1
|
Tranter I, Smoll N, Lau CL, Williams DL, Neucom D, Barnekow D, Dyda A. Onward Virus Transmission after Measles Secondary Vaccination Failure. Emerg Infect Dis 2024; 30:1747-1754. [PMID: 39173667 PMCID: PMC11346981 DOI: 10.3201/eid3009.240150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2024] Open
Abstract
Measles in persons with secondary vaccination failure (SVF) may be less infectious than cases in unvaccinated persons. Our systematic review aimed to assess transmission risk for measles after SVF. We searched PubMed, Embase, and Web of Science databases from their inception dates. Inclusion criteria were articles describing persons who were exposed to measles-infected persons who had experienced SVF. Across the included 14 studies, >3,030 persons were exposed to measles virus from SVF cases, of whom 180 were susceptible, indicating secondary attack rates of 0%-6.25%. We identified 109 cases of SVF from the studies; 10.09% (n = 11) of case-patients transmitted the virus, resulting in 23 further cases and yielding an effective reproduction number of 0.063 (95% CI 0.0-0.5). These findings suggest a remarkably low attack rate for SVF measles cases, suggesting that, In outbreak situations, public health management of unvaccinated persons could be prioritized over persons with SVF.
Collapse
|
2
|
Hagan JE, Crooke SN, Gunregjav N, Sowers SB, Mercader S, Hickman CJ, Mulders MN, Pastore R, Takashima Y, Durrheim DN, Goodson JL, Rota PA. Breakthrough Measles among Vaccinated Adults Born during the Post-Soviet Transition Period in Mongolia. Vaccines (Basel) 2024; 12:695. [PMID: 38932425 PMCID: PMC11209263 DOI: 10.3390/vaccines12060695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 06/17/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024] Open
Abstract
Mongolia experienced a nationwide measles outbreak during 1 March 2015-31 December 2016, with 49,077 cases reported to the WHO; many were among vaccinated young adults, suggesting a possible role of vaccine failure. Advanced laboratory methods, coupled with detailed epidemiological investigations, can help classify cases as vaccine failure, failure to vaccinate, or both. In this report, we conducted a study of cases to identify risk factors for breakthrough infection for a subset of laboratory-confirmed measles cases. Of the 193 cases analyzed, only 19 (9.8%) reported measles vaccination history, and 170 (88%) were uncertain. Measles-specific IgG avidity testing classified 120 (62%) cases as low IgG avidity, indicating no prior exposure to measles. Ten of these cases with low IgG avidity had a history of measles vaccination, indicating primary vaccine failure. Overall, sixty cases (31%) had high IgG avidity, indicating breakthrough infection after prior exposure to measles antigen through vaccination or natural infection, but the IgG avidity results were highly age-dependent. This study found that among young children aged 9 months-5 years, breakthrough infection was rare (4/82, 5%); however, among young adults aged 15-25 years, breakthrough infection due to secondary vaccine failure (SVF) occurred on a large scale during this outbreak, accounting for the majority of cases (42/69 cases, 61%). The study found that large-scale secondary vaccine failure occurred in Mongolia, which highlights the potential for sustained outbreaks in post-elimination settings due to "hidden" cohorts of young adults who may have experienced waning immunity. This phenomenon may have implications for the sustainability of measles elimination in countries that remain vulnerable to the importation of the virus from areas where it is still endemic. Until global measles elimination is achieved, enhanced surveillance and preparedness for future outbreaks in post- or peri-elimination countries may be required.
Collapse
Affiliation(s)
- José E. Hagan
- Expanded Programme on Immunization, World Health Organization Regional Office for the Western Pacific, 1000 Manila, Philippines
| | - Stephen N. Crooke
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA (P.A.R.)
| | - Nyamaa Gunregjav
- Mongolia National Center for Communicable Diseases, Ulaanbaatar 14210, Mongolia
| | - Sun B. Sowers
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA (P.A.R.)
| | - Sara Mercader
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA (P.A.R.)
| | - Carole J. Hickman
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA (P.A.R.)
| | - Mick N. Mulders
- Vaccine Preventable Diseases Laboratory Network, World Health Organization, 1211 Geneva, Switzerland;
| | - Roberta Pastore
- Expanded Programme on Immunization, World Health Organization Regional Office for the Western Pacific, 1000 Manila, Philippines
| | - Yoshihiro Takashima
- Expanded Programme on Immunization, World Health Organization Regional Office for the Western Pacific, 1000 Manila, Philippines
| | - David N. Durrheim
- School of Medicine and Public Health, University of Newcastle, Wallsend, NSW 2287, Australia
| | - James L. Goodson
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Paul A. Rota
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA (P.A.R.)
