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Evans I, Jury S, Morrison A, Best E, King V, Reynolds E. Onward transmission of measles virus among vaccinated cases in a large community outbreak in Auckland, New Zealand, 2019. Vaccine 2024; 42:126257. [PMID: 39191179 DOI: 10.1016/j.vaccine.2024.126257] [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] [Received: 03/26/2024] [Revised: 08/09/2024] [Accepted: 08/20/2024] [Indexed: 08/29/2024]
Abstract
BACKGROUND Isolation of cases and quarantining of non-immune contacts are the mainstay of measles outbreak management in elimination settings. Serology testing of exposed contacts may not be feasible in large outbreaks; therefore, vaccination history is used as a proxy for determining immunity to measles and thus prevention of onward virus transmission. This study sought to investigate the risk of measles virus transmission from individuals with a history of one or two doses of measles-containing vaccine (MCV). METHODS Retrospective analysis of data from measles cases reported to Auckland Regional Public Health Service during the 2019 Auckland region measles outbreak. Vaccination history was verified using patient records and the New Zealand National Immunisation Register. Onward transmission was determined through case interviews and assessment of exposed contacts. RESULTS 1451 measles cases were assessed as eligible for vaccination at the time of measles outbreak. Of these, 1015 (70.0%) were unvaccinated, 220 (15.2%) had unknown vaccination status, 139 (9.6%) had received only one dose of MCV and 77 (5.3%) had received two doses of the vaccine. Compared to unvaccinated cases, the odds of onward transmission were lower among those with one dose only (OR 0.41, 95% CI: 0.20-0.75) or two doses of MCV (OR 0.44, 95% CI: 0.17-0.95). Median time since vaccination was longer among those with onward transmission compared to those without onward transmission for one and two doses of the vaccine, suggesting a potential effect of waning immunity among this cohort. CONCLUSION These findings support the hypothesis that measles cases with a history of prior vaccination are less likely to transmit the virus to others compared to unvaccinated cases. Such information can be used to support decisions around quarantine requirements for vaccinated contacts in future measles outbreaks.
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Affiliation(s)
- Imogen Evans
- Auckland Regional Public Health Service, Health New Zealand - Te Whatu Ora Te Toka Tumai Auckland, New Zealand.
| | - Sheryl Jury
- Auckland Regional Public Health Service, Health New Zealand - Te Whatu Ora Te Toka Tumai Auckland, New Zealand
| | - Anne Morrison
- Auckland Regional Public Health Service, Health New Zealand - Te Whatu Ora Te Toka Tumai Auckland, New Zealand
| | - Emma Best
- Department of Paediatrics: Child and Youth Health, The University of Auckland, New Zealand
| | - Victoria King
- Department of Paediatrics: Child and Youth Health, The University of Auckland, New Zealand
| | - Edwin Reynolds
- Auckland Regional Public Health Service, Health New Zealand - Te Whatu Ora Te Toka Tumai Auckland, New Zealand
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2
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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.
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3
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Dor E, Fluss R, Israel A, Huppert A. Quantifying the long-term effects of measles infection-a retrospective cohort study. Clin Microbiol Infect 2024:S1198-743X(24)00393-8. [PMID: 39142629 DOI: 10.1016/j.cmi.2024.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 08/05/2024] [Accepted: 08/07/2024] [Indexed: 08/16/2024]
Abstract
OBJECTIVES To assess whether measles infection has an impact on the rate of non-measles infectious diseases over an extended period. METHODS This retrospective matched cohort study included 532 measles-diagnosed patients who were exactly matched with 2128 individuals without a previous measles diagnosis. Adjusted OR for any all-cause infectious diagnosis and any viral infection diagnosis ≤2 years after measles diagnosis between the measles and control groups was obtained from a conditional logistic regression model. The Cox proportional hazards model was used to estimate the hazard ratio. RESULTS Previous measles virus (MeV) exposure was associated with an increased risk for all-cause non-measles infectious disease diagnosis (OR: 1.83, 95% CI: 1.26-2.64, p 0.001), with 492 diagnoses in the MeV-exposed group and 1868 diagnoses in the control group. Additionally, previous MeV exposure was linked to a higher risk of viral infection diagnosis (OR: 1.23, 95% CI: 1.01-1.59, p < 0.05), with 302 viral infection diagnoses in the MeV-exposed group and 1107 diagnoses in the control group. The hazard ratio for viral diagnosis in the MeV-exposed group compared with the control group was 1.54 (95% CI: 1.18-2.02, p < 0.001). DISCUSSION Individuals diagnosed with measles had a moderately increased risk of being diagnosed with all-cause non-measles infectious disease or viral infection. This observational individual-level study supports previous ecological and individual population-level studies.
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Affiliation(s)
- Ella Dor
- The Bio-statistical and Bio-mathematical Unit, The Gertner Institute for Epidemiology and Health Policy, Tel Hashomer, Israel; Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Ronen Fluss
- The Bio-statistical and Bio-mathematical Unit, The Gertner Institute for Epidemiology and Health Policy, Tel Hashomer, Israel
| | - Ariel Israel
- Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Leumit Research Institue, Leumit Health Services, Tel Aviv, Israel
| | - Amit Huppert
- The Bio-statistical and Bio-mathematical Unit, The Gertner Institute for Epidemiology and Health Policy, Tel Hashomer, Israel; Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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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.
