1
|
Taffie W, Temesgen H, Ashebir W, Mekonen H. Measles second dose vaccine uptake and its associated factors among children aged 24-35 months in Northwest Ethiopia, 2022. Sci Rep 2024; 14:11059. [PMID: 38744908 PMCID: PMC11094091 DOI: 10.1038/s41598-024-61048-9] [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: 05/19/2023] [Accepted: 04/30/2024] [Indexed: 05/16/2024] Open
Abstract
Measles is a major public health problem in under-five children, leading to lifelong complications. Therefore, the study aimed to assess the magnitude of measles second-dose vaccine uptake and its determinants among children aged 24-35 months in Northwest Ethiopia. A community-based cross-sectional study was conducted among 418 children aged 24-35 months in Northwest Ethiopia between January 2022 and February 2022. A simple random sampling technique was used to access study subjects. A binary logistic regression model was employed. An adjusted odd ratio with a 95% confidence interval (CI) and a p-value < 0.05 was used to declare significant predictors of measles second dose vaccine uptake. The magnitude of the measles second dose vaccine uptake among children aged 24-35 months was 41.39%. Postnatal care visits (AOR: 4.78, CI 1.49, 15.34), child vaccination status of other scheduled vaccines (AOR: 3.88, CI 2.23, 6.73), awareness of the measles second dose vaccine and its schedule (AOR: 8.924, CI 5.27, 15.09), and distance from the vaccination center (AOR: 0.21, CI 0.06, 0.77) were significantly associated with measles second dose vaccine uptake. The uptake of measles second dose vaccine in the study area was low. Therefore, health workers and other partners should initiate awareness creation programs for mothers/caretaker to improve the uptake of measles second dose vaccine.
Collapse
Affiliation(s)
- Worku Taffie
- East Gojjam Zone, Shebel Berenta Woreda Health Office, Debre Markos, Ethiopia
| | - Habtamu Temesgen
- Department of Human Nutrition, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Wassachew Ashebir
- Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Habitamu Mekonen
- Department of Human Nutrition, College of Health Science, Debre Markos University, Debre Markos, Ethiopia.
| |
Collapse
|
2
|
Shimelis Y, Asrat A, Tadege T, Feleke SF. Measles outbreak investigation in Berhet District, North Shewa, Ethiopia. Front Public Health 2024; 12:1330205. [PMID: 38756880 PMCID: PMC11097952 DOI: 10.3389/fpubh.2024.1330205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/29/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction Measles, though usually self-limiting, can have severe consequences influenced by factors such as vaccination and nutrition, notably vitamin A deficiency and malnutrition. Despite progress, contextual changes and implementation issues have hampered efforts, resulting in increased outbreaks and cases of measles. This study seeks to pinpoint outbreak features, risk factors, and strategies for preventing and controlling measles. Methods A descriptive cross-sectional study and a 1:2 unmatched case-control study design were employed. All 101 suspected measles cases listed on the line-list were included in the descriptive research, with 60 measles patients and 120 controls included in the case-control investigation. Line-list data were cleaned and analyzed using a pivot table in Microsoft Excel 2016. Subsequently, the data were cleaned, entered into Epi Info 7.2, and exported to SPSS 26 for analysis. Results Twenty cases occurred per 10,000 individuals. Men accounted for 67.3% of cases, with ages ranging from 5 months to 45 years and mean and standard deviations of 9.6 and 7.6, respectively. Age group of 5-14 years comprised 57.4% of cases, followed by 1-4 years with 24.8%. Being unvaccinated against measles showed an adjusted odds ratio (AOR) of 12.06 (95% CI: 3.12-46.52). Travel history to regions with active cases had an AOR of 5.73 (95% CI: 1.78-18.38). Contact with a measles patient showed an AOR of 10.3 (95% CI: 3.48-30.5). Understanding the measles transmission mechanism had an AOR of 0.164 (95% CI: 0.049-0.55), and awareness of the disease's preventability had an AOR of 0.233 (95% CI: 0.67-0.811). All factors were independently associated with the illness. Conclusion This outbreak affected a broader age range with a high attack rate, mainly in the age group of 5-14-years. Over 35% of cases lacked measles vaccination, indicating low administrative vaccine coverage. Factors contributing to the outbreak include lack of measles vaccination, travel to areas with active disease, contact with cases, and insufficient knowledge of measles transmission and prevention strategies among mothers and caregivers.
Collapse
Affiliation(s)
- Yohannes Shimelis
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Anemaw Asrat
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Sefineh Fenta Feleke
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| |
Collapse
|
3
|
Stein-Zamir C, Abramson N, Sokolov I, Mor-Shimshi L, Shoob H. Case Ascertainment of Measles during a Large Outbreak-Laboratory Compared to Epidemiological Confirmation. Diagnostics (Basel) 2024; 14:943. [PMID: 38732357 PMCID: PMC11082954 DOI: 10.3390/diagnostics14090943] [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: 02/01/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/13/2024] Open
Abstract
Measles is a highly contagious viral disease, and hence, sufficient herd immunity is obligatory to prevent infection transmission. Measles is still a cause of considerable disease burden globally, mainly in children. During a national measles outbreak in Israel in 2018-2019, the peak incidence rates occurred in the Jerusalem district. Most measles cases in the Jerusalem district (75.5%, 1702) were observed in children younger than 15 years of age, 49.2% (1109) were in children under 5 years of age, and 18.9% (425) were in infants under 1 year of age. The routine measles vaccination schedule includes two doses at 1 and 6 years of age. Most cases (1828, 81.1%) were unvaccinated (zero measles vaccine doses). These cases comprised the 425 affected infants under 1 year of age, who were ineligible for vaccination, along with the 1403 children over 1 year of age, who were otherwise unvaccinated. This study aimed to describe the epidemiologic and laboratory features of this measles outbreak, and to investigate case ascertainment (laboratory confirmed compared to epidemiologically confirmed cases). The study population included 2254 measles cases notified during the period spanning June 2018 to May 2019 in the Jerusalem district (incidence rate 176 per 10,000 population). Of the 2254 cases, 716 (31.8%) were laboratory confirmed, and 1538 (68.2%) were confirmed as epidemiologically linked. Most laboratory confirmed cases (420, 58.7%) underwent real-time PCR tests. Serological tests (measles IgM and IgG) were used in 189 (26.4%) cases, and a combination of RT-PCR and serology was used in 107 (14.9%) cases. In a multivariate model analysis, the variables significantly associated (after adjustment) with higher odds for laboratory confirmation included month of disease onset (late), additional measles cases in the household (single case), place of medical treatment (hospital; either emergency department, or hospitalization) and vaccination status (at least one prior vaccine dose). The measles outbreak described demonstrates the urgency of addressing vaccination gaps with appropriate outbreak prevention programs. The road to measles elimination needs to be paved with robust public health infrastructure, excellent field epidemiology for outbreak surveillance, investigation, and control, and laboratory proficiency.
Collapse
Affiliation(s)
- Chen Stein-Zamir
- Jerusalem District Health Office, Ministry of Health, Jerusalem 9134302, Israel; (N.A.); (I.S.); (L.M.-S.); (H.S.)