| |
Collapse
|
3
|
Sanz JC, Pérez-Abeledo M. Measles in Spain at the elimination phase: The enemy knocking on the door. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:529-531. [PMID: 36464470 DOI: 10.1016/j.eimce.2021.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 06/17/2023]
Affiliation(s)
- Juan Carlos Sanz
- Laboratorio Regional de Salud Pública de la Comunidad de Madrid, Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain; Consorcio de Investigación Biomédica de Epidemiología y Salud Pública (CIBERESP), Spain.
| | - Marta Pérez-Abeledo
- Laboratorio Regional de Salud Pública de la Comunidad de Madrid, Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain
| |
Collapse
|
4
|
Bianchi FP, Stefanizzi P, Diella G, Martinelli A, Di Lorenzo A, Gallone MS, Tafuri S. Prevalence and management of rubella susceptibility in healthcare workers in Italy: A systematic review and meta-analysis. Vaccine X 2022; 12:100195. [PMID: 36032697 PMCID: PMC9399279 DOI: 10.1016/j.jvacx.2022.100195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/18/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction In the pre-vaccination era, all adults acquired immunity status due to natural infections during childhood and adolescence, whereas universal mass vaccination has changed the seroepidemiology of rubella among adults, showing lack of immunity in some subgroups. National and international guidelines recommend evaluating all healthcare workers (HCWs) for their immune status to rubella and possibly vaccinating those who are seronegative. We conducted a systematic review and meta-analysis to estimate the susceptibility rate to rubella among HCWs in Italy and to explore possible options for the management of those found to be susceptible. Methods Eight studies were included in the meta-analysis, selected from scientific papers available in the MEDLINE/PubMed and Google Scholar (till page 10) databases between January 1, 2015 and November 30, 2021. The following terms were used for the search strategy: (sero* OR seroprevalence OR prevalence OR susceptibilit* OR immunit* OR immunogenict*) AND (healthcare worker* OR health personnel OR physician* OR nurse OR student*) AND (rubella OR german measles OR TORCH) AND (Italy) Results The prevalence of rubella-susceptible HCWs was 9.0 % (95 %CI: 6.4–12.1 %). In a comparison of female vs. male serosusceptible HCWs, the RR was 0.67 (95 %CI = 0.51–0.88). Occupational medicine examinations for rubella screening with possible subsequent vaccination of seronegatives and exclusion of susceptible HCWs from high-risk settings were common management strategies. Conclusions HCWs susceptible to rubella are an important epidemiological concern in Italy, and efforts to identify and actively offer the vaccine to this population should be increased.
Collapse
|
5
|
Puthanakit T, Anugulruengkitt S, Angsuwatcharakon P, Bunjoungmanee P, Kowitdamrong E, Primsirikunawut A, Intarakhao S, Chetsonwisorn P, Sophonphan J, Tangsathapornpong A. Low Measles Seropositivity Rate among Thai Adolescents in the Thai National Immunization Program. Vaccines (Basel) 2022; 10:1269. [PMID: 36016157 PMCID: PMC9412740 DOI: 10.3390/vaccines10081269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
To achieve the goal of measles elimination, herd immunity with 95% seroprotection in the community is required. This study aimed to describe the measles seropositivity rate among Thai children and adolescents. A cross-sectional study was conducted among children aged 3−18 years in Bangkok and its suburbs. Measles IgG antibodies were measured using a EUROIMMUN enzyme-linked immunosorbent assay kit. Seropositivity is defined as a measles IgG titer of ≥200 IU/L, due to a correlation with a >85% positive rate with a plaque reduction neutralizing titer of >120. Factors associated with seropositivity were analyzed using logistic regression analysis. From May to July 2020, 570 children with a median (IQR) age of 11.7 (9.4−14.8) years were enrolled. The geometric mean titer (GMT) of anti-measles IgG was 281 IU/L (95% CI; 257−306). The proportion of children with seropositivity was inversely correlated with age; 3−5 years 85.3%, 6−9 years 72.5%, 10−14 years 50.7%, and 15−18 years 56.3%. Adolescents aged 10−18 years had a lower measles seropositivity rate compared with young children; aOR 0.29 (95% CI 0.17−0.48). Only half of the adolescents who received two doses of measles-containing vaccine maintained measles IgG above the seropositive level. A measles booster dose for young adults may be needed to achieve the measles elimination goal.
