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Dabbagh A, Patel MK, Dumolard L, Gacic-Dobo M, Mulders MN, Okwo-Bele JM, Kretsinger K, Papania MJ, Rota PA, Goodson JL. Progress Toward Regional Measles Elimination - Worldwide, 2000-2016. MMWR Morb Mortal Wkly Rep 2017; 66:1148-1153. [PMID: 29073125 PMCID: PMC5689104 DOI: 10.15585/mmwr.mm6642a6] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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Mulders MN, Serhan F, Goodson JL, Icenogle J, Johnson BW, Rota PA. Expansion of Surveillance for Vaccine-preventable Diseases: Building on the Global Polio Laboratory Network and the Global Measles and Rubella Laboratory Network Platforms. J Infect Dis 2017; 216:S324-S330. [PMID: 28838191 PMCID: PMC5853980 DOI: 10.1093/infdis/jix077] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Laboratory networks were established to provide accurate and timely laboratory confirmation of infections, an essential component of disease surveillance systems. The World Health Organization (WHO) coordinates global laboratory surveillance of vaccine-preventable diseases (VPDs), including polio, measles and rubella, yellow fever, Japanese encephalitis, rotavirus, and invasive bacterial diseases. In addition to providing high-quality laboratory surveillance data to help guide disease control, elimination, and eradication programs, these global networks provide capacity-building and an infrastructure for public health laboratories. There are major challenges with sustaining and expanding the global laboratory surveillance capacity: limited resources and the need for expansion to meet programmatic goals. Here, we describe the WHO-coordinated laboratory networks supporting VPD surveillance and present a plan for the further development of these networks.
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Affiliation(s)
- Mick N Mulders
- Expanded Program on Immunization, World Health Organization, Geneva, Switzerland
| | - Fatima Serhan
- Expanded Program on Immunization, World Health Organization, Geneva, Switzerland
| | - James L Goodson
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joseph Icenogle
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Paul A Rota
- Centers for Disease Control and Prevention, Atlanta, Georgia
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de Araujo J, Lo MK, Tamin A, Ometto TL, Thomazelli LM, Nardi MS, Hurtado RF, Nava A, Spiropoulou CF, Rota PA, Durigon EL. Antibodies Against Henipa-Like Viruses in Brazilian Bats. Vector Borne Zoonotic Dis 2017; 17:271-274. [DOI: 10.1089/vbz.2016.2051] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Affiliation(s)
- Jansen de Araujo
- Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Michael K. Lo
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Azaibi Tamin
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Tatiana L. Ometto
- Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | | | | | - Renata F. Hurtado
- Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | | | | | - Paul A. Rota
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Edison L. Durigon
- Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
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Fiebelkorn AP, Redd SB, Gastañaduy PA, Clemmons N, Rota PA, Rota JS, Bellini WJ, Wallace GS. A Comparison of Postelimination Measles Epidemiology in the United States, 2009-2014 Versus 2001-2008. J Pediatric Infect Dis Soc 2017; 6:40-48. [PMID: 26666559 PMCID: PMC4905815 DOI: 10.1093/jpids/piv080] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 10/25/2015] [Indexed: 11/14/2022]
Abstract
BACKGROUND Measles, a vaccine-preventable disease that can cause severe complications, was declared eliminated from the United States in 2000. The last published summary of US measles epidemiology was during 2001-2008. We summarized US measles epidemiology during 2009-2014. METHODS We compared demographic, vaccination, and virologic data on confirmed measles cases reported to the Centers for Disease Control and Prevention during January 1, 2009-December 31, 2014 and January 1, 2001-December 31, 2008. RESULTS During 2009-2014, 1264 confirmed measles cases were reported in the United States, including 275 importations from 58 countries and 66 outbreaks. The annual median number of cases and outbreaks during this period was 130 (range, 55-667 cases) and 10 (range, 4-23 outbreaks), respectively, compared with an annual median of 56 cases (P = .08) and 4 outbreaks during 2001-2008 (P = .04). Among US-resident case-patients during 2009-2014, children aged 12-15 months had the highest measles incidence (65 cases; 8.3 cases/million person-years), and infants aged 6-11 months had the second highest incidence (86 cases; 7.3 cases/million person-years). During 2009-2014, 865 (74%) of 1173 US-resident case-patients were unvaccinated and 188 (16%) had unknown vaccination status; of 917 vaccine-eligible US-resident case-patients, 600 (65%) were reported as having philosophical or religious objections to vaccination. CONCLUSIONS Although the United States has maintained measles elimination since 2000, measles outbreaks continue to occur globally, resulting in imported cases and potential spread. The annual median number of cases and outbreaks more than doubled during 2009-2014 compared with the earlier postelimination years. To maintain elimination, it will be necessary to maintain high 2-dose vaccination coverage, continue case-based surveillance, and monitor the patterns and rates of vaccine exemption.
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Affiliation(s)
- Amy Parker Fiebelkorn
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Susan B. Redd
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Paul A. Gastañaduy
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Nakia Clemmons
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Paul A. Rota
- Measles, Mumps, Rubella & Herpesviruses Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA
| | - Jennifer S. Rota
- Measles, Mumps, Rubella & Herpesviruses Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA
| | - William J. Bellini
- Measles, Mumps, Rubella & Herpesviruses Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA
| | - Gregory S. Wallace
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA
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Adhikari BB, Goodson JL, Chu SY, Rota PA, Meltzer MI. Assessing the Potential Cost-Effectiveness of Microneedle Patches in Childhood Measles Vaccination Programs: The Case for Further Research and Development. Drugs R D 2016; 16:327-338. [PMID: 27696306 PMCID: PMC5114202 DOI: 10.1007/s40268-016-0144-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Currently available measles vaccines are administered by subcutaneous injections and require reconstitution with a diluent and a cold chain, which is resource intensive and challenging to maintain. To overcome these challenges and potentially increase vaccination coverage, microneedle patches are being developed to deliver the measles vaccine. This study compares the cost-effectiveness of using microneedle patches with traditional vaccine delivery by syringe-and-needle (subcutaneous vaccination) in children's measles vaccination programs. METHODS We built a simple spreadsheet model to compute the vaccination costs for using microneedle patch and syringe-and-needle technologies. We assumed that microneedle vaccines will be, compared with current vaccines, more heat stable and require less expensive cool chains when used in the field. We used historical data on the incidence of measles among communities with low measles vaccination rates. RESULTS The cost of microneedle vaccination was estimated at US$0.95 (range US$0.71-US$1.18) for the first dose, compared with US$1.65 (range US$1.24-US$2.06) for the first dose delivered by subcutaneous vaccination. At 95 % vaccination coverage, microneedle patch vaccination was estimated to cost US$1.66 per measles case averted (range US$1.24-US$2.07) compared with an estimated cost of US$2.64 per case averted (range US$1.98-US$3.30) using subcutaneous vaccination. CONCLUSIONS Use of microneedle patches may reduce costs; however, the cost-effectiveness of patches would depend on the vaccine recipients' acceptability and vaccine effectiveness of the patches relative to the existing conventional vaccine-delivery method. This study emphasizes the need to continue research and development of this vaccine-delivery method that could boost measles elimination efforts through improved access to vaccines and increased vaccination coverage.
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Affiliation(s)
- Bishwa B Adhikari
- Division of Preparedness and Emerging Infections, Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, 1600 Clifton Road NE, MS-C18, Atlanta, GA, 30333, USA.
| | - James L Goodson
- Global Immunization Division, Centers for Disease Control and Prevention, Center for Global Health, Atlanta, GA, USA
| | - Susan Y Chu
- Global Immunization Division, Centers for Disease Control and Prevention, Center for Global Health, Atlanta, GA, USA
| | - Paul A Rota
- Division of Viral Diseases, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, GA, USA
| | - Martin I Meltzer
- Division of Preparedness and Emerging Infections, Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, 1600 Clifton Road NE, MS-C18, Atlanta, GA, 30333, USA
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Patel MK, Gacic-Dobo M, Strebel PM, Dabbagh A, Mulders MN, Okwo-Bele JM, Dumolard L, Rota PA, Kretsinger K, Goodson JL. Progress Toward Regional Measles Elimination — Worldwide, 2000–2015. MMWR Morb Mortal Wkly Rep 2016; 65:1228-1233. [DOI: 10.15585/mmwr.mm6544a6] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Gastañaduy PA, Budd J, Fisher N, Redd SB, Fletcher J, Miller J, McFadden DJ, Rota J, Rota PA, Hickman C, Fowler B, Tatham L, Wallace GS, de Fijter S, Parker Fiebelkorn A, DiOrio M. A Measles Outbreak in an Underimmunized Amish Community in Ohio. N Engl J Med 2016; 375:1343-1354. [PMID: 27705270 DOI: 10.1056/nejmoa1602295] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although measles was eliminated in the United States in 2000, importations of the virus continue to cause outbreaks. We describe the epidemiologic features of an outbreak of measles that originated from two unvaccinated Amish men in whom measles was incubating at the time of their return to the United States from the Philippines and explore the effect of public health responses on limiting the spread of measles. METHODS We performed descriptive analyses of data on demographic characteristics, clinical and laboratory evaluations, and vaccination coverage. RESULTS From March 24, 2014, through July 23, 2014, a total of 383 outbreak-related cases of measles were reported in nine counties in Ohio. The median age of case patients was 15 years (range, <1 to 53); a total of 178 of the case patients (46%) were female, and 340 (89%) were unvaccinated. Transmission took place primarily within households (68% of cases). The virus strain was genotype D9, which was circulating in the Philippines at the time of the reporting period. Measles-mumps-rubella (MMR) vaccination coverage with at least a single dose was estimated to be 14% in affected Amish households and more than 88% in the general (non-Amish) Ohio community. Containment efforts included isolation of case patients, quarantine of susceptible persons, and administration of the MMR vaccine to more than 10,000 persons. The spread of measles was limited almost exclusively to the Amish community (accounting for 99% of case patients) and affected only approximately 1% of the estimated 32,630 Amish persons in the settlement. CONCLUSIONS The key epidemiologic features of a measles outbreak in the Amish community in Ohio were transmission primarily within households, the small proportion of Amish people affected, and the large number of people in the Amish community who sought vaccination. As a result of targeted containment efforts, and high baseline coverage in the general community, there was limited spread beyond the Amish community. (Funded by the Ohio Department of Health and the Centers for Disease Control and Prevention.).
