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Zibolenová J, Malobická E, Ulbrichtová R, Novák M, Chladná Z, Waczulíková I, Litvová S, Mikas J, Mečochová A, Hudečková H. Probability of exposure to the wild measles virus in adult population - Estimation from seroepidemiology and historical data. Vaccine 2024; 42:1648-1655. [PMID: 38342718 DOI: 10.1016/j.vaccine.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 02/13/2024]
Abstract
Vaccination against measles is one of the most effective public health interventions which has saved millions of lives and interrupted circulation of the natural virus in the population. However, it is widely accepted that the immunity after vaccination can wane, especially in those who have had no contact with the virus. This study aimed to classify the particular birth cohorts of adults with regard to their exposure to the wild measles virus in the population with a long history of mandatory vaccination. We introduced two methods. In the first, we estimated the probability of exposure to the wild virus through an analysis of antibody levels from the Immunologic Survey performed in the Slovak Republic in 2018, while the second was based on historical epidemiological data. Both methods resulted in similar estimations. Cohorts born in Slovakia before 1964 can be considered to be cohorts in which most people were exposed to the wild measles virus. Cohorts born after 1977 can be designated as cohorts that most likely did not come into the contact with the wild virus. Cohorts born between 1965 and 1976 are composed of a mixture, with a decreasing proportion of people exposed to the wild virus with increasing year of birth. The proposed methods can help identify potential immunity gaps in the adult population. They can be applied in other countries with high measles vaccination coverage to estimate the probability of exposure to the wild measles virus in particular birth cohorts.
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Affiliation(s)
- Jana Zibolenová
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Malá Hora 11149/4B, 036 01 Martin, Slovakia
| | - Eva Malobická
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Malá Hora 11149/4B, 036 01 Martin, Slovakia
| | - Romana Ulbrichtová
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Malá Hora 11149/4B, 036 01 Martin, Slovakia
| | - Martin Novák
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Malá Hora 11149/4B, 036 01 Martin, Slovakia.
| | - Zuzana Chladná
- Department of Applied Mathematics and Statistics, Faculty of Mathematics, Physics and Informatics, Comenius University in Bratislava, Mlynská dolina F1, 842 48 Bratislava, Slovakia
| | - Iveta Waczulíková
- Department of Nuclear Physics and Biophysics, Faculty of Mathematics, Physics and Informatics, Comenius University in Bratislava, Mlynská dolina F1, 842 48 Bratislava, Slovakia
| | - Slávka Litvová
- Faculty of Healthcare, Alexander Dubcek University of Trencin, Trencin, Slovakia
| | - Ján Mikas
- Public Health Authority of the Slovak Republic, Trnavská cesta 52, 826 45 Bratislava, Slovakia
| | - Adriana Mečochová
- Public Health Authority of the Slovak Republic, Trnavská cesta 52, 826 45 Bratislava, Slovakia
| | - Henrieta Hudečková
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Malá Hora 11149/4B, 036 01 Martin, Slovakia
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Zibolenová J, Hudečková H, Chladná Z, Malobická E, Novák M, Waczulíková I, Mikas J, Mečochová A. Quantification of Waning Immunity After Measles Vaccination-Evidence From a Seroprevalence Study. Am J Epidemiol 2023; 192:1379-1385. [PMID: 36935110 DOI: 10.1093/aje/kwad065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 12/07/2022] [Accepted: 03/14/2023] [Indexed: 03/21/2023] Open
Abstract
We aimed to quantify rates of waning immunity after measles vaccination from seroprevalence data collected in a study of a population with high vaccination coverage and a fixed vaccination schedule. Data were collected during a national survey (the Immunological Survey) carried out in the Slovak Republic in 2018. The average rate of waning immunity against measles after the first dose of measles, mumps, and rubella (MMR) vaccine (ages 1.5-10 years) was 9.7% per year from the geometric mean titer value of 2,634 mUI/mL. The average waning rate after the second dose of MMR vaccine (ages 10-33 years) was significantly lower: 4.8% per year from the lower geometric mean titer of 1,331 mUI/mL. This decline in antibody levels suggests that vaccine-induced protection may be compromised and results in an increase in the proportion of seronegative/borderline individuals. These outcomes may provide a valuable source for critical assessment of direct and indirect effects of MMR vaccination.