Collapse
Affiliation(s)
- Thanyawee Puthanakit
- Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok 10330, Thailand
| | - Suvaporn Anugulruengkitt
- Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok 10330, Thailand
| | | | - Pornumpa Bunjoungmanee
- Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani 12120, Thailand
| | - Ekasit Kowitdamrong
- Division of Virology, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Athiwat Primsirikunawut
- National Institute of Thailand, Department of Medical Sciences, Ministry of Public Health, Nonthaburi 11000, Thailand
| | - Sukkrawan Intarakhao
- Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani 12120, Thailand
| | - Panadda Chetsonwisorn
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok 10330, Thailand
| | - Jiratchaya Sophonphan
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Chulalongkorn University, Bangkok 10330, Thailand
| | - Auchara Tangsathapornpong
- Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani 12120, Thailand
| |
Collapse
|
6
|
Fappani C, Gori M, Canuti M, Terraneo M, Colzani D, Tanzi E, Amendola A, Bianchi S. Breakthrough Infections: A Challenge towards Measles Elimination? Microorganisms 2022; 10:microorganisms10081567. [PMID: 36013985 PMCID: PMC9413104 DOI: 10.3390/microorganisms10081567] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 07/29/2022] [Accepted: 08/02/2022] [Indexed: 12/04/2022] Open
Abstract
Measles is one of the most contagious diseases known to man. Despite the existence of a safe and effective live attenuated vaccine, measles can appear in vaccinated individuals. Paradoxically, breakthrough cases increase as vaccination coverage in the general population rises. In measles endemic areas, breakthrough cases represent less than 10% of total infections, while in areas with high vaccination coverage these are over 10% of the total. Two different vaccination failures have been described: primary vaccination failure, which consists in the complete absence of humoral response and occurs in around 5% of vaccinated individuals; and secondary vaccination failure is due to waning immunity or incomplete immunity and occurs in 2–10% of vaccinees. Vaccination failures are generally associated with lower viral loads and milder disease (modified measles) since vaccination limits the risk of complicated disease. Vaccination failure seems to occur between six and twenty-six years after the last vaccine dose administration. This review summarizes the literature about clinical, serological, epidemiological, and molecular characteristics of measles breakthrough cases and their contribution to virus transmission. In view of the measles elimination goal, the assessment of the potential decline in antibody protection and the targeted implementation of catch-up vaccination are essential.
Collapse
Affiliation(s)
- Clara Fappani
- Department of Health Sciences, Università degli Studi di Milano, 20146 Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Maria Gori
- Department of Health Sciences, Università degli Studi di Milano, 20146 Milan, Italy
| | - Marta Canuti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milan, Italy
| | - Mara Terraneo
- Department of Health Sciences, Università degli Studi di Milano, 20146 Milan, Italy
| | - Daniela Colzani
- Department of Health Sciences, Università degli Studi di Milano, 20146 Milan, Italy
| | - Elisabetta Tanzi
- Department of Health Sciences, Università degli Studi di Milano, 20146 Milan, Italy
- Coordinated Research Center “EpiSoMI”, Università degli Studi di Milano, 20133 Milan, Italy
| | - Antonella Amendola
- Department of Health Sciences, Università degli Studi di Milano, 20146 Milan, Italy
- Coordinated Research Center “EpiSoMI”, Università degli Studi di Milano, 20133 Milan, Italy
- Correspondence: (A.A.); (S.B.)
| | - Silvia Bianchi
- Department of Health Sciences, Università degli Studi di Milano, 20146 Milan, Italy
- Correspondence: (A.A.); (S.B.)