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Affiliation(s)
- Paul A Gastañaduy
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Jeremy Budd
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Nicholas Fisher
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Susan B Redd
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Jackie Fletcher
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Julie Miller
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Dwight J McFadden
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Jennifer Rota
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Paul A Rota
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Carole Hickman
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Brian Fowler
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Lilith Tatham
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Gregory S Wallace
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Sietske de Fijter
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Amy Parker Fiebelkorn
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
| | - Mary DiOrio
- From the Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta (P.A.G., S.B.R., J.R., P.A.R., C.H., G.S.W., A.P.F.); and the Ohio Department of Health, Columbus (J.B., N.F., B.F., L.T., S.F., M.D.), Knox County Health Department, Mount Vernon (J.F., J.M.), and Holmes County Health Department, Millersburg (D.J.M.) - all in Ohio
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Jonas A, Cardemil CV, Beukes A, Anderson R, Rota PA, Bankamp B, Gary HE, Sawadogo S, Patel SV, Zeko S, Muroua C, Gaeb E, Wannemuehler K, Gerber S, Goodson JL. Rubella immunity among pregnant women aged 15–44 years, Namibia, 2010. Int J Infect Dis 2016; 49:196-201. [DOI: 10.1016/j.ijid.2016.05.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 04/04/2016] [Accepted: 05/11/2016] [Indexed: 11/25/2022] Open
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Cardemil CV, Jonas A, Beukes A, Anderson R, Rota PA, Bankamp B, Gary HE, Sawadogo S, Patel SV, Zeko S, Muroua C, Gaeb E, Wannemuehler K, Gerber S, Goodson JL. Measles immunity among pregnant women aged 15-44 years in Namibia, 2008 and 2010. Int J Infect Dis 2016; 49:189-95. [PMID: 27235084 PMCID: PMC6996213 DOI: 10.1016/j.ijid.2016.05.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 05/16/2016] [Accepted: 05/18/2016] [Indexed: 11/12/2022] Open
Abstract
Background: Namibia experienced a large measles outbreak starting in 2009, with 38% of reported cases in adults, including women of reproductive age. Population immunity was assessed among pregnant women to determine whether immunization activities were needed in adults to achieve measles elimination in Namibia. Methods: A total of 1708 and 2040 specimens sampled from Namibian pregnant women aged 15–44 years who were included in the 2008 and 2010 National HIV Sentinel Survey, respectively, were tested for measles immunoglobulin G antibody. The proportion of women seropositive overall and by 5-year age strata was determined, and factors associated with seropositivity were analyzed by logistic regression, including age, facility type, gravidity, HIV status, and urban/rural setting. Seropositivity in 2008 versus 2010 was compared. Results: In both analysis years, measles seropositivity was lower in 15–19-year-olds (77%) and 20–24-year-olds (85–87%) and higher in 25–44-year-olds (90–94%) (2008, p < 0.001; 2010, p < 0.001). Overall measles seropositivity did not differ between 2008 (87%) and 2010 (87%) (p = 0.7). HIV status did not affect seropositivity. Conclusions: Late in a large measles outbreak, 13% of pregnant women in Namibia, and almost one in four 15–19-year-old pregnant women, remained susceptible to measles. In Namibia, immunization campaigns with measles-containing vaccine should be considered for adults.
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Affiliation(s)
- Cristina V Cardemil
- Centers for Disease Control and Prevention, Global Immunization Division, 1600 Clifton Road, NE, Atlanta, GA 30333, USA.
| | - Anna Jonas
- Ministry of Health and Social Services, Directorate of Special Programmes, Primary Health Directorate, and Family Health Division (Expanded Programme on Immunizations), Windhoek, Namibia
| | - Anita Beukes
- Centers for Disease Control and Prevention, Windhoek, Namibia
| | - Raydel Anderson
- Centers for Disease Control and Prevention, Division of Viral Diseases, Atlanta, GA, USA
| | - Paul A Rota
- Centers for Disease Control and Prevention, Division of Viral Diseases, Atlanta, GA, USA
| | - Bettina Bankamp
- Centers for Disease Control and Prevention, Division of Viral Diseases, Atlanta, GA, USA
| | - Howard E Gary
- Ministry of Health and Social Services, Directorate of Special Programmes, Primary Health Directorate, and Family Health Division (Expanded Programme on Immunizations), Windhoek, Namibia
| | | | - Sadhna V Patel
- Centers for Disease Control and Prevention, Windhoek, Namibia
| | - Sikota Zeko
- Ministry of Health and Social Services, Directorate of Special Programmes, Primary Health Directorate, and Family Health Division (Expanded Programme on Immunizations), Windhoek, Namibia
| | - Clementine Muroua
- Ministry of Health and Social Services, Directorate of Special Programmes, Primary Health Directorate, and Family Health Division (Expanded Programme on Immunizations), Windhoek, Namibia
| | - Esegiel Gaeb
- Namibia Institute of Pathology, Windhoek, Namibia
| | - Kathleen Wannemuehler
- Centers for Disease Control and Prevention, Global Immunization Division, 1600 Clifton Road, NE, Atlanta, GA 30333, USA
| | - Sue Gerber
- Centers for Disease Control and Prevention, Windhoek, Namibia
| | - James L Goodson
- Centers for Disease Control and Prevention, Global Immunization Division, 1600 Clifton Road, NE, Atlanta, GA 30333, USA
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Mulders MN, Rota PA, Icenogle JP, Brown KE, Takeda M, Rey GJ, Ben Mamou MC, Dosseh AR, Byabamazima CR, Ahmed HJ, Pattamadilok S, Zhang Y, Gacic-Dobo M, Strebel PM, Goodson JL. Global Measles and Rubella Laboratory Network Support for Elimination Goals, 2010–2015. MMWR Morb Mortal Wkly Rep 2016; 65:438-42. [DOI: 10.15585/mmwr.mm6517a3] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Hales CM, Johnson E, Helgenberger L, Papania MJ, Larzelere M, Gopalani SV, Lebo E, Wallace G, Moturi E, Hickman CJ, Rota PA, Alexander HS, Marin M. Measles Outbreak Associated With Low Vaccine Effectiveness Among Adults in Pohnpei State, Federated States of Micronesia, 2014. Open Forum Infect Dis 2016; 3:ofw064. [PMID: 27186587 PMCID: PMC4866552 DOI: 10.1093/ofid/ofw064] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 03/21/2016] [Indexed: 12/03/2022] Open
Abstract
Background. A measles outbreak in Pohnpei State, Federated States of Micronesia in 2014 affected many persons who had received ≥1 dose of measles-containing vaccine (MCV). A mass vaccination campaign targeted persons aged 6 months to 49 years, regardless of prior vaccination. Methods. We evaluated vaccine effectiveness (VE) of MCV by comparing secondary attack rates among vaccinated and unvaccinated contacts after household exposure to measles. Results. Among 318 contacts, VE for precampaign MCV was 23.1% (95% confidence interval [CI], −425 to 87.3) for 1 dose, 63.4% (95% CI, −103 to 90.6) for 2 doses, and 95.9% (95% CI, 45.0 to 100) for 3 doses. Vaccine effectiveness was 78.7% (95% CI, 10.1 to 97.7) for campaign doses received ≥5 days before rash onset in the primary case and 50.4% (95% CI, −52.1 to 87.9) for doses received 4 days before to 3 days after rash onset in the primary case. Vaccine effectiveness for most recent doses received before 2010 ranged from 51% to 57%, but it increased to 84% for second doses received in 2010 or later. Conclusions. Low VE was a major source of measles susceptibility in this outbreak; potential reasons include historical cold chain inadequacies or waning of immunity. Vaccine effectiveness of campaign doses supports rapid implementation of vaccination campaigns in outbreak settings.
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Affiliation(s)
- Craig M Hales
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Eliaser Johnson
- Division of Primary Health Care , Pohnpei State , Federated States of Micronesia
| | - Louisa Helgenberger
- Department of Health and Social Affairs , Government of the Federated States of Micronesia
| | - Mark J Papania
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Maribeth Larzelere
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Sameer V Gopalani
- Department of Health and Social Affairs , Government of the Federated States of Micronesia
| | - Emmaculate Lebo
- Center for Global Health , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Greg Wallace
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Edna Moturi
- Center for Global Health , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Carole J Hickman
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Paul A Rota
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Hinden S Alexander
- Division of Primary Health Care , Pohnpei State , Federated States of Micronesia
| | - Mona Marin
- National Center for Immunization and Respiratory Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia
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62
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Bischoff WE, McNall RJ, Blevins MW, Turner J, Lopareva EN, Rota PA, Stehle JR. Detection of Measles Virus RNA in Air and Surface Specimens in a Hospital Setting. J Infect Dis 2016. [PMID: 26386428 DOI: 10.1093/infdis/jiv465,pubmed:26386428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Measles virus (MeV) is known to be highly contagious, with an infectious period lasting from 4 days before to 4 days after rash onset. An unvaccinated, young, female patient with measles confirmed by direct epidemiologic link was hospitalized on day 5 after rash onset. Environmental samples were collected over the 4-day period of hospitalization in a single room. MeV RNA was detectable in air specimens, on surface specimens, and on respirators on days 5-8 after rash onset. This is the first report of environmental surveillance for MeV, and the results suggest that MeV-infected fomites may be present in healthcare settings.