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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.)
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Sheffer R, Bucris E, Amitai Z, Indenbaum V, Lustig Y, Savion M, Nuss N, Roee Singer S, Alroy Preis S, Almagor S, Leshem E, Salama M. Measles outbreak associated with a preschool setting among partially vaccinated children in the Tel Aviv District, Israel, October 2023. Vaccine 2024; 42:3153-3156. [PMID: 38627149 DOI: 10.1016/j.vaccine.2024.04.013] [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] [Received: 01/07/2024] [Revised: 03/07/2024] [Accepted: 04/04/2024] [Indexed: 04/29/2024]
Abstract
In October 2023, the Tel Aviv District was notified of ten cases of measles. The outbreak initiated in a preschool with high vaccination coverage with one dose of MMR vaccine. Serological testing was available for eight patients (six children and two adults). Among the six children vaccinated with one dose of MMR vaccine, primary vaccine failure was demonstrated. Among the adults, secondary vaccine failure was confirmed. The outbreak was successfully contained due to a combination of factors, notably its occurrence within a population characterized by high vaccination coverage in Tel Aviv, during a period of restricted public interactions due to the prevailing state of war in the country. Despite challenging wartime conditions, effective prophylactic measures were promptly executed, encompassing a 2-dose MMR vaccination schedule for close contacts and the broader community of children in the TA district, successfully curbing the outbreak and preventing widespread infections.
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Affiliation(s)
- Rivka Sheffer
- Tel Aviv District Health Office, Ministry of Health, Israel
| | - Efrat Bucris
- Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5266202, Israel
| | - Ziva Amitai
- Tel Aviv District Health Office, Ministry of Health, Israel
| | - Victoria Indenbaum
- Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5266202, Israel
| | - Yaniv Lustig
- Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 5266202, Israel; School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Savion
- Tel Aviv District Health Office, Ministry of Health, Israel
| | - Naama Nuss
- Tel Aviv District Health Office, Ministry of Health, Israel
| | - Shepherd Roee Singer
- Israel Ministry of Health, Jerusalem, Israel; Hadassah/Hebrew University Braun School of Public Health, Israel
| | | | - Sharon Almagor
- Tel Aviv District Health Office, Ministry of Health, Israel
| | - Eyal Leshem
- School of Medicine, Tel Aviv University, Tel Aviv, Israel; Division of Infectious Diseases, Chaim Sheba Medical Center, Ramat Gan 5266202, Israel
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Choi S, Chung JW, Chang YJ, Lim EJ, Moon SH, Do HH, Lee JH, Cho SM, Kwon BS, Chung YS, Park SY. A Lesson from a Measles Outbreak among Healthcare Workers in a Single Hospital in South Korea: The Importance of Knowing the Prevalence of Susceptibility. Vaccines (Basel) 2023; 11:1505. [PMID: 37766181 PMCID: PMC10535736 DOI: 10.3390/vaccines11091505] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Despite the high vaccination coverage rate, in-hospital transmission of measles continues to occur in South Korea. We present a measles outbreak in which two healthcare workers (HCWs) with presumptive evidence of measles immunity were infected by a patient with typical measles at a single hospital in South Korea. This facilitated the evaluation of measles seroprevalence in all HCWs. METHODS In 2018, suspected patients and contacts exposed during a measles outbreak were investigated based on their medical histories and vaccination status. Cases were confirmed by the detection of measles-specific immunoglobulin M or RNA. After the measles outbreak in 2018, measles IgG testing was conducted on a total of 972 HCWs for point-prevalence, including those exposed to the measles. In addition, we have routinely performed measles IgG tests on newly employed HCWs within one week of their hire date since 2019. The measles vaccine was administered to HCWs who tested negative or equivocally negative for IgG antibodies. RESULTS An index patient who returned from China with fever and rash was diagnosed with measles at a hospital in Korea. Two additional HCWs were revealed as measles cases: one was vaccinated with the two-dose measles-mumps-rubella (MMR) vaccine, and the other, who was born in 1967, was presumed to have immunity from natural infection in South Korea. All three patients harbored the same D8 genotype. No additional measles cases were identified among the 964 contacts of secondary patients. A total of 2310 HCWs, including those tested during the 2018 outbreak, underwent measles IgG tests. The average age at the time of the test was 32.6 years, and 74.3% were female. The overall seropositivity of measles was 88.9% (95% confidence interval, 87.5-90.1). Although the birth cohorts between 1985 and 1994 were presumed to have received the measles-rubella (MR) catch-up vaccination in 2001, 175 (89.3%) HCWs were born after 1985 among the 195 seronegative cases. CONCLUSION Despite high population immunity, imported measles transmission occurred among HCWs with presumed immunity. This report underscores the importance of understanding the prevalence of measles susceptibility among newly employed HCWs. This is important for policymaking regarding hospital-wide vaccinations to prevent the spread of vaccine-preventable diseases.