- Faculty of Medicine, Hadassah Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Nitza Abramson
- Jerusalem District Health Office, Ministry of Health, Jerusalem 9134302, Israel; (N.A.); (I.S.); (L.M.-S.); (H.S.)
| | - Irina Sokolov
- Jerusalem District Health Office, Ministry of Health, Jerusalem 9134302, Israel; (N.A.); (I.S.); (L.M.-S.); (H.S.)
| | - Lia Mor-Shimshi
- Jerusalem District Health Office, Ministry of Health, Jerusalem 9134302, Israel; (N.A.); (I.S.); (L.M.-S.); (H.S.)
| | - Hanna Shoob
- Jerusalem District Health Office, Ministry of Health, Jerusalem 9134302, Israel; (N.A.); (I.S.); (L.M.-S.); (H.S.)
| |
Collapse
|
4
|
Durrheim DN, Murray P, Turner N. Resurgent global measles: A threat to Australia, New Zealand and Pacific Island Countries. J Paediatr Child Health 2024; 60:73-75. [PMID: 38426362 DOI: 10.1111/jpc.16530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 02/25/2024] [Indexed: 03/02/2024]
Affiliation(s)
- David N Durrheim
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Population Health, Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - Peter Murray
- Population Health, Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - Nikki Turner
- Deparment of General Practice and Primary Care, University of Auckland, Auckland, New Zealand
| |
Collapse
|
5
|
Stanescu A, Ruta SM, Cernescu C, Pistol A. Suboptimal MMR Vaccination Coverages-A Constant Challenge for Measles Elimination in Romania. Vaccines (Basel) 2024; 12:107. [PMID: 38276679 PMCID: PMC10819452 DOI: 10.3390/vaccines12010107] [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: 11/28/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
Measles is targeted for elimination since 2001, with a significant reduction in cases recorded worldwide, but outbreaks occur periodically due to immunization gaps. This study analyzes the evolution of vaccination coverage rates (VCRs) in Romania, a EU country with large measles epidemics during the last two decades, including an ongoing outbreak in 2023. Vaccination against measles has been part of the National Immunization Program since 1979, initially as a single dose, and from 1994 onwards it has had two doses. The initially high national VCRs of >97% gradually declined from 2010 onward and remained constantly under 90%, with further decreases during the COVID-19 pandemic. The lowest VCRs for both vaccine doses in the last decade were recorded in 2022 and were 83.4% for the first dose and 71.4% for the second dose, with significant differences among Romania's 42 counties. Several factors contributed to this decline, including failure to attend the general practitioners' offices, increased number of children lost to follow-up due to population movements, missed vaccination opportunities due to temporary medical contraindications, a surge in vaccine hesitancy/refusal, a decreasing number of general practitioners and discontinuities in vaccine supply. The persisting suboptimal VCRs in Romania threaten the progress toward measles elimination.
Collapse
Affiliation(s)
- Aurora Stanescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.S.); (A.P.)
- National Institute of Public Health, National Centre for Communicable Diseases Surveillance and Control, 050463 Bucharest, Romania
| | - Simona Maria Ruta
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.S.); (A.P.)
- Department of Viral Emerging Diseases, Stefan. S. Nicolau Institute of Virology, 030304 Bucharest, Romania
| | | | - Adriana Pistol
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (A.S.); (A.P.)
- National Institute of Public Health, National Centre for Communicable Diseases Surveillance and Control, 050463 Bucharest, Romania
| |
Collapse
|
6
|
Barakat M, Abdaljaleel M, Atawneh N, Alkhazaleh R, Aburumman D, Hamed E, Sallam M. Pervasive Parental Hesitancy and Resistance towards Measles Rubella Vaccination in Jordan. Vaccines (Basel) 2023; 11:1672. [PMID: 38006004 PMCID: PMC10674877 DOI: 10.3390/vaccines11111672] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
Measles remains a highly contagious and potentially severe infectious disease, necessitating high vaccine coverage. However, misinformation and measles vaccine hesitancy/resistance have posed significant challenges to achieving this goal. The COVID-19 pandemic further exacerbated these challenges, leading to a measles outbreak in Jordan in 2023. This study aimed to investigate the acceptance of the measles rubella (MR) vaccine among parents in Jordan and to identify its associated determinants. This cross-sectional questionnaire-based study was conducted using a previously Arabic-validated version of the Parental Attitudes towards Childhood Vaccines (PACV) survey instrument. Data collection took place in October 2023, and the final study sample comprised a total of 391 parents, with mothers representing 69.8% of the participants (n = 273). The majority of participating parents expressed either resistance (n = 169, 43.2%) or hesitancy (n = 168, 43.0%) towards MR vaccination, while only 54 participants (13.8%) expressed MR vaccine acceptance. Multivariate analysis revealed that trust in vaccine safety/efficacy, behavior, and having fewer offspring were significantly associated with MR vaccine acceptance. The current study revealed a concerning level of MR vaccine hesitancy/resistance among parents in Jordan, which could signal a public health alarm in the country. Urgent and targeted interventions are strongly recommended to address this issue, including mass campaigns aimed at building trust in the MR vaccine's safety/efficacy. Additionally, there is an urgent need for effective public health initiatives to ensure sufficient measles vaccine coverage to prevent future outbreaks of this serious disease.
Collapse
Affiliation(s)
- Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman 11931, Jordan;
- MEU Research Unit, Middle East University, Amman 11831, Jordan
| | - Maram Abdaljaleel
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
| | - Nada Atawneh
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Rawan Alkhazaleh
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Dana Aburumman
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Eman Hamed
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
| |
Collapse
|
7
|
Masters NB, Beck AS, Mathis AD, Leung J, Raines K, Paul P, Stanley SE, Weg AL, Pieracci EG, Gearhart S, Jumabaeva M, Bankamp B, Rota PA, Sugerman DE, Gastañaduy PA. Measles virus transmission patterns and public health responses during Operation Allies Welcome: a descriptive epidemiological study. Lancet Public Health 2023; 8:e618-e628. [PMID: 37516478 PMCID: PMC10411127 DOI: 10.1016/s2468-2667(23)00130-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 06/07/2023] [Accepted: 06/20/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND On Aug 29, 2021, Operation Allies Welcome (OAW) was established to support the resettlement of more than 80 000 Afghan evacuees in the USA. After identification of measles among evacuees, incoming evacuee flights were temporarily paused, and mass measles vaccination of evacuees aged 6 months or older was introduced domestically and overseas, with a 21-day quarantine period after vaccination. We aimed to evaluate patterns of measles virus transmission during this outbreak and the impact of control measures. METHODS We conducted a measles outbreak investigation among Afghan evacuees who were resettled in the USA as part of OAW. Patients with measles were defined as individuals with an acute febrile rash illness between Aug 29, 2021, and Nov 26, 2021, and either laboratory confirmation of infection or epidemiological link to a patient with measles with laboratory confirmation. We analysed the demographics and clinical characteristics of patients with measles and used epidemiological information and whole-genome sequencing to track transmission pathways. A transmission model was used to evaluate the effects of vaccination and other interventions. FINDINGS 47 people with measles (attack rate: 0·65 per 1000 evacuees) were reported in six US locations housing evacuees in four states. The median age of patients was 1 year (range 0-26); 33 (70%) were younger than 5 years. The age distribution shifted during the outbreak towards infants younger than 12 months. 20 (43%) patients with wild-type measles virus had rash onset after vaccination. No fatalities or community spread were identified, nor further importations after flight resumption. In a non-intervention scenario, transmission models estimated that a median of 5506 cases (IQR 10-5626) could have occurred. Infection clusters based on epidemiological criteria could be delineated into smaller clusters using phylogenetic analyses; however, sequences with few substitution count differences did not always indicate single lines of transmission. INTERPRETATION Implementation of control measures limited measles transmission during OAW. Our findings highlight the importance of integration between epidemiological and genetic information in discerning between individual lines of transmission in an elimination setting. FUNDING US Centers for Disease Control and Prevention.