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Affiliation(s)
- Werner E Bischoff
- Infectious Diseases, Wake Forest Baptist Health, Winston-Salem, North Carolina
| | - Rebecca J McNall
- Measles, Mumps, Rubella, and Herpesviruses Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Maria W Blevins
- Infectious Diseases, Wake Forest Baptist Health, Winston-Salem, North Carolina
| | - JoLyn Turner
- Infectious Diseases, Wake Forest Baptist Health, Winston-Salem, North Carolina
| | - Elena N Lopareva
- Measles, Mumps, Rubella, and Herpesviruses Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Paul A Rota
- Measles, Mumps, Rubella, and Herpesviruses Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - John R Stehle
- Infectious Diseases, Wake Forest Baptist Health, Winston-Salem, North Carolina
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Perry RT, Murray JS, Gacic-Dobo M, Dabbagh A, Mulders MN, Strebel PM, Okwo-Bele JM, Rota PA, Goodson JL. Progress toward regional measles elimination - worldwide, 2000-2014. MMWR Morb Mortal Wkly Rep 2015; 64:1246-51. [PMID: 26562349 DOI: 10.15585/mmwr.mm6444a4] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
In 2000, the United Nations General Assembly adopted the Millennium Development Goals (MDG), with MDG4 being a two-thirds reduction in child mortality by 2015, and with measles vaccination coverage being one of the three indicators of progress toward this goal.* In 2010, the World Health Assembly established three milestones for measles control by 2015: 1) increase routine coverage with the first dose of measles-containing vaccine (MCV1) for children aged 1 year to ≥90% nationally and ≥80% in every district; 2) reduce global annual measles incidence to fewer than five cases per million population; and 3) reduce global measles mortality by 95% from the 2000 estimate (1).† In 2012, the World Health Assembly endorsed the Global Vaccine Action Plan§ with the objective to eliminate measles in four World Health Organization (WHO) regions by 2015. WHO member states in all six WHO regions have adopted measles elimination goals. This report updates the 2000–2013 report (2) and describes progress toward global control and regional measles elimination during 2000–2014. During this period, annual reported measles incidence declined 73% worldwide, from 146 to 40 cases per million population, and annual estimated measles deaths declined 79%, from 546,800 to 114,900. However, progress toward the 2015 milestones and elimination goals has slowed markedly since 2010. To resume progress toward milestones and goals for measles elimination, a review of current strategies and challenges to improving program performance is needed, and countries and their partners need to raise the visibility of measles elimination, address barriers to measles vaccination, and make substantial and sustained additional investments in strengthening health systems.
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Bischoff WE, McNall RJ, Blevins MW, Turner J, Lopareva EN, Rota PA, Stehle JR. Detection of Measles Virus RNA in Air and Surface Specimens in a Hospital Setting. J Infect Dis 2015; 213:600-3. [PMID: 26386428 DOI: 10.1093/infdis/jiv465] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 09/16/2015] [Indexed: 11/14/2022] Open
Abstract
Measles virus (MeV) is known to be highly contagious, with an infectious period lasting from 4 days before to 4 days after rash onset. An unvaccinated, young, female patient with measles confirmed by direct epidemiologic link was hospitalized on day 5 after rash onset. Environmental samples were collected over the 4-day period of hospitalization in a single room. MeV RNA was detectable in air specimens, on surface specimens, and on respirators on days 5-8 after rash onset. This is the first report of environmental surveillance for MeV, and the results suggest that MeV-infected fomites may be present in healthcare settings.
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Affiliation(s)
- Werner E Bischoff
- Infectious Diseases, Wake Forest Baptist Health, Winston-Salem, North Carolina
| | - Rebecca J McNall
- Measles, Mumps, Rubella, and Herpesviruses Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Maria W Blevins
- Infectious Diseases, Wake Forest Baptist Health, Winston-Salem, North Carolina
| | - JoLyn Turner
- Infectious Diseases, Wake Forest Baptist Health, Winston-Salem, North Carolina
| | - Elena N Lopareva
- Measles, Mumps, Rubella, and Herpesviruses Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Paul A Rota
- Measles, Mumps, Rubella, and Herpesviruses Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - John R Stehle
- Infectious Diseases, Wake Forest Baptist Health, Winston-Salem, North Carolina
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65
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Coughlin MM, Collins M, Saxon G, Jarrahian C, Zehrung D, Cappello C, Dhere R, Royals M, Papania M, Rota PA. Effect of jet injection on infectivity of measles, mumps, and rubella vaccine in a bench model. Vaccine 2015; 33:4540-7. [DOI: 10.1016/j.vaccine.2015.07.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 06/11/2015] [Accepted: 07/07/2015] [Indexed: 11/25/2022]
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Affiliation(s)
- Paul A Rota
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Bettina Bankamp
- Centers for Disease Control and Prevention, Atlanta, Georgia
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67
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Edens C, Collins ML, Goodson JL, Rota PA, Prausnitz MR. A microneedle patch containing measles vaccine is immunogenic in non-human primates. Vaccine 2015; 33:4712-8. [PMID: 25770786 DOI: 10.1016/j.vaccine.2015.02.074] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 01/28/2015] [Accepted: 02/16/2015] [Indexed: 11/16/2022]
Abstract
Very high vaccination coverage is required to eliminate measles, but achieving high coverage can be constrained by the logistical challenges associated with subcutaneous injection. To simplify the logistics of vaccine delivery, a patch containing micron-scale polymeric needles was formulated to encapsulate the standard dose of measles vaccine (1000 TCID₅₀) and the immunogenicity of the microneedle patch was compared with subcutaneous injection in rhesus macaques. The microneedle patch was administered without reconstitution with diluent, dissolved in skin within 10 min, and caused only mild, transient skin erythema. Both groups of rhesus macaques generated neutralizing antibody responses to measles that were consistent with protection and the neutralizing antibody titers were equivalent. In addition, the microneedle patches maintained an acceptable level of potency after storage at elevated temperature suggesting improved thermostability compared to standard lyophilized vaccine. In conclusion, a measles microneedle patch vaccine was immunogenic in non-human primates, and this approach offers a promising delivery method that could help increase vaccination coverage.
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Affiliation(s)
- Chris Edens
- Coulter Department of Biomedical Engineering at Georgia Tech and Emory University, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Marcus L Collins
- National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - James L Goodson
- Center for Global Health, Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Paul A Rota
- National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
| | - Mark R Prausnitz
- Coulter Department of Biomedical Engineering at Georgia Tech and Emory University, Georgia Institute of Technology, Atlanta, GA 30332, USA; School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA.
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68
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Jin L, Örvell C, Myers R, Rota PA, Nakayama T, Forcic D, Hiebert J, Brown KE. Genomic diversity of mumps virus and global distribution of the 12 genotypes. Rev Med Virol 2014; 25:85-101. [DOI: 10.1002/rmv.1819] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 10/14/2014] [Accepted: 10/15/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Li Jin
- Virus Reference Department, Reference Microbiology Services; Public Health England; London UK
| | - Claes Örvell
- Division of Clinical Virology; Huddinge University Hospital; Stockholm Sweden
| | - Richard Myers
- Virus Reference Department, Reference Microbiology Services; Public Health England; London UK
| | - Paul A. Rota
- Centers for Disease Control and Prevention; Atlanta USA
| | | | - Dubravko Forcic
- University of Zagreb; Centre for Research and Knowledge Transfer in Biotechnology; Zagreb Croatia
| | - Joanne Hiebert
- National Microbiology Laboratory; Public Health Agency of Canada; Winnipeg Canada
| | - Kevin E. Brown
- Virus Reference Department, Reference Microbiology Services; Public Health England; London UK
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69
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Perry RT, Gacic-Dobo M, Dabbagh A, Mulders MN, Strebel PM, Okwo-Bele JM, Rota PA, Goodson JL. Progress toward regional measles elimination--worldwide, 2000-2013. MMWR Morb Mortal Wkly Rep 2014; 63:1034-8. [PMID: 25393223 PMCID: PMC5779499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In 2012, the World Health Assembly endorsed the Global Vaccine Action Plan with the objective to eliminate measles in four World Health Organization (WHO) regions by 2015. Member states of all six WHO regions have adopted measles elimination goals. In 2010, the World Health Assembly established three milestones for 2015: 1) increase routine coverage with the first dose of measles-containing vaccine (MCV1) for children aged 1 year to ≥90% nationally and ≥80% in every district; 2) reduce global annual measles incidence to <5 cases per million; and 3) reduce global measles mortality by 95% from the 2000 estimate. This report updates the 2000-2012 report and describes progress toward global control and regional measles elimination during 2000-2013. During this period, annual reported measles incidence declined 72% worldwide, from 146 to 40 per million population, and annual estimated measles deaths declined 75%, from 544,200 to 145,700. Four of six WHO regions have established regional verification commissions (RVCs); in the European (EUR) and Western Pacific regions (WPR), 19 member states successfully documented the absence of endemic measles. Resuming progress toward 2015 milestones and elimination goals will require countries and their partners to raise the visibility of measles elimination, address barriers to measles vaccination, and make substantial and sustained additional investments in strengthening health systems.