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Affiliation(s)
- Sungim Choi
- Department of Infectious Diseases, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea;
- Department of Infection Control, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
| | - Jae-Woo Chung
- Department of Infection Control, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
- Department of Laboratory Medicine, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
| | - Yun Jung Chang
- Department of Infection Control, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
| | - Eun Jung Lim
- Department of Infection Control, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
| | - Sun Hee Moon
- Department of Infection Control, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
| | - Han Ho Do
- Department of Emergency Medicine, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
| | - Jeong Hun Lee
- Department of Emergency Medicine, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
| | - Sung-Min Cho
- Department of Pediatrics, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
| | - Bum Sun Kwon
- Department of Rehabilitation Medicine, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
| | - Yoon-Seok Chung
- Division of Infectious Disease Diagnosis Control, Honam Regional Center for Disease Control and Prevention, Korea Disease Control and Prevention Agency, Gwangju 61947, Gyeonggi-do, Republic of Korea
| | - Seong Yeon Park
- Department of Infectious Diseases, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea;
- Department of Infection Control, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang-si 10326, Gyeonggi-do, Republic of Korea
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Biselli R, Nisini R, Lista F, Autore A, Lastilla M, De Lorenzo G, Peragallo MS, Stroffolini T, D’Amelio R. A Historical Review of Military Medical Strategies for Fighting Infectious Diseases: From Battlefields to Global Health. Biomedicines 2022; 10:2050. [PMID: 36009598 PMCID: PMC9405556 DOI: 10.3390/biomedicines10082050] [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: 07/27/2022] [Revised: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 11/17/2022] Open
Abstract
The environmental conditions generated by war and characterized by poverty, undernutrition, stress, difficult access to safe water and food as well as lack of environmental and personal hygiene favor the spread of many infectious diseases. Epidemic typhus, plague, malaria, cholera, typhoid fever, hepatitis, tetanus, and smallpox have nearly constantly accompanied wars, frequently deeply conditioning the outcome of battles/wars more than weapons and military strategy. At the end of the nineteenth century, with the birth of bacteriology, military medical researchers in Germany, the United Kingdom, and France were active in discovering the etiological agents of some diseases and in developing preventive vaccines. Emil von Behring, Ronald Ross and Charles Laveran, who were or served as military physicians, won the first, the second, and the seventh Nobel Prize for Physiology or Medicine for discovering passive anti-diphtheria/tetanus immunotherapy and for identifying mosquito Anopheline as a malaria vector and plasmodium as its etiological agent, respectively. Meanwhile, Major Walter Reed in the United States of America discovered the mosquito vector of yellow fever, thus paving the way for its prevention by vector control. In this work, the military relevance of some vaccine-preventable and non-vaccine-preventable infectious diseases, as well as of biological weapons, and the military contributions to their control will be described. Currently, the civil-military medical collaboration is getting closer and becoming interdependent, from research and development for the prevention of infectious diseases to disasters and emergencies management, as recently demonstrated in Ebola and Zika outbreaks and the COVID-19 pandemic, even with the high biocontainment aeromedical evacuation, in a sort of global health diplomacy.
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Affiliation(s)
- Roberto Biselli
- Ispettorato Generale della Sanità Militare, Stato Maggiore della Difesa, Via S. Stefano Rotondo 4, 00184 Roma, Italy
| | - Roberto Nisini
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy
| | - Florigio Lista
- Dipartimento Scientifico, Policlinico Militare, Comando Logistico dell’Esercito, Via S. Stefano Rotondo 4, 00184 Roma, Italy
| | - Alberto Autore
- Osservatorio Epidemiologico della Difesa, Ispettorato Generale della Sanità Militare, Stato Maggiore della Difesa, Via S. Stefano Rotondo 4, 00184 Roma, Italy
| | - Marco Lastilla
- Istituto di Medicina Aerospaziale, Comando Logistico dell’Aeronautica Militare, Viale Piero Gobetti 2, 00185 Roma, Italy
| | - Giuseppe De Lorenzo
- Comando Generale dell’Arma dei Carabinieri, Dipartimento per l’Organizzazione Sanitaria e Veterinaria, Viale Romania 45, 00197 Roma, Italy
| | - Mario Stefano Peragallo
- Centro Studi e Ricerche di Sanità e Veterinaria, Comando Logistico dell’Esercito, Via S. Stefano Rotondo 4, 00184 Roma, Italy
| | - Tommaso Stroffolini
- Dipartimento di Malattie Infettive e Tropicali, Policlinico Umberto I, 00161 Roma, Italy
| | - Raffaele D’Amelio
- Dipartimento di Medicina Clinica e Molecolare, Sapienza Università di Roma, Via di Grottarossa 1035-1039, 00189 Roma, Italy