Collapse
Affiliation(s)
- Nina B Masters
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Andrew S Beck
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Adria D Mathis
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jessica Leung
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kelley Raines
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Prabasaj Paul
- Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Scott E Stanley
- Office of the Joint Staff Surgeon, The Joint Staff, Department of Defense, Washington, DC, USA
| | - Alden L Weg
- Office of the Joint Staff Surgeon, The Joint Staff, Department of Defense, Washington, DC, USA
| | - Emily G Pieracci
- Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shannon Gearhart
- Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Madina Jumabaeva
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, USA
| | - Bettina Bankamp
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Paul A Rota
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - David E Sugerman
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Paul A Gastañaduy
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
8
|
Herdea V, Tarciuc P, Ghionaru R, Lupusoru M, Tataranu E, Chirila S, Rosu O, Marginean CO, Leibovitz E, Diaconescu S. Vaccine Hesitancy Phenomenon Evolution during Pregnancy over High-Risk Epidemiological Periods-"Repetitio Est Mater Studiorum". Vaccines (Basel) 2023; 11:1207. [PMID: 37515023 PMCID: PMC10384756 DOI: 10.3390/vaccines11071207] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: The recent epidemiological events were high-stress level generators for humanity, particularly for pregnant women, influencing their attitude, behavior, and decisions regarding vaccination during pregnancy or regarding their future child. The aim of this study was to analyze the anti-pertussis vaccination decision-shaping factors in pregnant women during two epidemiological periods: the measles epidemic and the COVID-19 pandemic. (2) Methods: Two groups of pregnant women were invited to be part of a medical education program, having as the main theme the infectious disease risks and their prevention through vaccination. Before launching the program, participants received a 12-item questionnaire. From a total number of 362 pregnant women enrolled in the study, 182 participated in 2019, and 180 participated in 2022. (3) Results: The socio-demographic data revealed that the age of pregnant women participating in medical education programs increased in 2022 by 1.7 years (p < 0.01). In vitro fertilization was reported in a significantly higher proportion (20% in 2022 vs 9.8% in 2019, p < 0.01). Participation in community-initiated educational programs almost doubled during the pandemic time from 18.7% in 2019 to 33.9% in 2022 (p < 0.01). Pertussis vaccine acceptancy (VA) dropped from 85% in 2019 to 44.4% in 2022 (p < 0.01) (4) Conclusions: In this study, we reported fast-growing vaccine hesitancy and severe declared vaccine reluctance. The results of this complex long-term study, which evaluated pregnant women over several years, showed a five-fold increase in the percentage of pregnant women who disagreed with personal pertussis vaccination. This draws attention to the risks of pertussis epidemic outbreaks in pregnant women and their future infants in the first couple of months of life before the initiation of vaccination.
Collapse
Affiliation(s)
- Valeria Herdea
- Doctoral School, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Petruta Tarciuc
- Doctoral School, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Raluca Ghionaru
- Romanian Association for Pediatric Education in Family Medicine, 021507 Bucharest, Romania
| | - Mircea Lupusoru
- Department of Physiology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Elena Tataranu
- Faculty of Medicine and Biological Sciences, “Stefan cel Mare” University of Suceava, 720229 Suceava, Romania
| | - Sergiu Chirila
- Faculty of Medicine, Ovidius University of Constanta, 900470 Constanta, Romania
| | - Oana Rosu
- Doctoral School, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Cristina Oana Marginean
- Department of Pediatrics, “George Emil Palade” University of Medicine, Pharmacy, Science, andTechnology of Targu Mures, 540142 Targu Mures, Romania;
| | - Eugene Leibovitz
- The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva 85025, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 85025, Israel
| | - Smaranda Diaconescu
- Medical-Surgical Department, Faculty of Medicine, Titu Maiorescu University of Medicine and Pharmacy, 031593 Bucharest, Romania;
| |
Collapse
|
9
|
Yılmaz TD, Üçeş Harmanoğulları L. Infectious Diseases and Migration: Measles Cases in a Province, Turkey Before and After the Pandemic. GÜNCEL PEDIATRI 2022. [DOI: 10.4274/jcp.2022.82246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
10
|
Immunogenicity after outbreak response immunization activities among young healthcare workers with secondary vaccine failure during the measles epidemic in Korea, 2019. BMC Infect Dis 2022; 22:530. [PMID: 35676650 PMCID: PMC9175155 DOI: 10.1186/s12879-022-07511-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite high vaccination coverage, measles outbreaks have been reported in measles elimination countries, especially among healthcare workers in their 20 and 30 s. This study was designed to identify measles-susceptible individuals and to evaluate whether primary or secondary vaccine failure occurred during measles outbreak response immunization (ORI) activities. METHODS The study population was divided into three groups as follows: natural immunity group (Group 1), vaccine-induced immunity group (Group 2), and vaccine failure group (Group 3). We evaluated the immunogenicity of measles among healthcare workers using three methods-enzyme-linked immunoassays, plaque reduction neutralization tests, and avidity assays. The results were assessed at baseline, 4 weeks after, and 6 months after the completion of measles-mumps-rubella (MMR) vaccination. RESULTS In total, 120 subjects were enrolled, with 40 subjects in each group. The median age of Group 3 was 29 years, which was significantly lower than that of the other groups. The baseline negative measles virus (MeV) IgG in Group 3 increased to a median value of 165 AU/mL at 4 weeks after ORI and was lower than that in Groups 1 and 2. The median neutralizing antibody titer was highest in Group 1, and this was significantly different from that in Group 2 or Group 3 at 4 weeks (944 vs. 405 vs. 482 mIU/mL, P = 0.001) and 6 months (826 vs. 401 vs. 470, P = 0.011) after ORI. The rates of high MeV avidity IgG were highest in Group 2, and these were significantly different from those in Groups 1 or 3 at 4 weeks (77.5 vs. 90% vs. 88.6%, P = 0.03) and 6 months (81 vs. 94.8 vs. 82.1%, P = 0.01) after ORI. CONCLUSIONS Considering the MeV-neutralizing antibodies and IgG avidity after MMR vaccination in measles-susceptible group, vaccine failure is inferred as secondary vaccine failure, and further data regarding the maintenance of immunogenicity are needed based on long-term data. The MeV-neutralizing antibody levels were highest in the natural immunity group, and the primary vaccine-induced immunity group showed the highest rates of high MeV IgG avidity.