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Kružlíková A, Gőczeová J, Šoltys K, Piťková R, Ťažký B, Mikas J. The first laboratory confirmed invasive meningococcal disease of serogroup C with abdominal clinical presentation in Slovakia, 2019. Epidemiol Mikrobiol Imunol 2021; 70:72-75. [PMID: 33853341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Acute abdominal clinical presentations as initial manifestation of meningococcal infection are uncommon and frequently provoked by hyperinvasive isolates of meningococci. 10% of patients infected by the meningococcal strain, that is on the rise in Europe, suffer from abdominal pain. We hereby report the first laboratory confirmed fatal case of an otherwise healthy adult male presented with acute abdominal pain during first 24-48 hours, masking Neisseria meningitidis (N. meningitidis) infection. In the National Reference Center for meningococci, in the blood of a man post-mortem, we identified N. meningitidis serogroup C using real time polymerase chain reaction (PCR). Subsequently, massivelly-parallel sequencing (MPS) was performed on isolated total DNA for pathogen confirmation and further investigation.
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Adlhoch C, Gomes Dias J, Bonmarin I, Hubert B, Larrauri A, Oliva Domínguez JA, Delgado-Sanz C, Brytting M, Carnahan A, Popovici O, Lupulescu E, O'Donnell J, Domegan L, Van Gageldonk-Lafeber AB, Meijer A, Kynčl J, Slezák P, Guiomar R, Orta Gomes CM, Popow-Kraupp T, Mikas J, Staroňová E, Melillo JM, Melillo T, Ikonen N, Lyytikäinen O, Snacken R, Penttinen P. Determinants of Fatal Outcome in Patients Admitted to Intensive Care Units With Influenza, European Union 2009-2017. Open Forum Infect Dis 2019; 6:ofz462. [PMID: 32258201 PMCID: PMC7105050 DOI: 10.1093/ofid/ofz462] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 10/23/2019] [Indexed: 01/13/2023] Open
Abstract
Background Morbidity, severity, and mortality associated with annual influenza epidemics are of public health concern. We analyzed surveillance data on hospitalized laboratory-confirmed influenza cases admitted to intensive care units to identify common determinants for fatal outcome and inform and target public health prevention strategies, including risk communication. Methods We performed a descriptive analysis and used Poisson regression models with robust variance to estimate the association of age, sex, virus (sub)type, and underlying medical condition with fatal outcome using European Union data from 2009 to 2017. Results Of 13 368 cases included in the basic dataset, 2806 (21%) were fatal. Age ≥40 years and infection with influenza A virus were associated with fatal outcome. Of 5886 cases with known underlying medical conditions and virus A subtype included in a more detailed analysis, 1349 (23%) were fatal. Influenza virus A(H1N1)pdm09 or A(H3N2) infection, age ≥60 years, cancer, human immunodeficiency virus infection and/or other immune deficiency, and heart, kidney, and liver disease were associated with fatal outcome; the risk of death was lower for patients with chronic lung disease and for pregnant women. Conclusions This study re-emphasises the importance of preventing influenza in the elderly and tailoring strategies to risk groups with underlying medical conditions.