| |
Collapse
|
7
|
Paret M, Trillo R, Lighter J, Youngster I, Ratner AJ, Pellett Madan R. Poor Uptake of MMR Vaccine 1-year Post-Measles Outbreak: New York City and Israel. J Pediatric Infect Dis Soc 2022; 11:322-328. [PMID: 35477779 DOI: 10.1093/jpids/piac026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 03/24/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND In 2018-2019, large outbreaks of measles occurred in Israel and in New York City, driven in part by travel of unimmunized children between the 2 communities. METHODS A retrospective chart review was conducted for children tested for measles (March 2018-September 2019) at NYU Langone Health in New York, NY, and in Ramla subdistrict, Israel. Vaccination records were reviewed to determine vaccination status for measles, mumps, and rubella (MMR) at the time of measles testing and 1-year post-testing. RESULTS A total of 264 children were tested for measles, and 102 (38.6%) had confirmed measles. Only 20 (19.6%) of measles-positive cases received a full 2-dose course of vitamin A. 82.4% of children with measles were ≥1 year at the time of diagnosis and fully eligible for MMR vaccine. Of the 100 measles-positive cases with available vaccine records, 63 were unvaccinated at testing, and 27 remained unimmunized against MMR 1 year later. At testing, measles-negative children were significantly more likely to have received MMR than measles-positive children (65.4% vs 37%, P < .01). One year later, 70.4% of measles-negative cases and only 57.1% of measles-positive cases had received MMR vaccine (P = .18). CONCLUSIONS The majority of measles cases occurred in unimmunized children eligible for vaccination, and >25% of children in both measles-positive and -negative groups remained unimmunized for MMR 1-year post-outbreak. Our results suggest the need for novel, longitudinal vaccination strategies and increased awareness of the role of vitamin A.
Collapse
Affiliation(s)
- Michal Paret
- Department of Pediatrics, Division of Pediatric Infectious Diseases, New York University Grossman School of Medicine, New York, New York, USA
| | - Rebecca Trillo
- New York University Grossman School of Medicine, New York, New York, USA
| | - Jennifer Lighter
- Department of Pediatrics, Division of Pediatric Infectious Diseases, New York University Grossman School of Medicine, New York, New York, USA
| | - Ilan Youngster
- The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adam J Ratner
- Department of Pediatrics, Division of Pediatric Infectious Diseases, New York University Grossman School of Medicine, New York, New York, USA
| | - Rebecca Pellett Madan
- Department of Pediatrics, Division of Pediatric Infectious Diseases, New York University Grossman School of Medicine, New York, New York, USA
| |
Collapse
|
8
|
Sanz JC, Ramos B, Pérez-Olmeda M, Fernández-García A. Reply to "Modified measles outbreak in vaccinated healthcare workers exposed to primary measles case". ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:344-345. [PMID: 35491354 DOI: 10.1016/j.eimce.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 11/17/2021] [Accepted: 11/26/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Juan Carlos Sanz
- Laboratorio Regional de Salud Pública de la Comunidad de Madrid, Dirección General de Salud Pública, Consejería de Sanidad Comunidad de Madrid, Madrid, Spain; Consorcio de Investigación Biomédica de Epidemiología y Salud Pública (CIBERESP), Spain.
| | - Belén Ramos
- Laboratorio Regional de Salud Pública de la Comunidad de Madrid, Dirección General de Salud Pública, Consejería de Sanidad Comunidad de Madrid, Madrid, Spain
| | - Mayte Pérez-Olmeda
- Laboratorio de Referencia e Investigación en Enfermedades Víricas Inmunoprevenibles, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Aurora Fernández-García
- Consorcio de Investigación Biomédica de Epidemiología y Salud Pública (CIBERESP), Spain; Laboratorio de Referencia e Investigación en Enfermedades Víricas Inmunoprevenibles, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|
9
|
Sanz JC, Ramos B, Pérez-Olmeda M, Fernández-García A. Réplica a «Brote de sarampión-modificado en personal sanitario tras exposición a un caso de sarampión clásico». Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
10
|
Characterization of Vaccine Breakthrough Cases during Measles Outbreaks in Milan and Surrounding Areas, Italy, 2017–2021. Viruses 2022; 14:v14051068. [PMID: 35632809 PMCID: PMC9147195 DOI: 10.3390/v14051068] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/13/2022] [Accepted: 05/13/2022] [Indexed: 02/04/2023] Open
Abstract
Despite the existence of an effective live-attenuated vaccine, measles can appear in vaccinated individuals. We investigated breakthrough measles cases identified during our surveillance activities within the measles/rubella surveillance network (MoRoNet) in Milan and surrounding areas (Northern Italy). Between 2017 and 2021, we confirmed measles virus (genotypes B3 or D8) infections in 653 patients and 51 of these (7.8%) were vaccinees. Among vaccinated individuals whose serum was available, a secondary failure was evidenced in 69.4% (25/36) of cases while 11 patients (30.6%) were non-responders. Non-responders were more frequently hospitalized and had significantly lower Ct values in both respiratory and urine samples. Median age and time since the last immunization were similar in the two groups. Importantly, we identified onward transmissions from vaccine failure cases. Vaccinees were involved in 20 outbreaks, in 10 of them they were able to transmit the virus, and in 8 of them, they were the index case. Comparing viral hemagglutinin sequences from vaccinated and non-vaccinated subjects did not show a specific mutation pattern. These results suggest that vaccination failure was likely due to the poor immune response of single individuals and highlights the importance of identifying breakthrough cases and characterizing their clinical and virologic profiles.