Collapse
|
11
|
Abstract
Measles is a highly contagious, potentially fatal, but vaccine-preventable disease caused by measles virus. Symptoms include fever, maculopapular rash, and at least one of cough, coryza, or conjunctivitis, although vaccinated individuals can have milder or even no symptoms. Laboratory diagnosis relies largely on the detection of specific IgM antibodies in serum, dried blood spots, or oral fluid, or the detection of viral RNA in throat or nasopharyngeal swabs, urine, or oral fluid. Complications can affect many organs and often include otitis media, laryngotracheobronchitis, pneumonia, stomatitis, and diarrhoea. Neurological complications are uncommon but serious, and can occur during or soon after the acute disease (eg, acute disseminated encephalomyelitis) or months or even years later (eg, measles inclusion body encephalitis and subacute sclerosing panencephalitis). Patient management mainly involves supportive therapy, such as vitamin A supplementation, monitoring for and treatment of secondary bacterial infections with antibiotics, and rehydration in the case of severe diarrhoea. There is no specific antiviral therapy for the treatment of measles, and disease control largely depends on prevention. However, despite the availability of a safe and effective vaccine, measles is still endemic in many countries and causes considerable morbidity and mortality, especially among children in resource-poor settings. The low case numbers reported in 2020, after a worldwide resurgence of measles between 2017 and 2019, have to be interpreted cautiously, owing to the effect of the COVID-19 pandemic on disease surveillance. Disrupted vaccination activities during the pandemic increase the potential for another resurgence of measles in the near future, and effective, timely catch-up vaccination campaigns, strong commitment and leadership, and sufficient resources will be required to mitigate this threat.
Collapse
Affiliation(s)
- Judith M Hübschen
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.
| | - Ionela Gouandjika-Vasilache
- Laboratoire des Virus Entériques et de la Rougeole, Institut Pasteur de Bangui, Bangui, Central African Republic
| | - Julia Dina
- Virology Department, Normandie University, UNICAEN, INSERM U1311 DynaMicURe, Caen University Hospital, Caen, France
| |
Collapse
|
12
|
Stanoeva KR, Kohl RHG, Bodewes R. Co-detection of the measles vaccine and wild-type virus by real-time PCR: public health laboratory protocol. Access Microbiol 2022; 3:000283. [PMID: 35018327 PMCID: PMC8742590 DOI: 10.1099/acmi.0.000283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/23/2021] [Indexed: 11/25/2022] Open
Abstract
In rare cases vaccination with the measles virus vaccine genotype A (MeVA) may cause a vaccine reaction with clinical signs similar to infection with wild-type measles virus (MeVwt). Rapid differentiation between MeVA and MeVwt infection is important for taking adequate public health measures. Recently, a few MeVA real-time reverse-transcription quantitative PCR methods (RT-qPCRs) were described that can distinguish between MeVA and MeVwt. However, detection of MeVA does in theory not exclude infection with MeVwt. In the present study, we established a protocol for determination of co-infections with MeVA and MeVwt. To this end, MeVA RT-qPCRs were used in combination with the routine measles virus (MeV) RT-qPCR, and the results suggested that the differences between the RT-qPCR Ct values (delta Ct, ∆Ct) could be used as criteria. Subsequently, we tested samples from vaccine-associated measles cases that were confirmed by genotyping. In addition, experimental mixtures of MeVA and MeVwt were tested in different concentrations. All tested MeVA clinical samples had ∆Ct ≤3.6. The results of experimental mixtures showed a mean ∆Ct ≤2.8 for genotype A alone and >3.2 when combined with either genotype B3 or D8. The results of a receiver operator characteristic analysis indicated that the optimum ∆Ct for use as a cut-off value was 3.5, while with ∆Ct values of 2.9 and 3.7 sensitivity and specificity were respectively 1.00. Thus, ∆Ct could be used to exclude the presence of MeVwt if MeVA is detected and ∆Ct is <2.9, while ∆Ct >3.7 were highly suggestive of co-infection and ≥2.9 ∆Ct <3.7 warranted additional confirmation, such as next-generation sequencing. This RT-qPCR-based protocol could be used for the exclusion of infection with MeVwt in cases with vaccine-associated measles reaction, crucial for the timely implementation of public health prevention and control measures.
Collapse
Affiliation(s)
- Kamelia R Stanoeva
- Centre for Infectious Disease Research, Diagnostics and laboratory Surveillance (IDS), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.,European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Robert H G Kohl
- Centre for Infectious Disease Research, Diagnostics and laboratory Surveillance (IDS), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Rogier Bodewes
- Centre for Infectious Disease Research, Diagnostics and laboratory Surveillance (IDS), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| |
Collapse
|
13
|
Banerjee E, Paul P, Griffith J, Laine E, Como-Sabetti K, Gastañaduy PA. Impact of isolation and exclusion as a public health strategy to contain measles virus transmission during a measles outbreak. Clin Infect Dis 2021; 75:152-154. [PMID: 34755856 DOI: 10.1093/cid/ciab939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Indexed: 11/14/2022] Open
Abstract
Responding to measles outbreaks in the United States puts a considerable strain on public health resources, and limited research exists about the effectiveness of containment strategies. In this paper we quantify the impact of isolation, contact tracing, and exclusion in reducing transmission during a measles outbreak in an under-vaccinated community.
Collapse
Affiliation(s)
- Emily Banerjee
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Prabasaj Paul
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jayne Griffith
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Ellen Laine
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | | | - Paul A Gastañaduy
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
14
|
Bangalee A, Bangalee V. Fake news and fallacies: Exploring vaccine hesitancy in South Africa. S Afr Fam Pract (2004) 2021; 63:e1-e3. [PMID: 34797097 PMCID: PMC8603179 DOI: 10.4102/safp.v63i1.5345] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/02/2021] [Accepted: 08/05/2021] [Indexed: 11/01/2022] Open
Abstract
Historically, vaccine hesitancy (VH) has been a thorn in the side of public health efforts to contain and eradicate infectious diseases. This phenomenon is magnified in light of the current coronavirus disease 2019 (COVID-19) pandemic. Surveys conducted across South Africa since the outbreak of COVID-19 demonstrate the complexity of factors that contribute towards VH in this population. Amidst the negative press that the COVID-19 vaccine has received, especially across social media, understanding and combatting VH remains important to achieve herd immunity. This article aims to shed light on key factors fuelling COVID-19 VH in South Africa and provides a framework from which to address this problem.
Collapse
Affiliation(s)
- Avania Bangalee
- Department of Medical Virology, Faculty of Health Sciences, Prinshof Campus, University of Pretoria, Pretoria, South Africa; and, National Health Laboratory Services, Johannesburg.
| | | |
Collapse
|
15
|
Social Distancing Associations with COVID-19 Infection and Mortality Are Modified by Crowding and Socioeconomic Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094680. [PMID: 33924821 PMCID: PMC8124372 DOI: 10.3390/ijerph18094680] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/23/2021] [Accepted: 04/25/2021] [Indexed: 12/21/2022]
Abstract
The SARS-CoV-2 virus is a public health emergency. Social distancing is a key approach to slowing disease transmission. However, more evidence is needed on its efficacy, and little is known on the types of areas where it is more or less effective. We obtained county-level data on COVID-19 incidence and mortality during the first wave, smartphone-based average social distancing (0–5, where higher numbers indicate more social distancing), and census data on demographics and socioeconomic status. Using generalized linear mixed models with a Poisson distribution, we modeled associations between social distancing and COVID-19 incidence and mortality, and multiplicative interaction terms to assess effect modification. In multivariable models, each unit increase in social distancing was associated with a 26% decrease (p < 0.0001) in COVID-19 incidence and a 31% decrease (p < 0.0001) in COVID-19 mortality. Percent crowding, minority population, and median household income were all statistically significant effect modifiers. County-level increases in social distancing led to reductions in COVID-19 incidence and mortality but were most effective in counties with lower percentages of black residents, higher median household incomes, and with lower levels of household crowding.