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Navalpotro-Rodríguez D, Garay-Moya Á, Chong-Valbuena A, Melero-García M. 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.2021.11.004] [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]
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Navalpotro-Rodríguez D, Garay-Moya Á, Chong-Valbuena A, Melero-Garcia M. Modified measles outbreak in vaccinated healthcare workers exposed to primary measles case. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:342-343. [PMID: 35484062 DOI: 10.1016/j.eimce.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 11/03/2021] [Indexed: 06/14/2023]
Affiliation(s)
| | - Ángel Garay-Moya
- Servicio de Medicina Preventiva, Consorcio Hospital General Universitario de Valencia, Valencia, Spain; Servicio de Medicina Preventiva, Hospital de Sagunto, Sagunto, Valencia, Spain
| | - Andrea Chong-Valbuena
- Servicio de Medicina Preventiva, Consorcio Hospital General Universitario de Valencia, Valencia, Spain; Sección de Epidemiología, Centro de Salud Pública de Valencia, Valencia, Spain
| | - Mercedes Melero-Garcia
- Servicio de Medicina Preventiva, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
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Kostinov MP, Zhuravlev PI, Loktionova MN, Shmitko AD, Polishchuk VB, Tatarinchik AA, Smirnova OA, Fursov IS. [Comparison of measles incidence in different age groups with the intensity of specific humoral immunity in healthcare workers in Moscow]. Vopr Virusol 2022; 67:27-36. [PMID: 35293186 DOI: 10.36233/0507-4088-85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 03/15/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION The study of the intensity of humoral immunity to the measles virus (Paramyxoviridae: Morbillivirus) (MV) remains relevant due to the ongoing registration of the cluster cases of measles (including nosocomial cases).The aim of the study was to analyze correlation between the intensity of the humoral immunity to measles virus and the measles incidence in different age groups of the Moscow residents. MATERIAL AND METHODS A simple analytic study was carried out under the framework of measles prevention improvement program conducted in the subjects of the Russian Federation. The study included the analysis of the reasons for the increase in the proportion of seronegative individuals and the comparison of the results of seromonitoring with the data of age-related measles incidence. Throughout 2018, total 1,855 blood serum samples obtained from employees of a large hospital center in Moscow who were previously vaccinated against measles were tested for IgG antibodies (ABs) to MV. The subjects were divided into 11 groups according to their age. Statistical analysis of the obtained data was performed using nonparametric criteria. RESULTS AND DISCUSSION The proportion of seronegative individuals among the staff of the medical facility decreased with age, from 38.5% in persons aged 19-23 to 0% among employees aged 64 and over. Persons aged 19-43 years were the most susceptible to measles infection, which was confirmed also by the highest incidence rate at these age groups (from 6.93 to 14.03 per 100,000 population). The age group most protected against measles was those over 64 years of age, who were all seropositive and had the lowest rates of incidence. This is probably due to the fact that by this age most of them have had a measles infection and have formed a sufficient immune response. At the same time, younger individuals living in the post-elimination era have only vaccine-induced ABs to MV, the level of which declines rapidly to non-protective values in the absence of boosterization due to the exposure to the wild-type strain of the pathogen. CONCLUSION The monitoring of the MV-specific IgG- AB levels is required for employees in the medical institutions under the age of 35. Administration of the single dose of the appropriate vaccine is recommended for seronegative individuals.
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Affiliation(s)
- M P Kostinov
- FSBRI «I.I. Mechnikov Research Institute of Vaccines and Sera»; FSAEI HE I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of the Health of Russia
| | - P I Zhuravlev
- FBIH «The Center of Hygiene and Epidemiology in Moscow» of the Federal Service for Surveillance of Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor)
| | - M N Loktionova
- FSAEI HE I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of the Health of Russia
| | - A D Shmitko
- FSBRI «I.I. Mechnikov Research Institute of Vaccines and Sera»
| | - V B Polishchuk
- FSBRI «I.I. Mechnikov Research Institute of Vaccines and Sera»
| | - A A Tatarinchik
- FBIH «The Center of Hygiene and Epidemiology in Moscow» of the Federal Service for Surveillance of Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor)
| | - O A Smirnova
- FBIH «The Center of Hygiene and Epidemiology in Moscow» of the Federal Service for Surveillance of Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor)
| | - I S Fursov
- FBIH «The Center of Hygiene and Epidemiology in Moscow» of the Federal Service for Surveillance of Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor)
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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.