Collapse
|
11
|
Ang LW, Gao Q, Cui L, Farwin A, Toh MPHS, Boudville IC, Chen MIC, Chow A, Lin RTP, Lee VJM, Leo YS. Prevalence of measles antibodies among migrant workers in Singapore: a serological study to identify susceptible population subgroups. BMC Infect Dis 2022; 22:88. [PMID: 35078426 PMCID: PMC8787927 DOI: 10.1186/s12879-022-07066-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 01/13/2022] [Indexed: 11/20/2022] Open
Abstract
Background In 2019, two clusters of measles cases were reported in migrant worker dormitories in Singapore. We conducted a seroprevalence study to measure the level of susceptibility to measles among migrant workers in Singapore. Methods Our study involved residual sera of migrant workers from seven Asian countries (Bangladesh, China, India, Indonesia, Malaysia, Myanmar and the Philippines) who had participated in a survey between 2016 and 2019. Immunoglobulin G (IgG) antibody levels were first measured using a commercial enzyme-linked immunosorbent assay (ELISA) test kit. Those with equivocal or negative IgG results were further evaluated using plaque reduction neutralization test (PRNT). Results A total of 2234 migrant workers aged 20–49 years were included in the study. The overall prevalence of measles IgG antibodies among migrant workers from the seven Asian countries was 90.5% (95% confidence interval 89.2–91.6%). The country-specific seroprevalence ranged from 80.3 to 94.0%. The seroprevalence was significantly higher among migrant workers born in 1965–1989 than those born in 1990–1999 (95.3% vs. 86.6%, p < 0.0005), whereas there was no significant difference by gender (90.8% in men vs. 89.9% in women, p = 0.508). 195 out of 213 samples with equivocal or negative ELISA results were tested positive using PRNT. Conclusion The IgG seroprevalence in migrant workers was below the herd immunity threshold of 95% for measles. Sporadic outbreaks may occur in susceptible individuals due to high transmissibility of measles virus. Seroprevalence surveys can help identify susceptible subgroups for vaccination. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07066-2.
Collapse
Affiliation(s)
- Li Wei Ang
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore, 308442, Singapore. .,Public Health Group, Ministry of Health, Singapore, Singapore.
| | - Qi Gao
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore, 308442, Singapore
| | - Lin Cui
- National Public Health Laboratory, National Centre for Infectious Diseases, Singapore, Singapore
| | - Aysha Farwin
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore, 308442, Singapore
| | - Matthias Paul Han Sim Toh
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore, 308442, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Irving Charles Boudville
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore, 308442, Singapore
| | - Mark I-Cheng Chen
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore, 308442, Singapore.,Public Health Group, Ministry of Health, Singapore, Singapore
| | - Angela Chow
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore, 308442, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore, Singapore
| | - Raymond Tzer-Pin Lin
- National Public Health Laboratory, National Centre for Infectious Diseases, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Laboratory Medicine, National University Hospital, National University Health System, Singapore, Singapore
| | - Vernon Jian Ming Lee
- Public Health Group, Ministry of Health, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Yee Sin Leo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,National Centre for Infectious Diseases, Singapore, Singapore.,Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore
| |
Collapse
|
12
|
Measles in Spain at the elimination phase: The enemy knocking on the door. Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
13
|
Probert WS, Glenn-Finer R, Espinosa A, Yen C, Stockman L, Harriman K, Hacker JK. Molecular Epidemiology of Measles in California, United States-2019. J Infect Dis 2021; 224:1015-1023. [PMID: 33528506 DOI: 10.1093/infdis/jiab059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/26/2021] [Indexed: 11/13/2022] Open
Abstract
In 2019, the United States (US) experienced the highest number of measles importations and cases in the postelimination era. More than a quarter of imported cases entered the US through California. Measles surveillance efforts in California resulted in the identification of 26 importations, 6 outbreaks, and 72 cases in 2019. Only genotype B3 and D8 measles strains were detected. Genotype-specific differences were noted in the incidence of vaccine failures, hospitalizations, and severe complications among cases. A targeted whole genome sequencing approach provided higher-resolution discrimination between epidemiologically linked and sporadically introduced strains than conventional N450 sequencing. Our report underscores the importance of ensuring appropriate measles vaccination status, especially prior to international travel to measles-endemic regions, and highlights the value of a strong measles surveillance system in minimizing outbreaks and preserving measles elimination status in the US.