Collapse
|
16
|
Hernandez N, Castro L, Medina-Quero J, Favela J, Michan L, Mortenson WB. Scoping Review of Healthcare Literature on Mobile, Wearable, and Textile Sensing Technology for Continuous Monitoring. JOURNAL OF HEALTHCARE INFORMATICS RESEARCH 2021; 5:270-299. [PMID: 33554008 PMCID: PMC7849621 DOI: 10.1007/s41666-020-00087-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/30/2020] [Accepted: 12/02/2020] [Indexed: 12/01/2022]
Abstract
Remote monitoring of health can reduce frequent hospitalisations, diminishing the burden on the healthcare system and cost to the community. Patient monitoring helps identify symptoms associated with diseases or disease-driven disorders, which makes it an essential element of medical diagnoses, clinical interventions, and rehabilitation treatments for severe medical conditions. This monitoring can be expensive and time-consuming and provide an incomplete picture of the state of the patient. In the last decade, there has been a significant increase in the adoption of mobile and wearable devices, along with the introduction of smart textile solutions that offer the possibility of continuous monitoring. These alternatives fuel a technology shift in healthcare, one that involves the continuous tracking and monitoring of individuals. This scoping review examines how mobile, wearable, and textile sensing technology have been permeating healthcare by offering alternate solutions to challenging issues, such as personalised prescriptions or home-based secondary prevention. To do so, we have selected 222 healthcare literature articles published from 2007 to 2019 and reviewed them following the PRISMA process under the schema of a scoping review framework. Overall, our findings show a recent increase in research on mobile sensing technology to address patient monitoring, reflected by 128 articles published in journals and 19 articles in conference proceedings between 2014 and 2019, which represents 57.65% and 8.55% respectively of all included articles.
Collapse
Affiliation(s)
- N Hernandez
- School of Computing, Campus Jordanstown, Ulster University, Newtownabbey, BT37-0QB UK
| | - L Castro
- Department of Computing and Design, Sonora Institute of Technology (ITSON), Ciudad Obregón, 85000 Mexico
| | - J Medina-Quero
- Department of Computer Science, Campus Las Lagunillas, University of Jaen, Jaén, 23071 Spain
| | - J Favela
- Department of Computer Science, Ensenada Centre for Scientific Research and Higher Education, Ensenada, 22860 Mexico
| | - L Michan
- Department of Comparative Biology, National Autonomous University of Mexico, Mexico City, 04510 Mexico
| | - W Ben Mortenson
- International Collaboration on Repair Discoveries and GF Strong Rehabilitation Research Program, University of British Columbia, Vancouver, V6T-1Z4 Canada
| |
Collapse
|
17
|
Dimala CA, Kadia BM, Nji MAM, Bechem NN. Factors associated with measles resurgence in the United States in the post-elimination era. Sci Rep 2021; 11:51. [PMID: 33420153 PMCID: PMC7794463 DOI: 10.1038/s41598-020-80214-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 12/18/2020] [Indexed: 11/29/2022] Open
Abstract
There have been growing concerns of a potential re-establishment of measles transmission in the United States (US) in the years to come. This study aims to explore potential factors underlying the resurgence of measles in the US by objectively assessing the associations between annual incidence rates (AIR), case importation, vaccination status and disease outbreaks. Data on measles transmission between January 1st, 2001 and December 31st, 2019 were obtained from the national centres for disease control and prevention (CDC) surveillance databases and other published reports. Changes in incidence rates over time were assessed by binomial regression models. Of the 3874 cases of measles in the US over the study period, 3506 (90.5%, 95% CI: 89.5-91.4) occurred in US residents. The AIR per million population in US residents over this period was 0.60 (95% CI: 0.59-0.61), with an overall significant increase over time (p = 0.011). The median percentage of imported and vaccinated cases were 36% [17.9-46.6] and 15% [12.1-23.2] respectively. There was a significant decrease in the percentage of imported cases (p < 0.001) but not of vaccinated cases (p = 0.159) over time. There was a moderate and weak negative correlation between the AIR and the percentage of imported and vaccinated cases respectively (r = -0.59 and r = -0.27 respectively). On multiple linear regression there was a significant linear association between the AIR and the number of outbreaks (p = 0.003) but not with the percentage of imported cases (p = 0.436) and vaccinated cases (p = 0.692), R2 = 0.73. Strong negative and positive correlations were seen between the number of outbreaks and the percentage of imported cases (r = -0.61) and the of number states affected (r = 0.88) respectively. Despite the overall reduction in the percentage of imported cases of measles over the past two decades, pockets of internal transmission of the disease following importation via increasing number of outbreaks in unvaccinated subpopulations, reinforced by vaccine hesitancy, account for the sustained increase in measles incidence rates in the US. Controlling indigenous transmission through efficient vaccination coverage in at-risk subpopulations and among international US travellers, improved disease surveillance and rapid outbreak containment are essential in curbing the measles resurgence.
Collapse
Affiliation(s)
- Christian Akem Dimala
- Department of Medicine, Reading Hospital, Tower Health System, West Reading, PA, USA
- Infectious Diseases Unit, University Hospitals of Leicester NHS, Leicester, UK
- Health and Human Development (2HD) Research Network, Douala, Cameroon
| | - Benjamin Momo Kadia
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
| | | | - Ndemazie Nkafu Bechem
- College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee, FL, USA
| |
Collapse
|
18
|
Zhang H, Chen C, Tang A, Wu B, Liu L, Wu M, Wang H. Epidemiological Investigation and Virus Tracing of a Measles Outbreak in Zhoushan Islands, China, 2019. Front Public Health 2020; 8:600196. [PMID: 33335880 PMCID: PMC7736039 DOI: 10.3389/fpubh.2020.600196] [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: 08/29/2020] [Accepted: 11/06/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Measles transmissions due to case importations challenge public health systems globally and herd immunities in all countries. In 2019, an imported measles case and its subsequently outbreak was found in the Zhoushan Islands. Here, the process of epidemiological investigation and virus tracing were summarized to provide references for the prevention and control of measles in the future. Materials and methods: The data on the demographic, epidemiological, and clinical manifestation of measles cases in this outbreak were collected. The 450 bp fragments of the measles virus (MeV) N gene were amplified and sequenced. The genome of the first imported case was further isolated. Then, the maximum-likelihood and time-scaled phylogenetic analysis was conducted. Results: A total of 28 measles cases were confirmed. Their onsets were between March 13 and May 18, 2019. The first patient was from the Ukraine. He was confirmed at the Fever Clinic in Zhoushan hospital on March 15, 2019 and at the same time, another patient had visited the hospital due to another illness and 10 days later, this second case had onset (March 25, 2019). The epidemic curve shows sustained community transmission. The majority of the following cases (19/26) were clustered on the Donggang street which was close to where the second case worked. The 22 measles virus strains successfully isolated from this outbreak all belonged to the D8.2a sub-cluster and clustered with the KY120864/MVs/GirSomnath.IND/42.16/[D8] which was the predominant genotype in the Ukraine during 2018-2019. The analysis of the complete D8 genotype genome pointed to the fact that this prevailing strain originated from India in 2015 and its substitution rate was estimated as 6.91 × 10-4 (5.64-7.98 × 10-4) nucleotide substitutions/site/year. Conclusion: This outbreak was caused by an imported case from the Ukraine. There was a possible nosocomial infection between the first case and the second case. Then, the second case played an important role in the spread of virus due to her occupation. The molecular phylogenetic analysis could help to track the origin of the virus. Increasing and maintaining the high level of vaccination coverage (≥95%) and an efficient response to imported cases are essential to prevent and control the recurrence and outbreak of measles virus.
