivity was met in all years except in 2016 and 2019. Children aged 5–9 years (Incidence Rate Ratio—IRR = 0.6) and residents of Central River region (IRR = 0.21) had lower measles risk whilst unvaccinated (Adjusted IRR = 5.95) and those with unknown vaccination status (IRR 2.21) had higher measles risk. Vaccine effectiveness was 89.5%. Conclusion The Gambia’s quest to attain measles elimination status by 2020 has registered significant success but it is unlikely that all target indicators will be met. Vaccination has been very effective in preventing cases. There is variation in measles risk by health region, and it will be important to take it into account when designing prevention and control strategies. The quality of case investigations should be improved to enhance the quality of surveillance for decision making.

Clinical fnd epidemiological features of measles by adults in modern period

Positive results have been achieved during the implementation of the measles elimination program in the Russian Federation and in the Northwestern Federal District (NWFD). However, measles remains an urgent problem for some regions due to the peculiarities of this infection.Purpose of the work: to characterize the clinical, epidemiological and molecular genetic characteristics of measles in adults during the period of increasing incidence in St. Petersburg.Materials and methods: the incidence of measles in the Northwestern Federal District was analyzed in 2006–2020, and the data of 30 patients of S.P. Botkin clinical infectious diseases hospital over 18 years old (2018). The diagnosis of measles is confirmed by enzyme immunoassay. Molecular genetic studies (PCR, sequencing) were carried out at the National Scientific and Methodological Center for the Surveillance of Measles and Rubella of G.N. Gabrichevsky Moscow Scientific Research Institute of Epidemiology and Microbiology, biological material was used (nasopharyngeal washings, urine).Results: there was an increase in morbidity in some regions of the Northwestern Federal District in conditions of high coverage of the population with measles vaccinations. In the age structure in 2018–2019 the proportion of adults was 65%. 74% of patients were not vaccinated against measles. A moderate-severe course (100%) was noted, regardless of the genotypes of the virus. Clinical manifestations were characterized by febrile, catarrhal and exanthema syndrome. Diarrhea was found in 36,7% of patients, hepatomegaly in 43.4%, and an increase in transaminases in 87%. 66,7% of patients traveled outside St. Petersburg. The genotypes of the virus were identified: B3 Kabul and B3 Dublin of African origin, D8 Girsomnath of Indian origin.Conclusions: measles remains an urgent problem, in recent years, adults prevail among patients, both local and imported cases are recorded. The clinical course of the disease may be accompanied by intestinal complications and other symptoms that make it difficult to diagnose at the prehospital stage. The use of molecular genetic methods makes it possible to identify the pathogen, assess the identity of viral isolates, and improve the epidemiological surveillance of the infection.

Diagnostic challenges and pockets of susceptibility identified during a measles outbreak, Luxembourg, 2019

Luxembourg was among the first countries in the World Health Organization (WHO) European Region documenting interruption of endemic measles transmission, but an increased incidence was registered in spring 2019. The outbreak started with an unvaccinated student who had been to a winter sports resort in a neighbouring country, where a measles outbreak was ongoing. Subsequently, 12 secondary and two tertiary cases were confirmed among students from the same school, relatives and healthcare workers, as well as six probably unrelated cases. Only 11 cases initially fulfilled the WHO definition for suspected measles cases. Fourteen of 20 cases with information on country of birth and the majority of unvaccinated cases (10/12) were born outside of Luxembourg. Measles IgM antibody results were available for 16 of the confirmed cases, and five of the eight IgM negative cases had been vaccinated at least once. All 21 cases were PCR positive, but for three previously vaccinated cases with multiple specimen types, at least one of these samples was negative. The outbreak highlighted diagnostic challenges from clinical and laboratory perspectives in a measles elimination setting and showed that people born abroad and commuters may represent important pockets of susceptible people in Luxembourg.