Collapse
Affiliation(s)
- William S Probert
- Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, California, USA
| | - Rosie Glenn-Finer
- Immunization Branch, California Department of Public Health, Richmond, California, USA
| | - Alex Espinosa
- Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, California, USA
| | - Cynthia Yen
- Immunization Branch, California Department of Public Health, Richmond, California, USA
| | - Lauren Stockman
- Immunization Branch, California Department of Public Health, Richmond, California, USA
| | - Kathleen Harriman
- Immunization Branch, California Department of Public Health, Richmond, California, USA
| | - Jill K Hacker
- Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, California, USA
| |
Collapse
|
14
|
Jaafar R, Zandotti C, Grimaldier C, Etoundi M, Kadri I, Boschi C, Jardot P, Colson P, Raoult D, La Scola B, Aherfi S. Epidemiological and genetic characterization of measles virus circulating strains at Marseille, France during 2017-2019 measles outbreak. J Infect 2021; 83:361-370. [PMID: 34310945 DOI: 10.1016/j.jinf.2021.07.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 07/01/2021] [Accepted: 07/15/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES We attempted to establish a molecular investigation by Next Generation sequencing of the measles virus (MeV) strains circulating in Marseille-France during the last outbreak that occurred between 2017 and 2019. METHODS The circulating MeV were isolated from clinical samples using cell culture method and whole genomes were sequenced by Illumina Miseq Next Generation. Genotyping and comparative analyses were assessed by phylogenetic reconstructions. Clinical and epidemiological data from cases were also recorded. RESULTS A total of 110 MeV strains were isolated in cell culture. Our analysis based on whole genome sequences of 98 isolates confirmed that 93 strains belonged to the genotype D8 and 5 to the genotype B3. Phylogenetic analyses revealed 4 distinct MeV circulating clones in Marseille. Measles mostly occured in children < 5 years-old and in adults 30-50 years-old. Measles infection also occurred in 2 adequately vaccinated cases (2 doses). Among 63 measles cases of whom we had available clinical data informations, a total of 35 patients were hospitalized and 19 developed complications including one death case recorded. CONCLUSIONS Whole Genome Sequencing seems to be a useful tool for more refined genomic characterization of large measles outbreak. Vaccination strategies for measles eradication need to be re-evaluated in the current context.
Collapse
Affiliation(s)
- Rita Jaafar
- IHU Méditerranée Infection, 19-21 Boulevard Jean Moulin, Marseille 13005, France; MEPHI, Institut de Recherche pour le Développement (IRD), Aix-Marseille Universite, Marseille, France
| | - Christine Zandotti
- IHU Méditerranée Infection, 19-21 Boulevard Jean Moulin, Marseille 13005, France; Assistance Publique - Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Clio Grimaldier
- IHU Méditerranée Infection, 19-21 Boulevard Jean Moulin, Marseille 13005, France; Assistance Publique - Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Maëlia Etoundi
- Assistance Publique - Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Ines Kadri
- IHU Méditerranée Infection, 19-21 Boulevard Jean Moulin, Marseille 13005, France; Assistance Publique - Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Celine Boschi
- IHU Méditerranée Infection, 19-21 Boulevard Jean Moulin, Marseille 13005, France; MEPHI, Institut de Recherche pour le Développement (IRD), Aix-Marseille Universite, Marseille, France; Assistance Publique - Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Priscilla Jardot
- IHU Méditerranée Infection, 19-21 Boulevard Jean Moulin, Marseille 13005, France; Assistance Publique - Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Philippe Colson
- IHU Méditerranée Infection, 19-21 Boulevard Jean Moulin, Marseille 13005, France; MEPHI, Institut de Recherche pour le Développement (IRD), Aix-Marseille Universite, Marseille, France; Assistance Publique - Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Didier Raoult
- IHU Méditerranée Infection, 19-21 Boulevard Jean Moulin, Marseille 13005, France; MEPHI, Institut de Recherche pour le Développement (IRD), Aix-Marseille Universite, Marseille, France; Assistance Publique - Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Bernard La Scola
- IHU Méditerranée Infection, 19-21 Boulevard Jean Moulin, Marseille 13005, France; MEPHI, Institut de Recherche pour le Développement (IRD), Aix-Marseille Universite, Marseille, France; Assistance Publique - Hôpitaux de Marseille (AP-HM), Marseille, France.