Collapse
Affiliation(s)
- Hui Zhang
- Zhoushan Center for Disease Control and Prevention, Zhoushan, China
| | - Can Chen
- Zhoushan Center for Disease Control and Prevention, Zhoushan, China
| | - An Tang
- Zhoushan Center for Disease Control and Prevention, Zhoushan, China
| | - Bing Wu
- Zhoushan Center for Disease Control and Prevention, Zhoushan, China
| | - Leijie Liu
- Putuo Center for Disease Control and Prevention, Zhoushan, China
| | - Mingyu Wu
- Zhoushan Center for Disease Control and Prevention, Zhoushan, China
| | - Hongling Wang
- Zhoushan Center for Disease Control and Prevention, Zhoushan, China
| |
Collapse
|
19
|
Greiner AL, Stehling-Ariza T, Bugli D, Hoffman A, Giese C, Moorhouse L, Neatherlin JC, Shahpar C. Challenges in Public Health Rapid Response Team Management. Health Secur 2020; 18:S8-S13. [PMID: 32004121 DOI: 10.1089/hs.2019.0060] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The International Health Regulations (2005) dictate the need for states parties to establish capacity to respond promptly and effectively to public health risks. Public health rapid response teams (RRTs) can fulfill this need as a component of a larger public health emergency response infrastructure. However, lack of a standardized approach to establishing and managing RRTs can lead to substantial delays in effective response measures. As part of the Global Health Security Agenda, national governments have sought to develop and more formally institute their RRTs. RRT challenges were identified from 21 countries spanning 4 continents from 2016 to 2018 through direct observation of RRTs deployed during public health emergencies, discussions with RRT managers involved in outbreak response, and during formal RRT management training workshops. One major challenge identified is the development and maintenance of an RRT roster to ensure deployable surge staff identification, selection, and availability. Another challenge is ensuring that RRT members are trained and have the relevant competencies to be effective in the field. Finally, the lack of defined RRT standard operating procedures covering both nonemergency maintenance measures and the multistage emergency response processes required for RRT function can delay the RRT's response time and effectiveness. These findings highlight the importance of planning to preemptively address these challenges to ensure rapid and effective response measures, ultimately strengthening global health security.
Collapse
Affiliation(s)
- Ashley L Greiner
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Tasha Stehling-Ariza
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Dante Bugli
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Adela Hoffman
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Coralie Giese
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Lisa Moorhouse
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - John C Neatherlin
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Cyrus Shahpar
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| |
Collapse
|
20
|
Warden CA, Warden AR, Huang SCT, Chen JF. Job Tension and Emotional Sensitivity to COVID-19 Public Messaging and Risk Perception. Popul Health Manag 2020; 24:182-189. [PMID: 32882155 DOI: 10.1089/pop.2020.0083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
During the COVID-19 pandemic, government social marketing messages support strategies of suppression (often stay-at-home orders or lockdowns) and/or mitigation (through testing, isolation, and tracing). Success at lowering the virus reproduction rate (R0) depends on social marketing messaging that rapidly changes behaviors. This study explores a potential side effect of a successful antivirus public health messaging campaign, when employees are back at work but the virus threat has not disappeared, that leads to on-the-job stress. The authors surveyed office employees in Shanghai, the People's Republic of China, where a nearly 2-month COVID-19 quarantine ended in late March 2020 and work locations reopened with strong public health messaging to encourage cooperation with continued virus spread suppression strategies-an approach likely to be followed in numerous countries. This study examines the relationship of pandemic public messaging sensitivity with tension and negative emotions on the job. Canonical correlation analysis is used with a sample of 1154 respondents, 4 predictor variables (reference group, self-regulation, media, and risk), and 2 criterion variables (negative emotions and job tension). Results show employees are differentially affected by the pandemic background noise. Those more sensitive to social-level virus risks and more open to reference group influence report increased levels of negative emotions and work tension.
Collapse
Affiliation(s)
- Clyde A Warden
- Marketing Department, National Chung Hsing University, Taichung, Taiwan
| | - Antony R Warden
- Institute for Personalized Medicine, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Stephen Chi-Tsun Huang
- Department of Marketing and Distribution, National Kaohsiung University of Science and Technology, Kaohsiung City, Taiwan
| | - Judy F Chen
- Business Administration Department, Overseas Chinese University, Taichung, Taiwan
| |
Collapse
|
21
|
Williamson KM, Merritt T, Durrheim DN. Australia: an island in a sea of measles. Med J Aust 2020; 213:101-103.e1. [DOI: 10.5694/mja2.50650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Kirsten M Williamson
- Hunter New England Local Health District Newcastle NSW
- Australian National University Canberra ACT
| | - Tony Merritt
- Hunter New England Local Health District Newcastle NSW
| | - David N Durrheim
- Hunter New England Local Health District Newcastle NSW
- University of Newcastle Newcastle NSW
| |
Collapse
|
22
|
Wongsanuphat S, Thitichai P, Jaiyong R, Plernprom P, Thintip K, Jitpeera C, Suphanchaimat R. Investigation of Measles Outbreak among Thai and Migrant Workers in Two Factories in Nakhon Pathom, Thailand, 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134627. [PMID: 32605070 PMCID: PMC7369850 DOI: 10.3390/ijerph17134627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/12/2020] [Accepted: 06/22/2020] [Indexed: 11/24/2022]
Abstract
On 22 March 2019 the Thai Department of Disease Control (DDC) was notified that 16 workers, including Thai and Myanmar migrant workers, from two factories located in Nakhon Phathom Province, had presented with a fever with rash during the previous 2 weeks. Active case finding was conducted among workers in both factories using face-to-face interviews. Suspected cases were defined as a worker who developed fever with rash with one of the following symptoms: cough, coryza or conjunctivitis. Testing for measles IgM antibodies and viral identification through throat swabs by polymerase chain reaction (PCR) were performed to confirm diagnosis. Vaccination history among cases was reviewed. Nationality and age-specific attack rates (AR) were calculated. An environmental study and a social network analysis were conducted to better understand the transmission process. A total 56 cases (AR = 0.97%) were identified. Of 21 serum measles IgM collected, 8 (38.0%) were positive. Of 8 throat swabs collected, 5 (62.5%) were positive for measles genotype D8. The disease attack rate in migrant employees was twice as large as the rate in Thai counterparts (AR = 0.7 and 1.4%). The first case was identified as a Myanmar worker who arrived in Thailand two weeks prior to his illness. The Myanmar workers’ accommodation was more crowded than that for Thai workers. The hot spots of transmission were found at a drinking water tank which had shared glasses. Among the cases, 62.5% could not recall their vaccination history, and 25% had never had an injection containing a measles vaccination. The majority of migrant cases had never completed a two-dose measles vaccination. To halt the outbreak, measles vaccines were administered to the employees, particularly those working in the same sections with the cases and shared glasses were removed. For future policy action, a vaccination program should be incorporated into the work permit issuance process.
