Measles in Geneva between 2003 and 2010: persistence of measles outbreaks despite high immunisation coverage (original) (raw)
Related papers
Archives of Public Health, 2013
Background: From Mid-February to April 2011 one of the largest measles-outbreak in Flanders, since the start of the 2-dose vaccination scheme in 1995, took place in Ghent, Belgium. The outbreak started in a day care center, infecting children too young to be vaccinated, after which it spread to anthroposophic schools with a low measles, mumps and rubella vaccination coverage. This report describes the outbreak and evaluates the control measures and interventions. Methods: Data collection was done through the system of mandatory notification of the public health authority. Vaccination coverage in the schools was assessed by a questionnaire and the electronic immunization database 'Vaccinnet'. A case was defined as anyone with laboratory confirmed measles or with clinical symptoms and an epidemiological link to a laboratory confirmed case. Towards the end of the outbreak we only sought laboratory confirmation for persons with an atypical clinical presentation or without an epidemiological link. In search for an index patient we determined the measles IgG level of infants from the day care center. Results: A total of 65 cases were reported of which 31 were laboratory confirmed. Twenty-five were confirmed by PCR and/or IgM. In 6 infants, too young to be vaccinated, only elevated measles IgG levels were found. Most cases (72%) were young children (0-9 years old). All but two cases were completely unimmunized. In the day care center all the infants who were too young to be vaccinated (N=14) were included as cases. Thirteen of them were laboratory confirmed. Eight of these infants were hospitalized with symptoms suspicious for measles. Vaccination coverage in the affected anthroposophic schools was low, 45-49% of the pupils were unvaccinated. We organized vaccination campaigns in the schools and vaccinated 79 persons (25% of those unvaccinated or incompletely vaccinated). Conclusions: Clustering of unvaccinated persons, in a day care center and in anthroposophic schools, allows for measles outbreaks and is an important obstacle for the elimination of measles. Isolation measures, a vacation period and an immunization campaign limited the spread of measles within the schools but could not prevent further spread among unvaccinated family members. It was necessary to raise clinicians' awareness of measles since it had become a rare, less known disease and went undiagnosed.
Public health significance of immunization and epidemic occurrence of measles
Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina, 2018
Aim To investigate epidemiological characteristics of the measles epidemic (risk factors and reasons for its emergence) in order to establish better control and prevention of future epidemics as well as to determine an influence of poor collective immunization of children against measles on appearance of epidemic disease. Methods An open retrospective epidemiological study of measles infection was conducted during the epidemic in Zenica-Doboj Canton (ZDC) in the period 2014-2015. Disease reports, Disease Reporting Forms for measles and rubella cases and the Bulletin of the Institute for Health and Food Safety Zenica were used for data collection. Results A total of 325 patients with the diagnosis of measles were registered, 262 (80.61%) in 2014 and 63 (19.39%) in 2015 resulting in overall incidence of 81.25/100.000. The majority of patients were aged 0-6 (p<0.05). Of the total number of patients, only 13 (4.73%) were orderly vaccinated (p <0.05). In the period 2009- 2015 in ZD...