| | - Sarah Aherfi
- IHU Méditerranée Infection, 19-21 Boulevard Jean Moulin, Marseille 13005, France; MEPHI, Institut de Recherche pour le Développement (IRD), Aix-Marseille Universite, Marseille, France; Assistance Publique - Hôpitaux de Marseille (AP-HM), Marseille, France.
| |
Collapse
|
15
|
Joshi D, Gala RP, Uddin MN, D'Souza MJ. Novel ablative laser mediated transdermal immunization for microparticulate measles vaccine. Int J Pharm 2021; 606:120882. [PMID: 34298102 DOI: 10.1016/j.ijpharm.2021.120882] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/03/2021] [Accepted: 07/11/2021] [Indexed: 12/20/2022]
Abstract
With the need for safe and efficacious vaccines which could be administered via non-invasive procedure, alternatives to traditional injectables vaccines are sought after. The present study aimed to develop the microparticulate formulation of measles vaccine and explore the feasibility of transdermal delivery via ablative laser mediated skin microporation. Transdermal route offers several advantages including painless immunization and ease of administration. We propose to use P.L.E.A.S.E. ablative laser for transdermal immunization of the microparticulate measles vaccine. This laser emits energy at 2940 µm, enabling cold ablation. This creates the micropores of defined size for delivery of vaccines into the skin. We compared the efficacy of transdermal immunization using the particulate formulation of the vaccine to that of traditional subcutaneous immunization using soluble and particulate vaccine. The microparticles were formulated using the biocompatible and biodegradable bovine serum albumin (BSA)-based polymer matrix. These vaccine microparticles were non-cytotoxic to the antigen presenting cells (APCs) and could effectively stimulate the innate immune response, confirmed by release of nitric oxide (NO) from the Griess's assay. The APCs when exposed to vaccine microparticles also showed a significantly higher expression of antigen-presenting molecules, MHC I and MHC II, and their co-stimulatory molecules, CD80 and CD40 as compared to the blank microparticles. The microparticulate measles vaccine was evaluated in vivo in the murine model. We compared the serum IgG and IgM levels in the mice receiving the vaccine subcutaneously and transdermally post-immunization. The results revealed that transdermal immunization with microparticulate vaccine is as efficient as the traditional subcutaneous administration.
Collapse
Affiliation(s)
- Devyani Joshi
- Center for Drug Delivery Research, Vaccine Nanotechnology Laboratory, College of Pharmacy, Mercer University, Atlanta, GA 30341, United States
| | - Rikhav P Gala
- Fraunhofer USA, Center Mid-Atlantic, Biotechnology Division, Newark, DE 19702, United States
| | - Mohammad N Uddin
- Center for Drug Delivery Research, Vaccine Nanotechnology Laboratory, College of Pharmacy, Mercer University, Atlanta, GA 30341, United States
| | - Martin J D'Souza
- Center for Drug Delivery Research, Vaccine Nanotechnology Laboratory, College of Pharmacy, Mercer University, Atlanta, GA 30341, United States.
| |
Collapse
|
16
|
Kauffmann F, Heffernan C, Meurice F, Ota MOC, Vetter V, Casabona G. Measles, mumps, rubella prevention: how can we do better? Expert Rev Vaccines 2021; 20:811-826. [PMID: 34096442 DOI: 10.1080/14760584.2021.1927722] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Measles, mumps, and rubella incidence decreased drastically following vaccination programs' implementation. However, measles and mumps' resurgence was recently reported, outbreaks still occur, and challenges remain to control these diseases. AREAS COVERED This qualitative narrative review provides an objective appraisal of the literature regarding current challenges in controlling measles, mumps, rubella infections, and interventions to address them. EXPERT OPINION While vaccines against measles, mumps, and rubella (including trivalent vaccines) are widely used and effective, challenges to control these diseases are mainly related to insufficient immunization coverage and changing vaccination needs owing to new global environment (e.g. traveling, migration, population density). By understanding disease transmission peculiarities by setting, initiatives are needed to optimize vaccination policies and increase vaccination coverage, which was further negatively impacted by COVID-19 pandemic. Also, awareness of the potential severity of infections and the role of vaccines should increase. Reminder systems, vaccination of disadvantaged, high-risk and difficult-to-reach populations, accessibility of vaccination, healthcare infrastructure, and vaccination services management should improve. Outbreak preparedness should be strengthened, including implementation of high-quality surveillance systems to monitor epidemiology. While the main focus should be on these public health initiatives to increase vaccination coverage, slightly more benefits could come from evolution of current vaccines.