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Affiliation(s)
- Robert T. Perry
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - Marta Gacic-Dobo
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - Alya Dabbagh
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - Mick N. Mulders
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - Peter M. Strebel
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - Jean-Marie Okwo-Bele
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - Paul A. Rota
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - James L. Goodson
- Global Immunization Division, Center for Global Health, CDC,Corresponding author: James L. Goodson, , 404-639-8170
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Agarkhedkar S, Kulkarni PS, Winston S, Sievers R, Dhere RM, Gunale B, Powell K, Rota PA, Papania M. Safety and immunogenicity of dry powder measles vaccine administered by inhalation: A randomized controlled Phase I clinical trial. Vaccine 2014; 32:6791-7. [DOI: 10.1016/j.vaccine.2014.09.071] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 09/29/2014] [Accepted: 09/30/2014] [Indexed: 10/24/2022]
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Xu S, Zhang Y, Rivailler P, Wang H, Ji Y, Zhen Z, Mao N, Li C, Bellini WJ, Xu W, Rota PA. Evolutionary genetics of genotype H1 measles viruses in China from 1993 to 2012. J Gen Virol 2014; 95:1892-1899. [PMID: 24914068 PMCID: PMC4135087 DOI: 10.1099/vir.0.066746-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Virologic surveillance is a critical component of measles management. One of the criteria for verification of elimination of endemic measles is genetic analysis of wild-type viruses to demonstrate lack of an indigenous genotype. Measles is yet to be eliminated in China, and genotype H1 has been detected continuously since virologic surveillance was initiated in 1993. Virologic surveillance has been very active in China, providing a unique opportunity to conduct a detailed study of the evolution of a single, endemic genotype over a timespan of nearly two decades. Phylogenetic analysis performed on the 450 nt coding sequence for the C-terminal 150 amino acids of the nucleoprotein (N-450), fusion (F) gene and haemagglutinin (H) gene confirmed the continued circulation of genotype H1 viruses for 19 years. No evidence of selective pressure for the H protein was found. The substitution rates ranged from 0.75×10(-3) substitutions site(-1) year(-1) for H to 1.65×10(-3) substitutions site(-1) year(-1) for N-450. The time of most recent common ancestor (TMRCA) for genotype H1 was estimated as approximately 1985 (95 % highest probability density, 1979-1989). Finally, the overall diversity of measles sequences from China decreased from 2005 to 2012, coincident with a substantial decrease in measles cases. The results suggest that detailed evolutionary analyses should facilitate the documentation of eventual measles elimination in China. Moreover, the molecular approaches used in this study can be applied in other countries approaching measles elimination.
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Affiliation(s)
- Songtao Xu
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Yan Zhang
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Pierre Rivailler
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Huiling Wang
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Yixin Ji
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Zhu Zhen
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Naiying Mao
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Chongshan Li
- Shanghai Center for Disease Control and Prevention, Shanghai City, PR China
| | - William J Bellini
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Wenbo Xu
- WHO Regional Reference Laboratory for Measles for the Western Pacific Region, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Paul A Rota
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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72
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Gastañaduy PA, Redd SB, Fiebelkorn AP, Rota JS, Rota PA, Bellini WJ, Seward JF, Wallace GS. Measles - United States, January 1-May 23, 2014. MMWR Morb Mortal Wkly Rep 2014; 63:496-9. [PMID: 24898167 PMCID: PMC5779360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Measles is a highly contagious, acute viral illness that can lead to serious complications and death. Although measles elimination (i.e., interruption of year-round endemic transmission) was declared in the United States in 2000, importations of measles cases from endemic areas of the world continue to occur, leading to secondary measles cases and outbreaks in the United States, primarily among unvaccinated persons. To update national measles data in the United States, CDC evaluated cases reported by states from January 1 through May 23, 2014. A total of 288 confirmed measles cases have been reported to CDC, surpassing the highest reported yearly total of measles cases since elimination (220 cases reported in 2011). Fifteen outbreaks accounted for 79% of cases reported, including the largest outbreak reported in the United States since elimination (138 cases and ongoing). The large number of cases this year emphasizes the need for health-care providers to have a heightened awareness of the potential for measles in their communities and the importance of vaccination to prevent measles.
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Affiliation(s)
- Paul A. Gastañaduy
- Division of Viral Disease, National Center for Immunization and Respiratory Diseases, CDC
| | - Susan B. Redd
- Division of Viral Disease, National Center for Immunization and Respiratory Diseases, CDC
| | - Amy Parker Fiebelkorn
- Division of Viral Disease, National Center for Immunization and Respiratory Diseases, CDC
| | - Jennifer S. Rota
- Division of Viral Disease, National Center for Immunization and Respiratory Diseases, CDC
| | - Paul A. Rota
- Division of Viral Disease, National Center for Immunization and Respiratory Diseases, CDC
| | - William J. Bellini
- Division of Viral Disease, National Center for Immunization and Respiratory Diseases, CDC
| | - Jane F. Seward
- Division of Viral Disease, National Center for Immunization and Respiratory Diseases, CDC
| | - Gregory S. Wallace
- Division of Viral Disease, National Center for Immunization and Respiratory Diseases, CDC
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Rosen JB, Rota JS, Hickman CJ, Sowers SB, Mercader S, Rota PA, Bellini WJ, Huang AJ, Doll MK, Zucker JR, Zimmerman CM. Outbreak of measles among persons with prior evidence of immunity, New York City, 2011. Clin Infect Dis 2014; 58:1205-10. [PMID: 24585562 DOI: 10.1093/cid/ciu105] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Measles was eliminated in the United States through high vaccination coverage and a public health system able to rapidly respond to measles. Measles may occur among vaccinated individuals, but secondary transmission from such individuals has not been documented. METHODS Suspected patients and contacts exposed during a measles outbreak in New York City in 2011 were investigated. Medical histories and immunization records were obtained. Cases were confirmed by detection of measles-specific immunoglobulin M and/or RNA. Tests for measles immunoglobulin G (IgG), IgG avidity, measurement of measles neutralizing antibody titers, and genotyping were performed to characterize the cases. RESULTS The index patient had 2 doses of measles-containing vaccine; of 88 contacts, 4 secondary patients were confirmed who had either 2 doses of measles-containing vaccine or a past positive measles IgG antibody. All patients had laboratory confirmation of measles infection, clinical symptoms consistent with measles, and high-avidity IgG antibody characteristic of a secondary immune response. Neutralizing antibody titers of secondary patients reached >80 000 mIU/mL 3-4 days after rash onset and that of the index was <500 mIU/mL 9 days after rash onset. No additional cases of measles occurred among 231 contacts of secondary patients. CONCLUSIONS This is the first report of measles transmission from a twice-vaccinated individual with documented secondary vaccine failure. The clinical presentation and laboratory data of the index patient were typical of measles in a naive individual. Secondary patients had robust anamnestic antibody responses. No tertiary cases occurred despite numerous contacts. This outbreak underscores the need for thorough epidemiologic and laboratory investigation of suspected cases of measles regardless of vaccination status.
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Affiliation(s)
- Jennifer B Rosen
- Bureau of Immunization, New York City Department of Health and Mental Hygiene, New York
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Perry RT, Gacic-Dobo M, Dabbagh A, Mulders MN, Strebel PM, Okwo-Bele JM, Rota PA, Goodson JL. Global control and regional elimination of measles, 2000-2012. MMWR Morb Mortal Wkly Rep 2014; 63:103-7. [PMID: 24500289 PMCID: PMC4584639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In 2010, the World Health Assembly established three milestones toward global measles eradication to be reached by 2015: 1) increase routine coverage with the first dose of measles-containing vaccine (MCV1) for children aged 1 year to ≥90% nationally and ≥80% in every district, 2) reduce and maintain annual measles incidence at <5 cases per million, and 3) reduce measles mortality by 95% from the 2000 estimate. After the adoption by member states of the South-East Asia Region (SEAR) of the goal of measles elimination by 2020, elimination goals have been set by member states of all six World Health Organization (WHO) regions, and reaching measles elimination in four WHO regions by 2015 is an objective of the Global Vaccine Action Plan (GVAP). This report updates the previous report for 2000-2011 and describes progress toward global control and regional elimination of measles during 2000-2012. During this period, increases in routine MCV coverage, plus supplementary immunization activities (SIAs) reaching 145 million children in 2012, led to a 77% decrease worldwide in reported measles annual incidence, from 146 to 33 per million population, and a 78% decline in estimated annual measles deaths, from 562,400 to 122,000. Compared with a scenario of no vaccination, an estimated 13.8 million deaths were prevented by measles vaccination during 2000-2012. Achieving the 2015 targets and elimination goals will require countries and their partners to raise the visibility of measles elimination and make substantial and sustained additional investments in strengthening health systems.
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Affiliation(s)
- Robert T. Perry
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - Marta Gacic-Dobo
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - Alya Dabbagh
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - Mick N. Mulders
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - Peter M. Strebel
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - Jean-Marie Okwo-Bele
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - Paul A. Rota
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
| | - James L. Goodson
- Global Immunization Division, Center for Global Health, CDC,Corresponding author: James L. Goodson, , 404-639-8170
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75
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Papania MJ, Wallace GS, Rota PA, Icenogle JP, Fiebelkorn AP, Armstrong GL, Reef SE, Redd SB, Abernathy ES, Barskey AE, Hao L, McLean HQ, Rota JS, Bellini WJ, Seward JF. Elimination of endemic measles, rubella, and congenital rubella syndrome from the Western hemisphere: the US experience. JAMA Pediatr 2014; 168:148-55. [PMID: 24311021 DOI: 10.1001/jamapediatrics.2013.4342] [Citation(s) in RCA: 134] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE To verify the elimination of endemic measles, rubella, and congenital rubella syndrome (CRS) from the Western hemisphere, the Pan American Health Organization requested each member country to compile a national elimination report. The United States documented the elimination of endemic measles in 2000 and of endemic rubella and CRS in 2004. In December 2011, the Centers for Disease Control and Prevention convened an external expert panel to review the evidence and determine whether elimination of endemic measles, rubella, and CRS had been sustained. OBJECTIVE To review the evidence for sustained elimination of endemic measles, rubella, and CRS from the United States through 2011. DESIGN, SETTING, AND PARTICIPANTS Review of data for measles from 2001 to 2011 and for rubella and CRS from 2004 to 2011 covering the US resident population and international visitors, including disease epidemiology, importation status of cases, molecular epidemiology, adequacy of surveillance, and population immunity as estimated by national vaccination coverage and serologic surveys. MAIN OUTCOMES AND MEASURES Annual numbers of measles, rubella, and CRS cases, by importation status, outbreak size, and distribution; proportions of US population seropositive for measles and rubella; and measles-mumps-rubella vaccination coverage levels. RESULTS Since 2001, US reported measles incidence has remained below 1 case per 1,000,000 population. Since 2004, rubella incidence has been below 1 case per 10,000,000 population, and CRS incidence has been below 1 case per 5,000,000 births. Eighty-eight percent of measles cases and 54% of rubella cases were internationally imported or epidemiologically or virologically linked to importation. The few cases not linked to importation were insufficient to represent endemic transmission. Molecular epidemiology indicated no endemic genotypes. The US surveillance system is adequate to detect endemic measles or rubella. Seroprevalence and vaccination coverage data indicate high levels of population immunity to measles and rubella. CONCLUSIONS AND RELEVANCE The external expert panel concluded that the elimination of endemic measles, rubella, and CRS from the United States was sustained through 2011. However, international importation continues, and health care providers should suspect measles or rubella in patients with febrile rash illness, especially when associated with international travel or international visitors, and should report suspected cases to the local health department.