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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
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12
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Song K, Lee JM, Lee EJ, Lee BR, Choi JY, Yun J, Lee SN, Jang MY, Kim HW, Kim HS, Moon SM, Kim YK. Control of a nosocomial measles outbreak among previously vaccinated adults in a population with high vaccine coverage: Korea, 2019. Eur J Clin Microbiol Infect Dis 2022; 41:455-466. [PMID: 34999974 DOI: 10.1007/s10096-021-04390-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/30/2021] [Indexed: 01/26/2023]
Abstract
We describe a measles outbreak among previously vaccinated healthcare workers (HCWs) and inpatients and the control measures implemented at a tertiary care hospital in 2019. Case-patients were laboratory-confirmed measles with throat swabs tested by quantitative polymerase chain reactions (PCR), during April-May 2019. Medical histories and documented immunization records were obtained. We compared attack rates (ARs) among HCWs by occupational subgroup and age and examined the outbreak-associated costs. The index case was not ascertained. Among 26 measles case-patients (22 HCWs, four inpatients) aged 18-28 years, 25 had previously received measles-mumps-rubella (MMR) vaccine (12/26, 46% (two doses); 13/26, 50% (one dose)), and 16 (62%) had positive results of measles IgG prior to measles diagnosis. ARs were higher among HCWs aged < 30 years (1.88%), especially in the subgroup under 25 years of age (2.22%). Control measures included work restrictions for seronegative HCWs (218/2320, 9.4%) in immunity verification, administration of the MMR vaccine (207 HCWs) or intravenous immunoglobulin (2 HCWs and 11 inpatients), enhanced health surveillance of HCWs, and mandatory assessment of patients with measles-like symptoms at the infectious diseases screening units. The hospital spent 90,417,132 Korean won (US $79,733) in response to the outbreak. Measles outbreaks can occur in healthcare settings despite high population immunity, highlighting the importance of stronger vaccination policies, particularly among young HCWs. Moreover, an effective outbreak response comprising immunization activities and enhanced surveillance of HCWs and patients to rapidly detect measles-like symptoms at a prodromal phase is essential to control nosocomial measles outbreaks.
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Affiliation(s)
- Kyunghyun Song
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Ju Mi Lee
- Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Eun Ju Lee
- Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Bo Ram Lee
- Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Ji Young Choi
- Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Jihee Yun
- Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Se Na Lee
- Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Mi Young Jang
- Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Han Wool Kim
- Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea.,Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Han-Sung Kim
- Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea.,Department of Laboratory Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Song Mi Moon
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.,Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea.,Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Yong Kyun Kim
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea. .,Department of Infection Control, Hallym University Sacred Heart Hospital, Anyang, Korea. .,Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
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13
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Antivirals targeting paramyxovirus membrane fusion. Curr Opin Virol 2021; 51:34-47. [PMID: 34592709 DOI: 10.1016/j.coviro.2021.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 01/29/2023]
Abstract
The Paramyxoviridae family includes enveloped single-stranded negative-sense RNA viruses such as measles, mumps, human parainfluenza, canine distemper, Hendra, and Nipah viruses, which cause a tremendous global health burden. The ability of paramyxoviral glycoproteins to merge viral and host membranes allows entry of the viral genome into host cells, as well as cell-cell fusion, an important contributor to disease progression. Recent molecular and structural advances in our understanding of the paramyxovirus membrane fusion machinery gave rise to various therapeutic approaches aiming at inhibiting viral infection, spread, and cytopathic effects. These therapeutic approaches include peptide mimics, antibodies, and small molecule inhibitors with various levels of success at inhibiting viral entry, increasing the potential of effective antiviral therapeutic development.
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14
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Eposi HC, Randolph NA, Benjamin KM. Measles outbreak investigation in a highly vaccinated community in the Centre region of Cameroon. J Public Health Afr 2021; 12:1775. [PMID: 34249295 PMCID: PMC8239452 DOI: 10.4081/jphia.2021.1775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 03/23/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Measles remains a threat in many African settings due to sub-optimal routine immunisation and catchup campaigns. The Global Vaccine Action Plan goal to eliminate measles by 2020 remains unmet as several countries reported an increase in cases in 2019. In Cameroon, a measles-rubella vaccination campaign was organised in 2019 to reduce the cohort of susceptible children. However, in 2020, eleven suspected cases of measles were notified in the Sa'a Health District and five were confirmed. OBJECTIVE This report summarizes a measles outbreak investigation and contact tracing in a highly vaccinated community residing in the Sa'a Health District of Cameroon. METHODS Outbreak investigations were carried out in the Sa'a, Nlong-Onambele and Nkolmgbana health areas from 18 to 21 February 2020. A register review from December 2019 to February 2020 was carried out in all health facilities of the affected health areas. followed by contact tracing in the community. RESULTS Thirty households were visited in four neighbourhoods. Six missed Epidemiologically-linked cases were discovered in the community, bringing the total number of suspected and confirmed cases to 17. Thirty-five percent of the cases had not received any measles-containing vaccine; 35% of the cases were aged 5 years or older; 53% had history of travel. Community transmission only occurred in the Sa'a health area through a breakthrough case. CONCLUSIONS This outbreak investigation portrayed the role that adequate vaccination coverage plays in preventing widespread outbreaks. Nonetheless, community sensitisation and routine immunisation require strengthening in order to erase pockets of susceptible children.