Collapse
Affiliation(s)
- Suphanat Wongsanuphat
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health and Thailand, Nonthaburi 11000, Thailand; (S.W.); (P.T.); (R.J.); (P.P.); (K.T.); (C.J.)
| | - Phanthanee Thitichai
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health and Thailand, Nonthaburi 11000, Thailand; (S.W.); (P.T.); (R.J.); (P.P.); (K.T.); (C.J.)
| | - Rungrot Jaiyong
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health and Thailand, Nonthaburi 11000, Thailand; (S.W.); (P.T.); (R.J.); (P.P.); (K.T.); (C.J.)
| | - Patchanee Plernprom
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health and Thailand, Nonthaburi 11000, Thailand; (S.W.); (P.T.); (R.J.); (P.P.); (K.T.); (C.J.)
| | - Kanthika Thintip
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health and Thailand, Nonthaburi 11000, Thailand; (S.W.); (P.T.); (R.J.); (P.P.); (K.T.); (C.J.)
| | - Charuttaporn Jitpeera
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health and Thailand, Nonthaburi 11000, Thailand; (S.W.); (P.T.); (R.J.); (P.P.); (K.T.); (C.J.)
| | - Rapeepong Suphanchaimat
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health and Thailand, Nonthaburi 11000, Thailand; (S.W.); (P.T.); (R.J.); (P.P.); (K.T.); (C.J.)
- International Health Policy Program, Ministry of Public Health, Nonthaburi 11000, Thailand
- Correspondence:
| |
Collapse
|
23
|
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.
Collapse
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.
| |
Collapse
|
24
|
Measles vaccination of young infants in China: A cost-effectiveness analysis. Vaccine 2020; 38:4616-4624. [PMID: 32451210 DOI: 10.1016/j.vaccine.2020.04.079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/27/2020] [Accepted: 04/30/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although global progress in measles control has been realized, achieving elimination has proven difficult in many regions of the world. China has adopted a goal of measles elimination but recent outbreaks predominantly affecting children <8 months who are ineligible for vaccination and incompletely protected by maternal antibodies has impeded progress. We assess the cost-effectiveness of adding an initial measles vaccine dose in China to earlier than the currently recommended 8 months of age. METHODS We conducted a cost-utility analysis comparing the costs and health benefits associated with adding a measles vaccine dose to the routine schedule at 4, 5, 6 or 7 months compared to the current recommendation for the first dose at age 8 months. A decision analytic model was developed in Microsoft Excel, including five non-severe and two fatal health outcomes associated with measles infection. Model parameters were informed by the literature and surveillance data. Future costs and health benefits were discounted at 3%. Primary outcomes included costs, Quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER) over a lifetime time horizon. RESULTS Lowering the recommended age for initiating the measles vaccination series to address susceptibility in children <8 months provided incremental health gains compared to minimal costs at the individual-level. The ICER was most favorable ($232.70 per QALY gain) for administering an initial dose at 4 months of age due to fewer incremental program costs when shifting measles administration to an immunization visit already established under the Chinese vaccination program. CONCLUSION We found potential beneficial health gains at a minimum cost associated with adding an earlier measles dose <8 months of age in China. Further investigation about disease transmission dynamics is required to more fully assess the tradeoffs of administering measles at a younger age to infants in China.
Collapse
|
25
|
Yang W. Transmission dynamics of and insights from the 2018-2019 measles outbreak in New York City: A modeling study. SCIENCE ADVANCES 2020; 6:eaaz4037. [PMID: 32548250 PMCID: PMC7272232 DOI: 10.1126/sciadv.aaz4037] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 03/18/2020] [Indexed: 05/24/2023]
Abstract
In 2018-2019, New York City experienced the largest measles outbreak in the United States in nearly three decades. To identify key contributing factors, we modeled the transmission dynamics of this outbreak. Results indicate that delayed vaccination of 1- to 4-year-olds enabled the initial spread and that increased infectious contact, likely via "measles parties," facilitated later transmission. We found that around half of infants were susceptible by age 1 and thus had many infections. Without the implemented vaccination campaigns, numbers of infections and hospitalizations could have been >10 times higher and would predominantly affect those under 4. These results suggest that a first vaccine dose before age 1 and the second dose before age 4 could allow parents to vaccinate and protect children more effectively should a high level of vaccine hesitancy persist. Enhanced public health education is needed to reduce activities that unnecessarily expose children to measles and other infections.
Collapse
|
26
|
Fakhruddin M, Suandi D, Sumiati S, Fahlena H, Nuraini N, Soewono E. Investigation of a measles transmission with vaccination: a case study in Jakarta, Indonesia. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2020; 17:2998-3018. [PMID: 32987513 DOI: 10.3934/mbe.2020170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Measles is a contagious disease caused by the measles virus of genus Morbillivirus, which has been spreading in many affected regions. This infection is characterized by the appearance of rashes all over the body and potentially cause serious complications, especially among infants and children. Before measles immunization was promoted, it is one of the endemic diseases that caused the most fatalities each year in the world. This paper aims to analyze and to investigate measles transmission in Jakarta via an SIHR epidemic model involving vaccination from January to December 2017. Jakarta Health Office collected the observed data of measles incidence. We then derived the basic reproduction number as a threshold of disease transmission and obtained the local as well as global stability of the equilibria under certain conditions. The unobserved parameters and initial conditions were estimated by minimizing errors between data and numerical results. Furthermore, a stochastic model was developed to capture the data and to accommodate the randomness of the transmission. Sensitivity analysis was also performed to analyze and to identify the parameters which give significant contributions to the spread of the virus. We then obtained simulations of vaccine level coverage. The data is shown within a 95% confidence interval of the stochastic solutions, and the average of the stochastic solutions is relatively close to the solution of the deterministic model. The most sensitive parameter in the infected compartment is the hospitalized rate, which can be considered to be one of the essential factors to reduce the number of cases for policymakers. We hence proposed a control strategy which is providing treatment accesses easier for infected individuals is better than vaccinating when an outbreak occurs.