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Affiliation(s)
- Mark J Papania
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gregory S Wallace
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Paul A Rota
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joseph P Icenogle
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Amy Parker Fiebelkorn
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Gregory L Armstrong
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan E Reef
- Global Immunization Division, Coordinating Office for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan B Redd
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Emily S Abernathy
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Albert E Barskey
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia4HIV Incidence and Case Surveillance Branch, Division of HIV/AIDS Prevention, National
| | - Lijuan Hao
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Huong Q McLean
- Epidemiology Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia5Marshfield Clinic Research Foundation, Marshfield, Wisconsin
| | - Jennifer S Rota
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - William J Bellini
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jane F Seward
- Office of the Director, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Cui A, Zhu Z, Chen M, Zheng H, Liu L, Wang Y, Ma Y, Wang C, Fang X, Li P, Guan R, Wang S, Zhou J, Zheng L, Gao H, Ding Z, Li L, Bo F, Sun Z, Zhang Z, Feng D, He J, Chen H, Jin L, Rota PA, Xu W. Epidemiologic and genetic characteristics of mumps viruses isolated in China from 1995 to 2010. Infection, Genetics and Evolution 2014; 21:384-90. [DOI: 10.1016/j.meegid.2013.12.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 12/05/2013] [Accepted: 12/07/2013] [Indexed: 10/25/2022]
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77
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Goldsmith CS, Ksiazek TG, Rollin PE, Comer JA, Nicholson WL, Peret TCT, Erdman DD, Bellini WJ, Harcourt BH, Rota PA, Bhatnagar J, Bowen MD, Erickson BR, McMullan LK, Nichol ST, Shieh WJ, Paddock CD, Zaki SR. Cell culture and electron microscopy for identifying viruses in diseases of unknown cause. Emerg Infect Dis 2013; 19:886-91. [PMID: 23731788 PMCID: PMC3713842 DOI: 10.3201/eid1906.130173] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
During outbreaks of infectious diseases or in cases of severely ill patients, it is imperative to identify the causative agent. This report describes several events in which virus isolation and identification by electron microscopy were critical to initial recognition of the etiologic agent, which was further analyzed by additional laboratory diagnostic assays. Examples include severe acute respiratory syndrome coronavirus, and Nipah, lymphocytic choriomeningitis, West Nile, Cache Valley, and Heartland viruses. These cases illustrate the importance of the techniques of cell culture and electron microscopy in pathogen identification and recognition of emerging diseases.
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Affiliation(s)
- Cynthia S Goldsmith
- Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop G32, Atlanta, GA 30329, USA.
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78
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Xu S, Zhang Y, Zhu Z, Liu C, Mao N, Ji Y, Wang H, Jiang X, Li C, Tang W, Feng D, Wang C, Zheng L, Lei Y, Ling H, Zhao C, Ma Y, He J, Wang Y, Li P, Guan R, Zhou S, Zhou J, Wang S, Zhang H, Zheng H, Liu L, Ma H, Guan J, Lu P, Feng Y, Zhang Y, Zhou S, Xiong Y, Ba Z, Chen H, Yang X, Bo F, Ma Y, Liang Y, Lei Y, Gu S, Liu W, Chen M, Featherstone D, Jee Y, Bellini WJ, Rota PA, Xu W. Genetic characterization of the hemagglutinin genes of wild-type measles virus circulating in china, 1993-2009. PLoS One 2013; 8:e73374. [PMID: 24073194 PMCID: PMC3779233 DOI: 10.1371/journal.pone.0073374] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 07/29/2013] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND China experienced several large measles outbreaks in the past two decades, and a series of enhanced control measures were implemented to achieve the goal of measles elimination. Molecular epidemiologic surveillance of wild-type measles viruses (MeV) provides valuable information about the viral transmission patterns. Since 1993, virologic surveillnace has confirmed that a single endemic genotype H1 viruses have been predominantly circulating in China. A component of molecular surveillance is to monitor the genetic characteristics of the hemagglutinin (H) gene of MeV, the major target for virus neutralizing antibodies. PRINCIPAL FINDINGS Analysis of the sequences of the complete H gene from 56 representative wild-type MeV strains circulating in China during 1993-2009 showed that the H gene sequences were clustered into 2 groups, cluster 1 and cluster 2. Cluster1 strains were the most frequently detected cluster and had a widespread distribution in China after 2000. The predicted amino acid sequences of the H protein were relatively conserved at most of the functionally significant amino acid positions. However, most of the genotype H1 cluster1 viruses had an amino acid substitution (Ser240Asn), which removed a predicted N-linked glycosylation site. In addition, the substitution of Pro397Leu in the hemagglutinin noose epitope (HNE) was identified in 23 of 56 strains. The evolutionary rate of the H gene of the genotype H1 viruses was estimated to be approximately 0.76×10(-3) substitutions per site per year, and the ratio of dN to dS (dN/dS) was <1 indicating the absence of selective pressure. CONCLUSIONS Although H genes of the genotype H1 strains were conserved and not subjected to selective pressure, several amino acid substitutions were observed in functionally important positions. Therefore the antigenic and genetic properties of H genes of wild-type MeVs should be monitored as part of routine molecular surveillance for measles in China.
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Affiliation(s)
- Songtao Xu
- Regional Reference Measles Laboratory for the WHO Western Pacific Region, Key Laboratory of Medical Virology Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Yan Zhang
- Regional Reference Measles Laboratory for the WHO Western Pacific Region, Key Laboratory of Medical Virology Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Zhen Zhu
- Regional Reference Measles Laboratory for the WHO Western Pacific Region, Key Laboratory of Medical Virology Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Chunyu Liu
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Naiying Mao
- Regional Reference Measles Laboratory for the WHO Western Pacific Region, Key Laboratory of Medical Virology Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Yixin Ji
- Regional Reference Measles Laboratory for the WHO Western Pacific Region, Key Laboratory of Medical Virology Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Huiling Wang
- Regional Reference Measles Laboratory for the WHO Western Pacific Region, Key Laboratory of Medical Virology Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Xiaohong Jiang
- Regional Reference Measles Laboratory for the WHO Western Pacific Region, Key Laboratory of Medical Virology Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Chongshan Li
- Shanghai Center for Disease Control and Prevention, Shanghai City, China
| | - Wei Tang
- Shanghai Center for Disease Control and Prevention, Shanghai City, China
| | - Daxing Feng
- Henan Center for Disease Control and Prevention, Zhengzhou City, Henan Province, China
| | - Changyin Wang
- Shandong Center for Disease Control and Prevention, Jinan City, Shandong Province, China
| | - Lei Zheng
- Shanxi Center for Disease Control and Prevention, Taiyuan City, Shanxi Province, China
| | - Yue Lei
- Tianjin Center for Disease Control and Prevention, Tianjin City, China
| | - Hua Ling
- Chongqing Center for Disease Control and Prevention, Chongqing City, China
| | - Chunfang Zhao
- Chongqing Center for Disease Control and Prevention, Chongqing City, China
| | - Yan Ma
- Hainan Center for Disease Control and Prevention, Haikou City, Hainan Province, China
| | - Jilan He
- Sichuan Center for Disease Control and Prevention, Chengdu City, Sichuan Province, China
| | - Yan Wang
- Liaoning Center for Disease Control and Prevention, Shenyang City, Liaoning Province, China
| | - Ping Li
- Shaanxi Center for Disease Control and Prevention, Xian City, Shannxi Province, China
| | - Ronghui Guan
- Shaanxi Center for Disease Control and Prevention, Xian City, Shannxi Province, China
| | - Shujie Zhou
- Anhui Center for Disease Control and Prevention, Hefei City, Anhui Province, China
| | - Jianhui Zhou
- Jilin Center for Disease Control and Prevention, Changchun City, Jilin Province, China
| | - Shuang Wang
- Jilin Center for Disease Control and Prevention, Changchun City, Jilin Province, China
| | - Hong Zhang
- Hunan Center for Disease Control and Prevention, Changsha City, Hunan Province, China
| | - Huanying Zheng
- Guangdong Center for Disease Control and Prevention, Guangzhou City, Guangzhou Province, China
| | - Leng Liu
- Guangdong Center for Disease Control and Prevention, Guangzhou City, Guangzhou Province, China
| | - Hemuti Ma
- Xinjiang Center for Disease Control and Prevention, Urumchi City, Xinjiang Province, China
| | - Jing Guan
- Xinjiang Center for Disease Control and Prevention, Urumchi City, Xinjiang Province, China
| | - Peishan Lu
- Jiangsu Center for Disease Control and Prevention, Nanjing City, Jiangsu Province, China
| | - Yan Feng
- Zhejiang Center for Disease Control and Prevention, Hangzhou City, Zhejiang Province, China
| | - Yanjun Zhang
- Zhejiang Center for Disease Control and Prevention, Hangzhou City, Zhejiang Province, China
| | - Shunde Zhou
- Jiangxi Center for Disease Control and Prevention, Nanchang City, Jiangxi Province, China
| | - Ying Xiong
- Jiangxi Center for Disease Control and Prevention, Nanchang City, Jiangxi Province, China
| | - Zhuoma Ba