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Affiliation(s)
- Haddison C. Eposi
- Saa District Health Service, Centre Regional Delegation of Public Health, Cameroon
| | | | - Kagina M. Benjamin
- Vaccines For Africa Initiative (VACFA), University of Cape Town, South Africa
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15
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Ashbaugh HR, Cherry JD, Hoff NA, Doshi RH, Alfonso VH, Gadoth A, Mukadi P, Higgins SG, Budd R, Randall C, Mwamba GN, Okitolonda-Wemakoy E, Muyembe-Tamfum JJ, Gerber SK, Rimoin AW. Measles antibody levels among vaccinated and unvaccinated children 6-59 months of age in the Democratic Republic of the Congo, 2013-2014. Vaccine 2021; 38:2258-2265. [PMID: 32057333 PMCID: PMC7026690 DOI: 10.1016/j.vaccine.2019.09.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 09/02/2019] [Accepted: 09/11/2019] [Indexed: 01/13/2023]
Abstract
Background Measles is endemic in the Democratic Republic of the Congo (DRC), and 89–94% herd immunity is required to halt its transmission. Much of the World Health Organization African Region, including the DRC, has vaccination coverage below the 95% level required to eliminate measles, heightening concern of inadequate measles immunity. Methods We assessed 6706 children aged 6–59 months whose mothers were selected for interview in the 2013–2014 DRC Demographic and Health Survey. History of measles was obtained by maternal report, and classification of children who had measles was completed using maternal recall and measles immunoglobulin G serostatus obtained from a multiplex chemiluminescent automated immunoassay dried blood spot analysis. A logistic regression model was used to identify associations of covariates with measles and seroprotection, and vaccine effectiveness (VE) was calculated. Results Out of our sample, 64% of children were seroprotected. Measles vaccination was associated with protection against measles (OR: 0.15, 95% CI: 0.03, 0.81) when administered to children 12 months of age or older. Vaccination was predictive of seroprotection at all ages. VE was highest (88%) among children 12–24 months of age. Conclusion Our results demonstrated lower than expected seroprotection against measles among vaccinated children. Understanding the factors that affect host immunity to measles will aid in developing more efficient and effective immunization programs in DRC.
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Affiliation(s)
- Hayley R Ashbaugh
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, United States.
| | - James D Cherry
- David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States.
| | - Nicole A Hoff
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, United States
| | - Reena H Doshi
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, United States
| | | | - Adva Gadoth
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, United States
| | - Patrick Mukadi
- Kinshasa University, School of Medicine, Kinshasa, The Democratic Republic of the Congo
| | - Stephen G Higgins
- Lentigen Technology, Incorporated, Gaithersburg, MD 20878, United States
| | - Roger Budd
- DYNEX Technologies Incorporated, Chantilly, VA 20151, United States
| | | | - Guillaume Ngoie Mwamba
- Expanded Program on Immunization, Ministry of Public Health, Kinshasa, The Democratic Republic of the Congo
| | | | | | - Sue K Gerber
- Bill and Melinda Gates Foundation, Seattle, WA 98109, United States
| | - Anne W Rimoin
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, United States.
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16
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Bassal R, Indenbaum V, Pando R, Levin T, Shinar E, Amichay D, Barak M, Ben-Dor A, Haim AB, Mendelson E, Cohen D, Shohat T. Seropositivity of measles antibodies in the Israeli population prior to the nationwide 2018 - 2019 outbreak. Hum Vaccin Immunother 2020; 17:1353-1357. [PMID: 33121333 DOI: 10.1080/21645515.2020.1824968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Measles vaccine is administered in Israel as part of the routine childhood immunization program, at ages 1 and 6 years. In this study, we assessed seropositivity of the Israeli population against measles before the onset and propagation of the 2018-2019 measles outbreak. From the Israel Center for Disease Control National Serum Bank, 3,164 samples collected during 2015 were tested for measles antibodies. All the tests were performed using Enzyme-Linked Immunosorbent Assay (ELISA) commercial kit (Enzygnost, Anti-Measles Virus/IgG: Behring, Marburg, Germany). The overall seropositivity rate for measles was 90.7%. The seropositivity rate at 6 months and younger was 48.9%, and decreased to 3.8% among infants aged 6-11 months. Seropositivity increased to 90.7% in the 1-4-year age group, and reached 96.1% for 5-9 year-old children. Our results suggest high immunity in the Israeli population against measles virus, but not high enough to prevent outbreaks because of pockets of specific population groups with low immunization coverage. Infants between ages 6 and 11 months and children younger than 2 years had the lowest seropositivity rates being the age groups with the highest attack rates of measles during the epidemic of 2018. Efforts should be aimed at avoiding any delay in vaccination once a child reaches the age of 1 year and improving immunity levels in children aged 1-4 years.