Measles lessons in an anti-vaccination era: public health is a social duty, not a political option
Italian Journal of Pediatrics
Background: Measles virus, member of the genus Morbillivirus in the family Paramyxoviridae, is a highly contagious human pathogen. An effective live-attenuated vaccine is available and its use has the potential to eradicate the disease from the human population. Although the vaccine was introduced in national vaccination schedules, several measles outbreaks have occurred because of insufficient vaccination coverage. Since early January 2017, a new outbreak of measles in Italy has been observed. Methods: We analyzed all the patients admitted to the Emergency Department of Bambino Gesù Children Hospital of Rome from the 1st of January 2017 to the end of May 2017 and discharged with diagnosis of suspected or confirmed measles or admitted to the Pediatric and Infectious Disease Unit. For each confirmed case, demographic data, vaccination history, exposure to source case, clinical presentation, date of onset of symptoms, hospitalization, laboratory test results, complications and therapy were collected. Results: From the 1st of January 2017 to the 31st of May 2017, we enrolled 139 patients who were conducted to the Emergency Department of Bambino Gesù Children's Hospital because of measles: 33 patients were discharged with the diagnosis of suspected measles by clinical manifestations; 33 discharged with the diagnosis of confirmed measles by laboratory tests and 73 were admitted to the Pediatric and Infectious Disease Unit. Seven patients, who were exposed to mothers with measles, were admitted to receive treatment with Measles Immune Globulin intravenously. Among the 66 patients admitted to the hospital with measles, 31 cases (47%) occurred in unvaccinated individuals who were age-eligible for measles vaccination; 29 (44%) were infants too young to be vaccinated; only five patients (8%) received one dose of measles-containing vaccine. Out of the 66 patients, 35 (53%) developed complications. Acute respiratory failure was the most reported complications (20%). Death, due to multiorgan failure by measles, occurred in one 9-girl-year-age patient with genetic disorders who was unvaccinated. Conclusions: Measles still represents a serious public health problem worldwide. Vaccination against measles is safe, effective, and cost-effective. High vaccination coverage (>95%) with two doses of measles vaccine is crucial to elimination. Health care professionals play an important role in vaccination uptake and prevention of measles spread during an outbreak.
Increase in cases of measles in Europe
Medycyna Ogólna i Nauki o Zdrowiu
Introduction. Measles still remains a serious global epidemiological challenge. The article discusses the problem of epidemiological threats associated with the increasing incidence of measles in Europe in recent years. An exceptionally high contagion index (95%) of measles is underlined in the characteristics of this disease. Objective. The aim is to illustrate the epidemiological threat and risk for the European continent associated with the increase in the incidence of measles in recent years. Brief description of the state of knowledge. The incidence of measles was increasing in the investigated time period. This is thought to be associated with a worsening epidemiological situation in Ukraine, Romania, France, Germany and Italy, which is linked with the failure to implement national immunisation programmes that continue to be the most effective instrument for measles prevention. Conclusions. There is a certain correlation between the increase in the incidence of measles in the past years and level.of vaccination coverage. Migration from countries with a high percentage of non-vaccinated people and with a high increase in incidence, to countries where measles prevention is superior, is also a source of threat within the evaluated region. Tightening the immunisation system and administration of vaccines to non-vaccinated migrants in the target country seems to be the only solution. It is also extremely important to make parents aware of the safety of vaccination as the most effective protection against infectious diseases.
Effectiveness of Measles Vaccination After Household Exposure During a Measles Outbreak
The Pediatric Infectious Disease Journal, 2005
Background: A measles outbreak was recently observed in Coburg, Bavaria, in a population with vaccination rates of 76.5% in 5-to 6-year-old children in the years preceding the outbreak. Only a small proportion of children had received 2 vaccinations against measles. Vaccine effectiveness is estimated in a household contact study and also by a screening method. Methods: A household contact study was conducted in families with at least 1 measles case by standardized computer-assisted telephone interviews to assess secondary attack rate and to estimate vaccine effectiveness. Vaccine effectiveness was also estimated with Farrington's screening method with information from school entry examinations and from questionnaires of confirmed measles cases in the Coburg outbreak. Results: Thirty-eight children were primary cases. Of their contacts, 20 children were included in the study as secondary cases (1 vaccinated), and 23 children were contacts who did not develop measles (12 vaccinated once and 4 vaccinated twice), resulting in a vaccine effectiveness of 90% (95% confidence interval, 35-97%) for one vaccine dose. The proportion of the population vaccinated reached 81.5% during the outbreak and the proportion of the cases vaccinated was 10.9%, resulting in a vaccine effectiveness estimated using the screening method of 97.2% (95% confidence interval, 95.7-98.3%). Conclusions: With the use of 2 approaches to estimate the effectiveness of measles vaccination, a consistently high vaccine effectiveness of 90% or above was shown during a measles outbreak in Western Europe.