- Qinghai Center for Disease Control and Prevention, Xining City, Qinghai Province, China
| | - Hui Chen
- Ningxia Center for Disease Control and Prevention, Yinchuan City, Ningxia Province, China
| | - Xiuhui Yang
- Fujian Center for Disease Control and Prevention, Fuzhou City, Fujian Province, China
| | - Fang Bo
- Heilongjiang Center for Disease Control and Prevention, Harbin City, Heilongjiang Province, China
| | - Yujie Ma
- Heilongjiang Center for Disease Control and Prevention, Harbin City, Heilongjiang Province, China
| | - Yong Liang
- Hebei Center for Disease Control and Prevention, Shijiazhuang City, Hebei Province, China
| | - Yake Lei
- Hubei Center for Disease Control and Prevention, Wuhan City, Hubei Province, China
| | - Suyi Gu
- Inner Mongolia Center for Disease Control and Prevention, Hohhot City, Inner Mongolia Province, China
| | - Wei Liu
- Guangxi Center for Disease Control and Prevention, Nanning City, Guangxi Province, China
| | - Meng Chen
- Beijing Center for Disease Control and Prevention, Beijing City, China
| | - David Featherstone
- Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Youngmee Jee
- Expanded Programme on Immunization, Western Pacific Regional Office, World Health Organization, Manila, Philippines
| | - William J. Bellini
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Paul A. Rota
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Wenbo Xu
- Regional Reference Measles Laboratory for the WHO Western Pacific Region, Key Laboratory of Medical Virology Ministry of Health, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
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Sazzad HMS, Hossain MJ, Gurley ES, Ameen KMH, Parveen S, Islam MS, Faruque LI, Podder G, Banu SS, Lo MK, Rollin PE, Rota PA, Daszak P, Rahman M, Luby SP. Nipah virus infection outbreak with nosocomial and corpse-to-human transmission, Bangladesh. Emerg Infect Dis 2013; 19:210-7. [PMID: 23347678 PMCID: PMC3559054 DOI: 10.3201/eid1902.120971] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Particularly vulnerable are health care workers who do not use personal protective equipment and persons who do not wash hands after traditional burial practices. Active Nipah virus encephalitis surveillance identified an encephalitis cluster and sporadic cases in Faridpur, Bangladesh, in January 2010. We identified 16 case-patients; 14 of these patients died. For 1 case-patient, the only known exposure was hugging a deceased patient with a probable case, while another case-patient’s exposure involved preparing the same corpse for burial by removing oral secretions and anogenital excreta with a cloth and bare hands. Among 7 persons with confirmed sporadic cases, 6 died, including a physician who had physically examined encephalitis patients without gloves or a mask. Nipah virus–infected patients were more likely than community-based controls to report drinking raw date palm sap and to have had physical contact with an encephalitis patient (29% vs. 4%, matched odds ratio undefined). Efforts to prevent transmission should focus on reducing caregivers’ exposure to infected patients’ bodily secretions during care and traditional burial practices.
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80
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Abstract
Respiratory viruses (including adenovirus, influenza virus, respiratory syncytial virus, coronavirus, and rhinovirus) cause a broad spectrum of disease in humans, ranging from mild influenza-like symptoms to acute respiratory failure. While species D adenoviruses and subtype H7 influenza viruses are known to possess an ocular tropism, documented human ocular disease has been reported following infection with all principal respiratory viruses. In this review, we describe the anatomical proximity and cellular receptor distribution between ocular and respiratory tissues. All major respiratory viruses and their association with human ocular disease are discussed. Research utilizing in vitro and in vivo models to study the ability of respiratory viruses to use the eye as a portal of entry as well as a primary site of virus replication is highlighted. Identification of shared receptor-binding preferences, host responses, and laboratory modeling protocols among these viruses provides a needed bridge between clinical and laboratory studies of virus tropism.
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Affiliation(s)
- Jessica A Belser
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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81
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Coughlin MM, Bellini WJ, Rota PA. Contribution of dendritic cells to measles virus induced immunosuppression. Rev Med Virol 2012; 23:126-38. [DOI: 10.1002/rmv.1735] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 10/29/2012] [Accepted: 10/30/2012] [Indexed: 12/19/2022]
Affiliation(s)
- Melissa M. Coughlin
- Centers for Disease Control and Prevention, Measles, Mumps, Rubella and Herpesvirus Laboratory Branch; Atlanta GA USA
| | - William J. Bellini
- Centers for Disease Control and Prevention, Measles, Mumps, Rubella and Herpesvirus Laboratory Branch; Atlanta GA USA
| | - Paul A. Rota
- Centers for Disease Control and Prevention, Measles, Mumps, Rubella and Herpesvirus Laboratory Branch; Atlanta GA USA
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82
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Barskey AE, Schulte C, Rosen JB, Handschur EF, Rausch-Phung E, Doll MK, Cummings KP, Alleyne EO, High P, Lawler J, Apostolou A, Blog D, Zimmerman CM, Montana B, Harpaz R, Hickman CJ, Rota PA, Rota JS, Bellini WJ, Gallagher KM. Mumps outbreak in Orthodox Jewish communities in the United States. N Engl J Med 2012; 367:1704-13. [PMID: 23113481 DOI: 10.1056/nejmoa1202865] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND By 2005, vaccination had reduced the annual incidence of mumps in the United States by more than 99%, with few outbreaks reported. However, in 2006, a large outbreak occurred among highly vaccinated populations in the United States, and similar outbreaks have been reported worldwide. The outbreak described in this report occurred among U.S. Orthodox Jewish communities during 2009 and 2010. METHODS Cases of salivary-gland swelling and other symptoms clinically compatible with mumps were investigated, and demographic, clinical, laboratory, and vaccination data were evaluated. RESULTS From June 28, 2009, through June 27, 2010, a total of 3502 outbreak-related cases of mumps were reported in New York City, two upstate New York counties, and one New Jersey county. Of the 1648 cases for which clinical specimens were available, 50% were laboratory-confirmed. Orthodox Jewish persons accounted for 97% of case patients. Adolescents 13 to 17 years of age (27% of all patients) and males (78% of patients in that age group) were disproportionately affected. Among case patients 13 to 17 years of age with documented vaccination status, 89% had previously received two doses of a mumps-containing vaccine, and 8% had received one dose. Transmission was focused within Jewish schools for boys, where students spend many hours daily in intense, face-to-face interaction. Orchitis was the most common complication (120 cases, 7% of male patients ≥12 years of age), with rates significantly higher among unvaccinated persons than among persons who had received two doses of vaccine. CONCLUSIONS The epidemiologic features of this outbreak suggest that intense exposures, particularly among boys in schools, facilitated transmission and overcame vaccine-induced protection in these patients. High rates of two-dose coverage reduced the severity of the disease and the transmission to persons in settings of less intense exposure.
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Affiliation(s)
- Albert E Barskey
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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83
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Lo MK, Peeples ME, Bellini WJ, Nichol ST, Rota PA, Spiropoulou CF. Distinct and overlapping roles of Nipah virus P gene products in modulating the human endothelial cell antiviral response. PLoS One 2012; 7:e47790. [PMID: 23094089 PMCID: PMC3477106 DOI: 10.1371/journal.pone.0047790] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 09/17/2012] [Indexed: 12/15/2022] Open
Abstract
Nipah virus (NiV) is a highly pathogenic zoonotic paramyxovirus that causes fatal encephalitis in up to 75% of infected humans. Like other paramyxoviruses, NiV employs co-transcriptional mRNA editing during transcription of the phosphoprotein (P) gene to generate additional mRNAs encoding the V and W proteins. The C protein is translated from the P mRNA, but in an alternative reading frame. There is evidence from both in vitro and in vivo studies to show that the P gene products play a role in NiV pathogenesis. We have developed a reverse genetic system to dissect the individual roles of the NiV P gene products in limiting the antiviral response in primary human microvascular lung endothelial cells, which represent important targets in human NiV infection. By characterizing growth curves and early antiviral responses against a number of recombinant NiVs with genetic modifications altering expression of the proteins encoded by the P gene, we observed that multiple elements encoded by the P gene have both distinct and overlapping roles in modulating virus replication as well as in limiting expression of antiviral mediators such as IFN-β, CXCL10, and CCL5. Our findings corroborate observations from in vivo hamster infection studies, and provide molecular insights into the attenuation and the histopathology observed in hamsters infected with C, V, and W-deficient NiVs. The results of this study also provide an opportunity to verify the results of earlier artificial plasmid expression studies in the context of authentic viral infection.
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Affiliation(s)
- Michael K Lo
- Centers for Disease Control & Prevention, Viral Special Pathogens Branch, Atlanta, Georgia, United States of America.