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Affiliation(s)
- Ravit Bassal
- Ministry of Health, Gertner Institute, Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Victoria Indenbaum
- Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Rakefet Pando
- Ministry of Health, Gertner Institute, Chaim Sheba Medical Center, Ramat-Gan, Israel.,Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Tal Levin
- Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Eilat Shinar
- Blood Services, Magen David Adom, Ramat-Gan, Israel
| | - Doron Amichay
- Soroka University Medical Center, Clalit Health Services, Beer Sheva, Israel
| | - Mira Barak
- Haifa and Western Galilee Laboratories, Clalit Health Services, Nesher, Israel
| | - Anat Ben-Dor
- Schneider Children Medical Center, Clalit Health Services, Petah-Tiqwa, Israel
| | - Adina Bar Haim
- Blood Services, Mayanei Hayeshua Medical Center, Bnei-Brak, Israel
| | - Ella Mendelson
- Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat-Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dani Cohen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tamy Shohat
- Ministry of Health, Gertner Institute, Chaim Sheba Medical Center, Ramat-Gan, Israel.,Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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17
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Kobayashi A, Shimada T, Tanaka-Taya K, Kanai M, Okuno H, Kinoshita M, Matsui T, Oishi K. Epidemiology of a workplace measles outbreak dominated by modified measles cases at Kansai international airport, Japan, during august-september 2016. Vaccine 2020; 38:4996-5001. [PMID: 32535017 DOI: 10.1016/j.vaccine.2020.05.067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES In August 2016, a measles outbreak at Kansai International Airport was the first workplace measles outbreak since Japan was verified as having achieved measles-elimination status in March 2015. We investigated this outbreak with a focus on evaluating the ability of vaccinated individuals to transmit measles virus (MV). METHODS We considered a case of laboratory-confirmed measles with onset between August 9 and September 29, 2016, among workers of Kansai International Airport. History of vaccination status with measles-containing vaccine (MCV) was confirmed by reviewing records. The potential sources of each MV infection were assessed by interviewing each infected worker about the clinical course of their infection and their behavioral history. RESULTS Of 30 affected ground crews identified, 16 (53%) were vaccinated with ≥ 1 dose of MCV, 2 (7%) were unvaccinated, and 12 (40%) had an unknown vaccination status. The index case, a patient with classical measles with unknown vaccination status, presumably transmitted MV to all the subsequent 29 cases. The majority of patients (23, 77%; 15 vaccinated, 8 in unknown vaccination status) were diagnosed with modified measles due to mild illness. Modified measles were characterized clinically by signs of catarrh (4/23, 17%) in a few cases, with a median incubation period of 16 (range, 11-21) days. No onward transmission from vaccinated cases was suggested. An overseas traveler who visited the airport with measles symptoms was identified as the possible primary source of this outbreak. CONCLUSIONS The low MV transmission ability of vaccinated individuals was reaffirmed. Contact tracing of vaccinated modified measles cases can be limited to a person at high risk of infection (e.g., households, person with immunosuppression). To maintain measles-elimination status, completing two doses of MCV should be ensured, especially for international travelers and for those who are frequently exposed to these travelers, such as airport workers.
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Affiliation(s)
- Ayako Kobayashi
- Field Epidemiology Training Program, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjyuku, Tokyo 162-8640, Japan
| | - Tomoe Shimada
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjyuku, Tokyo 162-8640, Japan
| | - Keiko Tanaka-Taya
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjyuku, Tokyo 162-8640, Japan
| | - Mizue Kanai
- Field Epidemiology Training Program, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjyuku, Tokyo 162-8640, Japan
| | - Hideo Okuno
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjyuku, Tokyo 162-8640, Japan
| | - Masaru Kinoshita
- Medical Administration Division, Public Health and Medical Administration Office, Department of Public Health and Medical Affairs, Osaka Prefectural Government, Otemae, Chuo, Osaka 540-8570, Japan
| | - Tamano Matsui
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjyuku, Tokyo 162-8640, Japan
| | - Kazunori Oishi
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjyuku, Tokyo 162-8640, Japan; Toyama Institute of Health, Imizu, Toyama 939-0363, Japan.
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18
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Sundell N, Dotevall L, Lindh M, Westin J, Liljeqvist JÅ, Bergström T, Studahl M, Andersson LM. Authors' response: Measles outbreak in Gothenburg urban area, Sweden, 2017/18: lower viral load in breakthrough infections. ACTA ACUST UNITED AC 2020; 24. [PMID: 31362806 PMCID: PMC6668285 DOI: 10.2807/1560-7917.es.2019.24.30.1900478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Nicklas Sundell
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Leif Dotevall
- Department of Communicable Disease Control, Region Västra Götaland, Sweden
| | - Magnus Lindh
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Johan Westin
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jan-Åke Liljeqvist
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Tomas Bergström
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marie Studahl
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars-Magnus Andersson
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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19
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El Zarif T, Kassir MF, Bizri N, Kassir G, Musharrafieh U, Bizri AR. Measles and mumps outbreaks in Lebanon: trends and links. BMC Infect Dis 2020; 20:244. [PMID: 32216754 PMCID: PMC7098136 DOI: 10.1186/s12879-020-04956-1] [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: 07/03/2019] [Accepted: 03/10/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Lebanon has experienced several measles and mumps outbreaks in the past 20 years. In this article, a case-based surveillance of both measles and mumps outbreaks in Lebanon was carried out in an attempt to outline factors contributing to the failure of elimination plans and to provide potential solutions. The relationship between the outbreaks of both diseases was described and explored. METHODS A retrospective descriptive study of confirmed cases of measles and mumps in Lebanon between 2003 and 2018 collected from the Lebanese Ministry of Public Health Epidemiological Surveillance Unit public database was carried out. The information collected was graphically represented taking into consideration dates of reported cases, age groups affected, and vaccination status. RESULTS The mean number of measles cases was 150.25 cases/year in the 1-4 years age group, 87 cases/year in individuals aging between 5 and 14, and 63.68 cases/year in those > 14 years old. In the latter group, only 18.05% were unvaccinated. The mean number of mumps cases was 30.4 cases/year in the < 4 year age group and 53.8 cases/year in the 10-19 years age group. During the study period, every spike in measles cases was followed by a similar spike in mumps. 9.66% of measles cases occurred in individuals who received at least 2 doses of the vaccine, 52.26% in the unvaccinated, and 38% in those whose vaccination status was undetermined. CONCLUSIONS Measles in Lebanon is a disease of the pediatric population, but adults remain at risk. Outbreaks of mumps followed those of measles and were mainly among adolescents. Presence of a large number of Syrian refugees in the country may further complicate the situation. Vaccination activities need to be intensified.