Collapse
Affiliation(s)
| | - Catherine Heffernan
- NHS England (London Region), 1st Floor, Wellington House, 133-155 Waterloo Road, London, SE16UG, UK
| | - François Meurice
- GSK, Avenue Fleming 20, 1300 Wavre, Belgium.,Biomedical Sciences Department, Faculty of Medicine, University of Namur (UNamur), Rue de Bruxelles 61, 5000 Namur, Belgium
| | | | | | | |
Collapse
|
17
|
Bianchi S, Canuti M, Ciceri G, Gori M, Colzani D, Dura M, Pennati BM, Baggieri M, Magurano F, Tanzi E, Amendola A. Molecular Epidemiology of B3 and D8 Measles Viruses through Hemagglutinin Phylogenetic History. Int J Mol Sci 2020; 21:ijms21124435. [PMID: 32580384 PMCID: PMC7352894 DOI: 10.3390/ijms21124435] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 01/15/2023] Open
Abstract
Of the 24 known measles genotypes, only D8 and B3 are responsible for outbreaks in the last years in Europe, Asia, and America. In this study the H gene of 92 strains circulating between 2015 and 2019 in Lombardy, Northern Italy, and 1273 H sequences available in GenBank were analyzed in order to evaluate the genetic variability and to assess the conservation of the immunodominant sites. Overall, in Lombardy we observed the presence of four different B3 and three different D8 clusters, each one of them including sequences derived from viruses found in both vaccinated and unvaccinated subjects. Worldwide, the residue 400 within the H protein, a position located within the main immune epitope, is mutated in all circulating strains that belong to the two globally endemic genotypes, B3 and D8. Our data demonstrate the usefulness of measles virus (MV) H gene sequencing. Indeed, the monitoring the H protein epitopes of circulating strains could be included in the measles laboratory surveillance activities in order to improve and optimize strategies for measles control, as countries go towards elimination phase.
Collapse
Affiliation(s)
- Silvia Bianchi
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy; (S.B.); (G.C.); (M.G.); (D.C.); (M.D.); (B.M.P.); (A.A.)
| | - Marta Canuti
- Department of Biology, Memorial University of Newfoundland, 232 Elizabeth Ave., St. John’s, NL A1B 3X9, Canada;
| | - Giulia Ciceri
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy; (S.B.); (G.C.); (M.G.); (D.C.); (M.D.); (B.M.P.); (A.A.)
| | - Maria Gori
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy; (S.B.); (G.C.); (M.G.); (D.C.); (M.D.); (B.M.P.); (A.A.)
| | - Daniela Colzani
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy; (S.B.); (G.C.); (M.G.); (D.C.); (M.D.); (B.M.P.); (A.A.)
| | - Marco Dura
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy; (S.B.); (G.C.); (M.G.); (D.C.); (M.D.); (B.M.P.); (A.A.)
| | - Beatrice Marina Pennati
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy; (S.B.); (G.C.); (M.G.); (D.C.); (M.D.); (B.M.P.); (A.A.)
| | - Melissa Baggieri
- Department of Infectious Diseases, National Reference Laboratory for Measles and Rubella, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Rome, Italy; (M.B.); (F.M.)
| | - Fabio Magurano
- Department of Infectious Diseases, National Reference Laboratory for Measles and Rubella, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Rome, Italy; (M.B.); (F.M.)
| | - Elisabetta Tanzi
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy; (S.B.); (G.C.); (M.G.); (D.C.); (M.D.); (B.M.P.); (A.A.)
- Coordinated Research Center “EpiSoMI”, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy
- Correspondence:
| | - Antonella Amendola
- Department of Biomedical Sciences for Health, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy; (S.B.); (G.C.); (M.G.); (D.C.); (M.D.); (B.M.P.); (A.A.)
- Coordinated Research Center “EpiSoMI”, University of Milan, via Carlo Pascal 36, 20133 Milan, Italy
| |
Collapse
|
18
|
Yang L, Grenfell BT, Mina MJ. Measles vaccine immune escape: Should we be concerned? Eur J Epidemiol 2019; 34:893-896. [PMID: 31676977 DOI: 10.1007/s10654-019-00574-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 10/26/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Luojun Yang
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
| | - Bryan T Grenfell
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA.,Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Michael J Mina
- Center for Communicable Disease Dynamics, Department of Epidemiology, Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA, USA. .,Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| |
Collapse
|