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84
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Edens C, Collins ML, Ayers J, Rota PA, Prausnitz MR. Measles vaccination using a microneedle patch. Vaccine 2012; 31:3403-9. [PMID: 23044406 DOI: 10.1016/j.vaccine.2012.09.062] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Revised: 08/22/2012] [Accepted: 09/24/2012] [Indexed: 12/15/2022]
Abstract
Measles vaccination programs would benefit from delivery methods that decrease cost, simplify logistics, and increase safety. Conventional subcutaneous injection is limited by the need for skilled healthcare professionals to reconstitute and administer injections, and by the need for safe needle handling and disposal to reduce the risk of disease transmission through needle re-use and needlestick injury. Microneedles are micron-scale, solid needles coated with a dry formulation of vaccine that dissolves in the skin within minutes after patch application. By avoiding the use of hypodermic needles, vaccination using a microneedle patch could be carried out by minimally trained personnel with reduced risk of blood-borne disease transmission. The goal of this study was to evaluate measles vaccination using a microneedle patch to address some of the limitations of subcutaneous injection. Viability of vaccine virus dried onto a microneedle patch was stabilized by incorporation of the sugar, trehalose, and loss of viral titer was less than 1 log10(TCID50) after storage for at least 30 days at room temperature. Microneedle patches were then used to immunize cotton rats with the Edmonston-Zagreb measles vaccine strain. Vaccination using microneedles at doses equaling the standard human dose or one-fifth the human dose generated neutralizing antibody levels equivalent to those of a subcutaneous immunization at the same dose. These results show that measles vaccine can be stabilized on microneedles and that vaccine efficiently reconstitutes in vivo to generate a neutralizing antibody response equivalent to that generated by subcutaneous injection.
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Affiliation(s)
- Chris Edens
- Coulter Department of Biomedical Engineering at Georgia Tech and Emory University, Georgia Institute of Technology, Atlanta, GA 30332, United States
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85
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Pattamadilok S, Incomserb P, Primsirikunawut A, Lukebua A, Rota PA, Sawanpanyalert P. Genetic characterization of measles viruses that circulated in Thailand from 1998 to 2008. J Med Virol 2012; 84:804-13. [PMID: 22431030 DOI: 10.1002/jmv.23249] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
During the period between 1998 and 2008, 48 representative measles viruses (MeVs) circulating in Thailand were subjected to genetic characterization. Three genotypes, G2, D5, and D9 were detected. The results suggested that measles genotype D5, which has been circulating since at least 1998, is the endemic genotype in Thailand. Genotype G2 was detected between 1998 and 2001. In addition, almost all of the MeVs detected throughout the country in 2008 were genotype D9. This is the first report of genotype D9 in Thailand. This report provides important baseline data about measles genotypes in Thailand and this information will be needed to help verify measles elimination in Thailand.
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Affiliation(s)
- Sirima Pattamadilok
- National Institute of Health, Department of Medical Sciences, Nonthaburi, Thailand.
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86
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Lo MK, Lowe L, Hummel KB, Sazzad HMS, Gurley ES, Hossain MJ, Luby SP, Miller DM, Comer JA, Rollin PE, Bellini WJ, Rota PA. Characterization of Nipah virus from outbreaks in Bangladesh, 2008-2010. Emerg Infect Dis 2012; 18:248-55. [PMID: 22304936 PMCID: PMC3310473 DOI: 10.3201/eid1802.111492] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
New genotyping scheme facilitates classification of virus sequences. Nipah virus (NiV) is a highly pathogenic paramyxovirus that causes fatal encephalitis in humans. The initial outbreak of NiV infection occurred in Malaysia and Singapore in 1998–1999; relatively small, sporadic outbreaks among humans have occurred in Bangladesh since 2001. We characterized the complete genomic sequences of identical NiV isolates from 2 patients in 2008 and partial genomic sequences of throat swab samples from 3 patients in 2010, all from Bangladesh. All sequences from patients in Bangladesh comprised a distinct genetic group. However, the detection of 3 genetically distinct sequences from patients in the districts of Faridpur and Gopalganj indicated multiple co-circulating lineages in a localized region over a short time (January–March 2010). Sequence comparisons between the open reading frames of all available NiV genes led us to propose a standardized protocol for genotyping NiV; this protcol provides a simple and accurate way to classify current and future NiV sequences.
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Affiliation(s)
- Michael K Lo
- Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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87
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Zhang Y, Xu S, Wang H, Zhu Z, Ji Y, Liu C, Zhang X, Sun L, Zhou J, Lu P, Hu Y, Feng D, Zhang Z, Wang C, Fang X, Zheng H, Liu L, Sun X, Tang W, Wang Y, Liu Y, Gao H, Tian H, Ma J, Gu S, Wang S, Feng Y, Bo F, Liu J, Si Y, Zhou S, Ma Y, Wu S, Zhou S, Li F, Ding Z, Yang Z, Rota PA, Featherstone D, Jee Y, Bellini WJ, Xu W. Single endemic genotype of measles virus continuously circulating in China for at least 16 years. PLoS One 2012; 7:e34401. [PMID: 22532829 PMCID: PMC3332093 DOI: 10.1371/journal.pone.0034401] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 02/27/2012] [Indexed: 11/18/2022] Open
Abstract
The incidence of measles in China from 1991 to 2008 was reviewed, and the nucleotide sequences from 1507 measles viruses (MeV) isolated during 1993 to 2008 were phylogenetically analyzed. The results showed that measles epidemics peaked approximately every 3 to 5 years with the range of measles cases detected between 56,850 and 140,048 per year. The Chinese MeV strains represented three genotypes; 1501 H1, 1 H2 and 5 A. Genotype H1 was the predominant genotype throughout China continuously circulating for at least 16 years. Genotype H1 sequences could be divided into two distinct clusters, H1a and H1b. A 4.2% average nucleotide divergence was found between the H1a and H1b clusters, and the nucleotide sequence and predicted amino acid homologies of H1a viruses were 92.3%-100% and 84.7%-100%, H1b were 97.1%-100% and 95.3%-100%, respectively. Viruses from both clusters were distributed throughout China with no apparent geographic restriction and multiple co-circulating lineages were present in many provinces. Cluster H1a and H1b viruses were co-circulating during 1993 to 2005, while no H1b viruses were detected after 2005 and the transmission of that cluster has presumably been interrupted. Analysis of the nucleotide and predicted amino acid changes in the N proteins of H1a and H1b viruses showed no evidence of selective pressure. This study investigated the genotype and cluster distribution of MeV in China over a 16-year period to establish a genetic baseline before MeV elimination in Western Pacific Region (WPR). Continuous and extensive MeV surveillance and the ability to quickly identify imported cases of measles will become more critical as measles elimination goals are achieved in China in the near future. This is the first report that a single endemic genotype of measles virus has been found to be continuously circulating in one country for at least 16 years.
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Affiliation(s)
- Yan Zhang
- WHO WPRO Regional Reference Measles Lab, National Institute for Viral Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
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88
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Ayers JD, Rota PA, Collins ML, Drew CP. Alternatives to retroorbital blood collection in hispid cotton rats (Sigmodon hispidus). J Am Assoc Lab Anim Sci 2012; 51:239-245. [PMID: 22776125 PMCID: PMC3314528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Revised: 10/11/2011] [Accepted: 10/18/2011] [Indexed: 06/01/2023]
Abstract
Cotton rats (Sigmodon hispidus) are a valuable animal model for many human viral diseases, including polio virus, measles virus, respiratory syncytial virus, and herpes simplex virus. Although cotton rats have been used in research since 1939, few publications address handling and sampling techniques for this species, and the retroorbital sinus remains the recommended blood sampling site. Here we assessed blood sampling methods that are currently used in other species and a novel subzygomatic sampling site for their use in S. hispidus. The subzygomatic approach accesses a venous sinus that possibly is unique to this species and that lies just below the zygomatic arch of the maxilla and deep to the masseter muscle. We report that both the novel subzygomatic approach and the sublingual vein method can be used effectively in cotton rats.
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Affiliation(s)
- Jessica D Ayers
- Division of Scientific Resources, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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89
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Abstract
Nipah (NiV) and Hendra (HeV) viruses comprise the genus Henipavirus and are highly pathogenic paramyxoviruses, which cause fatal encephalitis and respiratory disease in humans. Since their respective initial outbreaks in 1998 and 1994, they have continued to cause sporadic outbreaks resulting in fatal disease. Due to their designation as Biosafety Level 4 pathogens, the level of containment required to work with live henipaviruses is available only to select laboratories around the world. This chapter provides an overview of the molecular virology of NiV and HeV including comparisons to other, well-characterized paramyxoviruses. This chapter also describes the sequence diversity present among the henipaviruses.
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Affiliation(s)
- Paul A Rota
- MS-C-22, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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90
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Duraisamy R, Rota PA, Palani G, Elango V, Sambasivam M, Lowe L, Lopareva E, Ramamurty N. Molecular characterization of wild-type measles viruses in Tamil Nadu, India, during 2005-2006: Relationship of genotype D8 strains from Tamil Nadu to global strains. J Med Virol 2011; 84:348-57. [DOI: 10.1002/jmv.22244] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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91
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Ksiazek TG, Rota PA, Rollin PE. A review of Nipah and Hendra viruses with an historical aside. Virus Res 2011; 162:173-83. [PMID: 21963678 DOI: 10.1016/j.virusres.2011.09.026] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Revised: 09/17/2011] [Accepted: 09/18/2011] [Indexed: 11/29/2022]
Abstract
The emergence of Hendra and Nipah viruses in the 1990s has been followed by the further emergence of these viruses in the tropical Old World. The history and current knowledge of the disease, the viruses and their epidemiology is reviewed in this article. A historical aside summarizes the role that Dr. Brian W.J. Mahy played at critical junctures in the early stories of these viruses.
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Affiliation(s)
- Thomas G Ksiazek
- Galveston National Laboratory, Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0610, USA.