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Affiliation(s)
- Talal El Zarif
- Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | | | - Nazih Bizri
- Faculty of Medicine, University of Balamand, Koura, Lebanon
| | - Ghida Kassir
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Umayya Musharrafieh
- Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Abdul Rahman Bizri
- Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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20
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Abstract
PURPOSE OF REVIEW Owing to vaccine hesitancy, there has been a resurgence of measles infections in developed countries. Practitioners can expect to see an increase in patients with neurologic complications of measles. These devastating disorders include primary measles encephalitis, acute post measles encephalitis, subacute sclerosing panencephalitis (SSPE), and measles inclusion body encephalitis (MIBE). RECENT FINDINGS Although there are many unanswered questions regarding the neurologic complications of measles, recent advances have led to better understanding of the mechanism of the spread of measles within the nervous system, particularly the disruption of F protein function, which raises the possibility of treatment with fusion-inhibiting molecules. Measles and its neurological complications are preventable and must be prevented. Neurologists must educate other clinicians and the public regarding the consequences of inadequate herd immunity to measles. More effective treatments for SSPE and MIBE may be available in the near future, but currently these remain lethal diseases.
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Affiliation(s)
- Marc C Patterson
- Mayo Clinic Children's Center, Mayo Clinic College of Medicine and Science, 200 First Street SW, Rochester, MN, 55905, USA.
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21
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Kurata T, Kanbayashi D, Egawa K, Kinoshita M, Yoshida H, Miyazono M, Motomura K. A measles outbreak from an index case with immunologically confirmed secondary vaccine failure. Vaccine 2020; 38:1467-1475. [DOI: 10.1016/j.vaccine.2019.11.075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/19/2019] [Accepted: 11/27/2019] [Indexed: 02/07/2023]
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22
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Tariku MK, Misikir SW. Measles outbreak investigation in Artuma Fursi Woreda, Oromia Zone, Amhara Region, Ethiopia, 2018: a case control study. BMC Res Notes 2019; 12:765. [PMID: 31752989 PMCID: PMC6873760 DOI: 10.1186/s13104-019-4806-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 11/12/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To confirm the existence of Outbreak, describe cases in person, place and time, and identify determinants of the outbreak. Unmatched case control study in the ratio of 1:4 (38 cases and 152 controls) was conducted in Artuma Fursi Woreda from July 13 to August 1/2018. Data were collected with standard questionnaires. Collected data were entered into Epi Info version 7 and exported to Statistical package for social science (SPSS) version 23 for analysis. RESULTS A total of 38 cases and 1 death with attack rate and case fatality rate 11.8/100,000 and 2.6%, respectively. All study participants had not vaccination history. Females and age group 5-14 were more affected. Being 5-14 years old versus (vs) ≥ 15 years [adjusted odd ratio (AOR) = 3.53; 95% CI 1.52-8.45)], contact with cases vs no contact with cases [AOR = 2.78; 95% CI 1.23-8.67] and travel history 7-18 days prior onset of illness vs no travel history [AOR = 2.53; 95% CI 1.31-7.24] were significantly associated with contracting measles. Routine and supplement immunization should be strengthened to reduce future occurrence of outbreak.
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Bolotin S, Crowcroft NS, Hughes SL, De Serres G. Letter to the editor: Measles outbreak in Gothenburg urban area, Sweden, 2017 to 2018: low viral load in breakthrough infections. Euro Surveill 2019; 24. [PMID: 31362810 PMCID: PMC6668287 DOI: 10.2807/1560-7917.es.2019.24.30.1900465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Shelly Bolotin
- Department of Laboratory Medicine and Pathobiology, University of Toronto, 1 King’s College Circle, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Canada
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, Canada
| | - Natasha S Crowcroft
- ICES, 2075 Bayview Ave, Toronto, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, 1 King’s College Circle, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Canada
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, Canada
| | - Stephanie L Hughes
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, Canada
| | - Gaston De Serres
- Laval University, Quebec, Canada
- Institut National de Santé Publique du Québec, Québec, Canada
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