Collapse
Affiliation(s)
- Muhammad Fakhruddin
- Faculty of Mathematics and Natural Sciences, Institut Teknologi Bandung, Bandung 40132, Indonesia
| | - Dani Suandi
- Faculty of Mathematics and Natural Sciences, Institut Teknologi Bandung, Bandung 40132, Indonesia
| | | | - Hilda Fahlena
- Faculty of Mathematics and Natural Sciences, Institut Teknologi Bandung, Bandung 40132, Indonesia
| | - Nuning Nuraini
- Faculty of Mathematics and Natural Sciences, Institut Teknologi Bandung, Bandung 40132, Indonesia
| | - Edy Soewono
- Faculty of Mathematics and Natural Sciences, Institut Teknologi Bandung, Bandung 40132, Indonesia
| |
Collapse
|
27
|
Koniushevska AA, Parkhomenko TA, Sharunova MV, Kazantsev AB, Yakovenko DV. Epidemiology and features of the measles course in children during the outbreak of 2018–2019 in the city of Mariupol. REGULATORY MECHANISMS IN BIOSYSTEMS 2020. [DOI: 10.15421/022010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
In 2017, Ukraine ranked in the top three among European countries in terms of measles incidence, and ranked first in measles growth in 2018. High morbidity, mortality and development of complications make the problem of knowing features of the measles clinical course, timely diagnosis and active prevention highly relevant. The purpose of the research is to study the dynamics of the incidence and clinical features of measles in children during the outbreak of 2018–2019 in the city of Mariupol, Donetsk region. A peculiarity of the measles outbreak in 2018–2019 in Mariupol is prevalence of the disease in preschool children (60.4%), including 30.2% – those under one year of age; low vaccination rate: 52.3% of children unvaccinated; only 22.2% of children were vaccinated twice, according to the schedule. In all age groups, a moderately severe measles course prevailed (69.8%). The clinical course of measles in preschool and school age children had definitive features. Thus, Belsky–Filatov–Koplik spots were observed three times more frequently in preschool children than in schoolchildren (63.9% and 23.3%, respectively). Abdominal pain and diarrhea were only observed in children under 6 years of age (30.2%). Skin pigmentation was absent in children under one year of age and was detected in preschool and school-age children (69.8%). Skin sloughing was only observed in schoolchildren (10.4%). Severe disease course occurred in patients of all ages (29.3%), but children aged under one year and preschool children with severe disease were two times more numerous than those of the school age. Among the observed complications, the vast majority were associated with the respiratory organs: pneumonia (38.3%), subcutaneous emphysema (1.7%), bronchitis (53.2%), laryngitis (3.3%), otitis media (5%). No fatalities were observed. The city should form a commitment to immunization, restore public trust in vaccination, using all forms and means of information, and develop a program to implement the vaccination schedule into practice.
Collapse
|
28
|
Sitepu FY, Depari E, Mudatsir M, Harapan H. Being unvaccinated and contact with measles cases as the risk factors of measles outbreak, North Sumatera, Indonesia. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2019.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
29
|
Affiliation(s)
- Richard A Stein
- Department of Chemical and Biomolecular Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
| |
Collapse
|
30
|
McMahon J, Mackay IM, Lambert SB. Measles Vaccine Virus RNA in Children More Than 100 Days after Vaccination. Viruses 2019; 11:E636. [PMID: 31295941 PMCID: PMC6669751 DOI: 10.3390/v11070636] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 07/07/2019] [Accepted: 07/09/2019] [Indexed: 11/16/2022] Open
Abstract
Measles vaccines have been in use since the 1960s with excellent safety and effectiveness profiles. Limited data are available on detection of measles vaccine virus (MeVV) RNA in human subjects following vaccination. Available evidence suggests MeVV RNA can be identified up to 14 days after vaccination, with detection beyond this rare. In routine diagnostic testing, we used two real-time reverse transcription-polymerase chain reaction (RT-rPCR) assays targeting M and F genes to identify measles virus (MeV) and MeVV RNA. Confirmatory testing was performed with an N gene RT-rPCR, followed by sequence confirmation of RT-rPCR positives by semi-nested conventional RT-PCR assays targeting portions of the N, H, and L genes. We report detection and confirmation of MeVV RNA from the respiratory tract of 11 children between 100 and 800 days after most recent receipt of measles-containing vaccine. These novel findings emphasize the importance of genotyping all MeV detections and highlight the need for further work to assess whether persistent MeVV RNA represents viable virus and if transmission to close contacts can occur.
Collapse
Affiliation(s)
- Jamie McMahon
- Public Health Virology Laboratory, Forensic and Scientific Services, 39 Kessels Road, Coopers Plains, QLD 4108, Australia.
- Child Health Research Centre, The University of Queensland, 62 Graham Street, South Brisbane, QLD 4101, Australia.
| | - Ian M Mackay
- Public Health Virology Laboratory, Forensic and Scientific Services, 39 Kessels Road, Coopers Plains, QLD 4108, Australia
- Child Health Research Centre, The University of Queensland, 62 Graham Street, South Brisbane, QLD 4101, Australia
| | - Stephen B Lambert
- Child Health Research Centre, The University of Queensland, 62 Graham Street, South Brisbane, QLD 4101, Australia
| |
Collapse
|
31
|
Hong DT, Hien ND, Thao PTP, Anh DD, Mai HH, Huyen DTT, Huong NL, Phuong BH, Iijima M, Ito T, Nakayama T. Immunogenicity of the AIK-C measles vaccine in infants aged <9 months in Vietnam. Vaccine 2019; 37:4576-4580. [PMID: 31174936 DOI: 10.1016/j.vaccine.2019.04.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/10/2019] [Accepted: 04/12/2019] [Indexed: 10/26/2022]
Abstract
Measles-associated deaths have been reported in infants <9 months during outbreaks. A cohort study was conducted on 210 infants aged 6-8 months to evaluate the immunogenicity and safety of the AIK-C measles vaccine containing 104.21 plaque-forming units (PFU)/0.5 mL produced in Vietnam. Paired serum samples were obtained from 196 subjects. Seropositivity was defined as ≥120 mIU/mL. The seroresponse rate was 173/196 (88.27%, 95% confidence interval (CI): 83.77-92.77%) with geometric mean titer (GMT) of 511 mIU/mL (95% CI: 688-880 mIU/mL), and no significant differences were observed by different age groups. Among 196 paired sera, they were categorized into four groups: 122 subjects <14 IU/mL, 28 subjects 14-<60 mIU/mL, 30 subjects 60-<120 mIU/mL, and 16 subjects ≥ 120 mIU/mL. The seroresponse rate was 112/122 (91.8%, 95% CI: 86.94-96.67%) with GMT (597 mIU/mL, 95% CI: 749-1002 mIU/mL) in the <14 mIU/L group. In the 14-<60 mIU/mL group, the seroresponse rate was 18/28 (64.29%) with 184 mIU/L of GMT and was significantly lower (p < 0.01) than that in the <14 mIU/mL group. In the 16 seropositive group, all subjects showed seroconversion (4-fold higher than before) with a higher GMT of 1078 mIU/mL. Local pain and itching at the injection site were observed in 8 subjects (3.8%) within 7 days of the vaccination. Regarding systemic adverse reactions, febrile illness ≥37.5 °C was observed in 14 subjects (6.7%). These results indicate that the AIK-C measles vaccine is effective and safe for infants aged 6-8 months and will contribute to reducing the number of measles-associated deaths in future outbreaks.
Collapse
Affiliation(s)
- Duong Thi Hong
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | - Nguyen Dang Hien
- Center for Research and Production of Vaccine and Biological, Hanoi, Viet Nam
| | | | - Dang Duc Anh
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | - Hoang Hong Mai
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | | | | | - Bui Huy Phuong
- Hai Duong Center for Diseases Control, Hai Duong, Viet Nam
| | | | - Takashi Ito
- Laboratory of Viral Infection II, Kitasato Institute for Life Sciences, Tokyo, Japan
| | - Tetsuo Nakayama
- Laboratory of Viral Infection II, Kitasato Institute for Life Sciences, Tokyo, Japan.
| |
Collapse
|
32
|
Is the global measles resurgence a “public health emergency of international concern”? Int J Infect Dis 2019; 83:95-97. [DOI: 10.1016/j.ijid.2019.04.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 04/16/2019] [Indexed: 11/20/2022] Open
|