EDUKASI PEMBERIAN IMUNISASI MR (MEASLES RUBELLA) PADA IBU YANG MEMILIKI ANAK USIA BALITA

Campak dan Rubella merupakan penyakit infeksi menular melalui saluran nafas yang disebabkan oleh virus Campak dan Rubella.Vaksin MR (Measles Rubella) memberikan manfaat seperti dapat melindungi anak dari kecacatan dan kematian akibat komplikasi pneumonia, diare, kerusakan otak, ketulian, kebutaan, dan penyakit jantung bawaan. Indonesia telah berkomitmen untuk mencapai eliminasi campak dan pengendalian rubella/Congenital Rubella Syndrome (CRS) pada tahun 2020. Berdasarkan hasil surveilans dan cakupan imunisasi, maka imunisasi campak rutin saja belum cukup untuk mencapai target eliminasi campak. Sedangkan untuk akselerasi pengendalian rubella/CRS maka perlu dilakukan kampanye imunisasi tambahan sebelum introduksi vaksin MR ke dalam imunisasi rutin. Program Pengabdian Masyarakat ini melalui penerapan Ipteks bagi masyarakat bertujuan mengenalkan dan tercapainya cakupan imunisasi measles rubella. Kegiatan pengabmas dilaksanakan hari Rabu tanggal 18 Februari 2021 pukul 10.00 Wib, tempat pelaksanaan di Puskesmas Nanggalo Padang. Peserta yang hadir jumlah 15 orang ibu-ibu yang mempunyai anak usia balita. Berdasarkan hasil kegiatan tersebut terjadinya peningkatan pengetahuan ibu yang mempunyai anak usia balita tentang pemberian imunisasi MR. Diharapkan petugas kesehatan meningkatkan edukasi tentang pemberian imunisasi MR. Kata Kunci: Imunisasi MR (Measles Rubella) ABSTRACT Measles and Rubella are infectious diseases that are transmitted through the respiratory tract caused by the measles and rubella viruses. The MR (Measles Rubella) vaccine provides benefits such as protecting children from disability and death due to complications of pneumonia, diarrhea, brain damage, deafness, blindness and heart disease. built-in. Indonesia has committed to achieve elimination of measles and control of rubella / Congenital Rubella Syndrome (CRS) by 2020. Based on the results of surveillance and immunization coverage, routine measles immunization alone is not sufficient to achieve the target of measles elimination. Meanwhile, for the acceleration of rubella / CRS control, it is necessary to carry out an additional immunization campaign before the introduction of the MR vaccine into routine immunization. This Community Service Program through the application of science and technology for the community aims to introduce and achieve measles rubella immunization coverage. Community service activities will be carried out on Wednesday, February 18, 2021 at 10.00 WIB, the place of implementation is at the Nanggalo Padang Health Center. Participants who attended were 15 mothers who have children under five. Based on the results of these activities there is an increase in the knowledge of mothers who have children aged under five about giving MR immunization. It is hoped that health workers will increase education about MR immunization. Keywords: immunization MR (Measles Rubella)Campak dan Rubella merupakan penyakit infeksi menular melalui saluran nafas yang disebabkan oleh virus Campak dan Rubella.Vaksin MR (Measles Rubella) memberikan manfaat seperti dapat melindungi anak dari kecacatan dan kematian akibat komplikasi pneumonia, diare, kerusakan otak, ketulian, kebutaan, dan penyakit jantung bawaan. Indonesia telah berkomitmen untuk mencapai eliminasi campak dan pengendalian rubella/Congenital Rubella Syndrome (CRS) pada tahun 2020. Berdasarkan hasil surveilans dan cakupan imunisasi, maka imunisasi campak rutin saja belum cukup untuk mencapai target eliminasi campak. Sedangkan untuk akselerasi pengendalian rubella/CRS maka perlu dilakukan kampanye imunisasi tambahan sebelum introduksi vaksin MR ke dalam imunisasi rutin. Program Pengabdian Masyarakat ini melalui penerapan Ipteks bagi masyarakat bertujuan mengenalkan dan tercapainya cakupan imunisasi measles rubella. Kegiatan pengabmas dilaksanakan hari Rabu tanggal 18 Februari 2021 pukul 10.00 Wib, tempat pelaksanaan di Puskesmas Nanggalo Padang. Peserta yang hadir jumlah 15 orang ibu-ibu yang mempunyai anak usia balita. Berdasarkan hasil kegiatan tersebut terjadinya peningkatan pengetahuan ibu yang mempunyai anak usia balita tentang pemberian imunisasi MR. Diharapkan petugas kesehatan meningkatkan edukasi tentang pemberian imunisasi MR. Kata Kunci: Imunisasi MR (Measles Rubella) ABSTRACT Measles and Rubella are infectious diseases that are transmitted through the respiratory tract caused by the measles and rubella viruses. The MR (Measles Rubella) vaccine provides benefits such as protecting children from disability and death due to complications of pneumonia, diarrhea, brain damage, deafness, blindness and heart disease. built-in. Indonesia has committed to achieve elimination of measles and control of rubella / Congenital Rubella Syndrome (CRS) by 2020. Based on the results of surveillance and immunization coverage, routine measles immunization alone is not sufficient to achieve the target of measles elimination. Meanwhile, for the acceleration of rubella / CRS control, it is necessary to carry out an additional immunization campaign before the introduction of the MR vaccine into routine immunization. This Community Service Program through the application of science and technology for the community aims to introduce and achieve measles rubella immunization coverage. Community service activities will be carried out on Wednesday, February 18, 2021 at 10.00 WIB, the place of implementation is at the Nanggalo Padang Health Center. Participants who attended were 15 mothers who have children under five. Based on the results of these activities there is an increase in the knowledge of mothers who have children aged under five about giving MR immunization. It is hoped that health workers will increase education about MR immunization. Keywords: immunization MR (Measles Rubella)

Measles surveillance in Canada, 2019

Background: The Public Health Agency of Canada (PHAC) has conducted enhanced measles surveillance since 1998, the year endemic measles transmission was eliminated in Canada. The objective of this annual national measles surveillance report is to provide an epidemiologic summary of measles activity reported in Canada for 2019 in order to provide evidence to support the continued verification of Canada’s measles elimination status. Methods: Measles surveillance data are housed in the Canadian Measles and Rubella Surveillance System (CMRSS) database. Descriptive analyses of demographics and risk factors were performed. Outbreak characteristics were summarized and genotypic analyses conducted. Surveillance, laboratory and vaccine coverage data for 2019 were used to assess Canada’s status against the Pan American Health Organization (PAHO) essential criteria for the verification of measles elimination. Results: In 2019, 113 measles cases were reported in Canada (crude incidence rate of 3.0 cases per 1,000,000 population). Of these cases, 42 (37%) were imported into Canada, and of the imported cases, 12 (29%) resulted in further transmission. Infants younger than one year had the highest age-specific incidence rate at 13.1 cases per 1,000,000 population. Only 29% of cases had one or more documented doses of measles-containing vaccine. One-fifth (19%) of cases were hospitalized; no deaths were reported. Genotype information was available for 100% of outbreaks reported in 2019 and 90% of non-outbreak-related measles cases; of cases with genotype information available, 27% were B3 and 73% were D8. Conclusion: Despite meeting/partially meeting only three out of four of PAHO’s essential criteria for measles elimination status, there is no evidence that endemic measles transmission has been reestablished in Canada.