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92
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Rahman MA, Hossain MJ, Sultana S, Homaira N, Khan SU, Rahman M, Gurley ES, Rollin PE, Lo MK, Comer JA, Lowe L, Rota PA, Ksiazek TG, Kenah E, Sharker Y, Luby SP. Date palm sap linked to Nipah virus outbreak in Bangladesh, 2008. Vector Borne Zoonotic Dis 2011; 12:65-72. [PMID: 21923274 DOI: 10.1089/vbz.2011.0656] [Citation(s) in RCA: 135] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION We investigated a cluster of patients with encephalitis in the Manikgonj and Rajbari Districts of Bangladesh in February 2008 to determine the etiology and risk factors for disease. METHODS We classified persons as confirmed Nipah cases by the presence of immunoglobulin M antibodies against Nipah virus (NiV), or by the presence of NiV RNA or by isolation of NiV from cerebrospinal fluid or throat swabs who had onset of symptoms between February 6 and March 10, 2008. We classified persons as probable cases if they reported fever with convulsions or altered mental status, who resided in the outbreak areas during that period, and who died before serum samples were collected. For the case-control study, we compared both confirmed and probable Nipah case-patients to controls, who were free from illness during the reference period. We used motion-sensor-infrared cameras to observe bat's contact of date palm sap. RESULTS We identified four confirmed and six probable case-patients, nine (90%) of whom died. The median age of the cases was 10 years; eight were males. The outbreak occurred simultaneously in two communities that were 44 km apart and separated by a river. Drinking raw date palm sap 2-12 days before illness onset was the only risk factor most strongly associated with the illness (adjusted odds ratio 25, 95% confidence intervals 3.3-∞, p<0.001). Case-patients reported no history of physical contact with bats, though community members often reported seeing bats. Infrared camera photographs showed that Pteropus bats frequently visited date palm trees in those communities where sap was collected for human consumption. CONCLUSION This is the second Nipah outbreak in Bangladesh where date palm sap has been implicated as the vehicle of transmission. Fresh date palm sap should not be drunk, unless effective steps have been taken to prevent bat access to the sap during collection.
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Affiliation(s)
- Muhammad Aziz Rahman
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
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93
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Abstract
The complete genomic sequences of 9 measles vaccine strains were compared with the sequence of the Edmonston wild-type virus. AIK-C, Moraten, Rubeovax, Schwarz, and Zagreb are vaccine strains of the Edmonston lineage, whereas CAM-70, Changchun-47, Leningrad-4 and Shanghai-191 were derived from 4 different wild-type isolates. Nucleotide substitutions were found in the noncoding regions of the genomes as well as in all coding regions, leading to deduced amino acid substitutions in all 8 viral proteins. Although the precise mechanisms involved in the attenuation of individual measles vaccines remain to be elucidated, in vitro assays of viral protein functions and recombinant viruses with defined genetic modifications have been used to characterize the differences between vaccine and wild-type strains. Although almost every protein contributes to an attenuated phenotype, substitutions affecting host cell tropism, virus assembly, and the ability to inhibit cellular antiviral defense mechanisms play an especially important role in attenuation.
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Affiliation(s)
- Bettina Bankamp
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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94
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Featherstone DA, Rota PA, Icenogle J, Mulders MN, Jee Y, Ahmed H, de Filippis AMB, Ramamurty N, Gavrilin E, Byabamazima C, Dosseh A, Xu W, Komase K, Tashiro M, Brown D, Bellini WJ, Strebel P. Expansion of the global measles and rubella laboratory network 2005-09. J Infect Dis 2011; 204 Suppl 1:S491-8. [PMID: 21666205 DOI: 10.1093/infdis/jir107] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Enhancing measles surveillance with integration of epidemiologic and laboratory information is one of the key strategies for accelerated measles control and elimination. The World Health Organization (WHO) Global Measles and Rubella Laboratory Network (LabNet) has been developed since 2000 to currently include 690 laboratories serving 183 countries. The LabNet testing strategy follows well-validated, standardized procedures for confirming suspected cases and for monitoring measles and rubella virus transmission patterns. The strength of the LabNet is a strong quality assurance program that monitors the performance of all laboratories through annual proficiency testing and continuous assessment. In the 5-year period 2005-2009, the results of >1 million measles immunoglobulin M (IgM) tests have been reported by the LabNet and, in addition, sequence information on >7000 measles and 600 rubella viruses has been shared. Progress with the development of the LabNet during 2005-2009 is discussed.
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Affiliation(s)
- David A Featherstone
- Department of Immunization, Vaccines and Biologicals, Family and Community Health Cluster, World Health Organization (WHO), Geneva, Switzerland.
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95
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Rota JS, Hickman CJ, Sowers SB, Rota PA, Mercader S, Bellini WJ. Two case studies of modified measles in vaccinated physicians exposed to primary measles cases: high risk of infection but low risk of transmission. J Infect Dis 2011; 204 Suppl 1:S559-63. [PMID: 21666213 DOI: 10.1093/infdis/jir098] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In 2009, measles outbreaks in Pennsylvania and Virginia resulted in the exposure and apparent infection of 2 physicians, both of whom had a documented history of vaccination with >2 doses of measles-mumps-rubella vaccine. These physicians were suspected of having been infected with measles after treating patients who subsequently received a diagnosis of measles. The clinical presentation was nonclassical in regard to progression, duration, and severity. It is hypothesized that the 2 physicians mounted vigorous secondary immune responses typified by high avidity measles immunoglobulin G antibody and remarkably high neutralizing titers in response to intense and prolonged exposure to a primary measles case patient. Both of the physicians continued to see patients, because neither considered that they could have measles. Despite surveillance for cases among contacts, including unvaccinated persons, no additional cases were identified.
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Affiliation(s)
- Jennifer S Rota
- Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch, Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Affiliation(s)
- Peter M Strebel
- Accelerated Disease Control, Expanded Programme on Immunization, Dept of Immunization, Vaccines and Biologicals, World Health Organization, Avenue Appia, CH-1211, Geneva 27, Switzerland.
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97
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Rota PA, Brown KE, Hübschen JM, Muller CP, Icenogle J, Chen MH, Bankamp B, Kessler JR, Brown DW, Bellini WJ, Featherstone D. Improving Global Virologic Surveillance for Measles and Rubella. J Infect Dis 2011; 204 Suppl 1:S506-13. [DOI: 10.1093/infdis/jir117] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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98
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Rota PA, Brown K, Mankertz A, Santibanez S, Shulga S, Muller CP, Hübschen JM, Siqueira M, Beirnes J, Ahmed H, Triki H, Al-Busaidy S, Dosseh A, Byabamazima C, Smit S, Akoua-Koffi C, Bwogi J, Bukenya H, Wairagkar N, Ramamurty N, Incomserb P, Pattamadilok S, Jee Y, Lim W, Xu W, Komase K, Takeda M, Tran T, Castillo-Solorzano C, Chenoweth P, Brown D, Mulders MN, Bellini WJ, Featherstone D. Global Distribution of Measles Genotypes and Measles Molecular Epidemiology. J Infect Dis 2011; 204 Suppl 1:S514-23. [DOI: 10.1093/infdis/jir118] [Citation(s) in RCA: 199] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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99
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Xu P, Li Z, Sun D, Lin Y, Wu J, Rota PA, He B. Rescue of wild-type mumps virus from a strain associated with recent outbreaks helps to define the role of the SH ORF in the pathogenesis of mumps virus. Virology 2011; 417:126-36. [PMID: 21676427 DOI: 10.1016/j.virol.2011.05.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 05/08/2011] [Accepted: 05/09/2011] [Indexed: 11/28/2022]
Abstract
Mumps virus (MuV) causes acute infections in humans. In recent years, MuV has caused epidemics among highly vaccinated populations. The largest outbreak in the U.S. in the past 20 years occurred in 2005-2006 with over 5000 reported cases in which the majority of the cases was in vaccinated young adults. We sequenced the complete genome of a representative strain from the epidemic (MuV-IA). MuV-IA is a member of genotype G, the same genotype of MuV that was associated with the outbreak in the UK in 2004-2005. We constructed a reverse genetics system for MuV-IA (rMuV-IA), and rescued a virus lacking the open reading frame (ORF) of the SH gene (rMuV∆SH). rMuV∆SH infection in L929 cells induced increased NF-κB activation, TNF-α production and apoptosis compared to rMuV-IA. rMuV∆SH was attenuated in an animal model. These results indicated that the SH ORF of MuV plays a significant role in interfering with TNF-α signaling and viral pathogenesis during virus infection.
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Affiliation(s)
- Pei Xu
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, GA 30602, USA
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100
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Chen SY, Anderson S, Kutty PK, Lugo F, McDonald M, Rota PA, Ortega-Sanchez IR, Komatsu K, Armstrong GL, Sunenshine R, Seward JF. Health care-associated measles outbreak in the United States after an importation: challenges and economic impact. J Infect Dis 2011; 203:1517-25. [PMID: 21531693 DOI: 10.1093/infdis/jir115] [Citation(s) in RCA: 140] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND On 12 February 2008, an infected Swiss traveler visited hospital A in Tucson, Arizona, and initiated a predominantly health care-associated measles outbreak involving 14 cases. We investigated risk factors that might have contributed to health care-associated transmission and assessed outbreak-associated hospital costs. METHODS Epidemiologic data were obtained by case interviews and review of medical records. Health care personnel (HCP) immunization records were reviewed to identify non-measles-immune HCP. Outbreak-associated costs were estimated from 2 hospitals. RESULTS Of 14 patients with confirmed cases, 7 (50%) were aged ≥ 18 years, 4 (29%) were hospitalized, 7 (50%) acquired measles in health care settings, and all (100%) were unvaccinated or had unknown vaccination status. Of the 11 patients (79%) who had accessed health care services while infectious, 1 (9%) was masked and isolated promptly after rash onset. HCP measles immunity data from 2 hospitals confirmed that 1776 (25%) of 7195 HCP lacked evidence of measles immunity. Among these HCPs, 139 (9%) of 1583 tested seronegative for measles immunoglobulin G, including 1 person who acquired measles. The 2 hospitals spent US$799,136 responding to and containing 7 cases in these facilities. CONCLUSIONS Suspecting measles as a diagnosis, instituting immediate airborne isolation, and ensuring rapidly retrievable measles immunity records for HCPs are paramount in preventing health care-associated spread and in minimizing hospital outbreak-response costs.
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Affiliation(s)
- Sanny Y Chen
- Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, Georgia
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