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Affiliation(s)
- Cornelia Adlhoch
- Surveillance and Response Support, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Joana Gomes Dias
- Surveillance and Response Support, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | | | - Bruno Hubert
- Bruno Hubert, Santé Public France, Saint-Maurice Cedex, France
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Jesús A Oliva Domínguez
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Concepción Delgado-Sanz
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Mia Brytting
- The Public Health Agency of Sweden, Solna, Sweden
| | | | - Odette Popovici
- National Institute of Public Health, Romania National Centre for Communicable Diseases Surveillance and Control, Bucuresti, Romania
| | - Emilia Lupulescu
- National Institute of Public Health, Romania National Centre for Communicable Diseases Surveillance and Control, Bucuresti, Romania
| | - Joan O'Donnell
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | - Lisa Domegan
- Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland
| | | | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Jan Kynčl
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic
| | - Pavel Slezák
- Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czech Republic
| | - Raquel Guiomar
- Instituto Nacional de Saúde Doutor Ricardo Jorge (National Institute of Health Dr. Ricardo Jorge), Lisboa, Portugal
| | - Carlos M Orta Gomes
- Department of Public Health of Regional Health Administration of Lisbon and Tagus Valley, Lisboa, Portugal
| | | | - Ján Mikas
- Public Health Authority of the Slovak Republic, Bratislava, Slovakia
| | - Edita Staroňová
- Public Health Authority of the Slovak Republic, Bratislava, Slovakia
| | - Jackie M Melillo
- Infectious Disease Prevention and Control Unit, Health Regulation, Malta
| | - Tanya Melillo
- Infectious Disease Prevention and Control Unit, Health Regulation, Malta
| | - Niina Ikonen
- Department of Health Security, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Outi Lyytikäinen
- Department of Health Security, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - René Snacken
- Surveillance and Response Support, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Pasi Penttinen
- Office of the Chief Scientist, European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
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Abstract
OBJECTIVES The aim of this study is to describe demographic, clinical and epidemiological characteristics of cases with laboratory-confirmed pandemic influenza virus A(H1N1)pdm09 reported in Slovakia from May 28, 2009 to December 30, 2009 and analyse the association between risk factors and severe outcome of these cases. BACKGROUND In the spring of 2009, an outbreak of a pandemic influenza virus A(H1N1)pdm09, emerged in Mexico and spread globally. Until December 2009, 1,014 cases were notified in Slovakia. METHODS The data were collected within national influenza surveillance system. Odds ratios (95% CI) were calculated. Associations were found to be significantly associated with the worse outcome (p < 0.05) in the univariate analysis and were adjusted for possible effects of age and sex by using a logistic regression model. RESULTS Out of the total number of 1,014 cases, 131 (12.9 %) cases were hospitalized, and 43 (4.2 %) of those were admitted to intensive care units. During the reporting period, 38 deaths were reported, representing a case fatality rate of 3.75 %. The median age of severe cases (35 years, IQR = 29 y) was significantly higher than the median age of mild cases (24 years, IQR = 19 y; p < 0.001). By using a logistic regression, we found out that chronic obstructive pulmonary disease (COPD) (aOR = 9.2; 95%CI: 1.42-59.98), cardiovascular diseases (aOR = 14.97; 95%CI: 5.49-40.79), malignity (aOR = 7.6; 95%CI: 1.95-29.37) and gravidity (aOR = 55.21; 95% CI: 14.40-211.58) were significantly associated with severe outcomes of the cases. CONCLUSION The fact, that 35% of severely ill patients did not report any risk factor suggests the importance of vaccination as a prevention of influenza (Tab. 2, Fig. 1, Ref. 18). Text in PDF www.elis.sk.
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Varecková E, Blaskovicová H, Gocník M, Mikas J, Adamcáková J, Fislová T, Kostolanský F, Mucha V. Evaluation of clinical specimens for influenza A virus positivity using various diagnostic methods. Acta Virol 2006; 50:181-6. [PMID: 17131937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The diagnostic method for Influenza A virus, utilizing the SERION ELISA Antigen kit (SERION EIA), if results were evaluated according to the manufacturer's instructions, has repeatedly failed to detect a great number of clinical samples positive by virus isolation and RT-PCR. Therefore we compared the SERION EIA with the one-step 44/107L-Px immunocapture enzyme immunoassay (44/107L-Px EIA), developed in our laboratory (Tkácová and Varecková, J. Virol. Methods 60, 65-71, 1996). Seventy-three clinical specimens, of which 65 were positive by virus isolation (used as reference method), were tested by both EIAs. By the SERION EIA, out of the 65 reference-positive samples only 8 (12%) were positive, 5 (8%) were ambiguous, and 52 (80%) were negative, which corresponded to the sensitivity of 12%. On the contrary, the sensitivity of the 44/107L-Px EIA was 74%. However, the calculation of cut-off values for the evaluation of positivity of clinical specimens in these two assays were not the same. If the evaluation procedure used for the 44/107L-Px EIA was applied to the SERION EIA, the sensitivity and the specificity of both EIAs became comparable, namely 71% and 100% for the SERION EIA and 74% and 100% for the 44/107L-Px EIA, respectively. From these results it follows that not the detection ability of the SERION EIA, but the evaluation procedure recommended by its manufacturer led to a loss of large number of positive specimens.
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Affiliation(s)
- E Varecková
- Institute of Virology, Slovak Academy of Sciences, Dúbravská cesta 9, 845 05 Bratislava, Slovak Republic.
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