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Adamu AA, Ndwandwe D, Jalo RI, Wiysonge CS. Positioning implementation science in national immunization programmes to improve coverage equity and advance progress toward Immunization Agenda 2030: An urgent global health imperative. Hum Vaccin Immunother 2024; 20:2331872. [PMID: 38556477 PMCID: PMC10984125 DOI: 10.1080/21645515.2024.2331872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/14/2024] [Indexed: 04/02/2024] Open
Abstract
Despite the availability of effective vaccines for preventing common childhood infectious diseases, there is still significant disparities in access and utilization across many low- and middle-income countries (LMIC). The factors that drive these disparities are often multilevel, originating from individuals, health facilities, health systems and communities, and also multifaceted. Implementation science has emerged as a field to help address "know-do" gaps in health systems, and can play a significant role in strengthening immunization systems to understand and solve implementation barriers that limit access and uptake within their contexts. This article presents a reflexive perspective on how to position implementation research in immunization programmes to improve coverage equity. Furthermore, key points of synergy between implementation research and vaccination are highlighted, and some potential practice changes that can be applied within specific contexts were proposed. Using a human rights lens, it was concluded that the cost that is associated with implementation failure in immunization programmes is significant and unjust, and future directions for implementation research to optimize its application in practice settings have been recommended.
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Affiliation(s)
- Abdu A. Adamu
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Duduzile Ndwandwe
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Rabiu I. Jalo
- Department of Community Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Charles S. Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Vaccine-Preventable Diseases Programme, World Health Organization Regional Office for Africa, Brazzaville, Congo
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Li M, Zhang W, Zheng S, Guo J, He H, Ma Y, Huang Y, Feng Y, Ji C. A real-world study on the changing characteristics of measles antibodies in premature infants in China. Hum Vaccin Immunother 2024; 20:2338505. [PMID: 38599768 PMCID: PMC11008540 DOI: 10.1080/21645515.2024.2338505] [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: 12/18/2023] [Accepted: 03/31/2024] [Indexed: 04/12/2024] Open
Abstract
The waning of maternal antibodies may cause infants to lose protection against measles before receiving measles-containing vaccine (MCV). The aim of this study is to investigate the changing characteristics and influencing factors of measles antibodies in preterm infants (PT), and to provide scientific basis for optimizing MCV vaccination strategy of the target population. Blood samples were collected from PT and full-term infants (FT) at the chronological age (CA) of 3, 6, and 12 months. Measles antibodies were quantitatively detected by enzyme-linked immunosorbent assay. Demographic and vaccination information were both collected. Kruskal-Wallis rank sum test was used to compare the measles antibodies among different gestation age (GA) groups, and multiple linear regression was performed to identify the correlative factors for the antibodies. Measles antibodies of PT decreased significantly with age increasing before MCV vaccination. The positive rates of antibodies of PT were 10.80% and 3.30% at the age of 3 and 6 months, respectively (p < .001). At 12 months, the measles antibodies and seropositive rate in the infants who received MCV vaccination increased sharply (p < .001). Regression analyzes showed that the younger the GA or the older the age, the lower the antibodies at 3 months(p < .001,p = .018); while the lower measles antibody levels at 3 months and older age predicted the lower antibodies at 6 months(p < .001, p = .029). PT were susceptible to measles due to the low level of maternally derived antibodies before MCV vaccination. More efforts should be considered to protect the vulnerable population during their early postnatal life.
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Affiliation(s)
- Mingyan Li
- Department of Child Health Care, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Weiwei Zhang
- Department of Child Health Care, Maternal and Child Health Hospital of Changxing, Huzhou, China
| | - Shuangshuang Zheng
- Department of Child Health Care, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Junxia Guo
- Department of Child Health Care, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Hanqing He
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yongjun Ma
- Department of Pediatrics, Maternal and Child Healthcare Hospital Department of Shangyu, Shaoxing, China
| | - Yan Huang
- Department of Immunization Program, Center for Disease Control and Prevention of Shangyu, Shaoxing, China
| | - Yan Feng
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Chai Ji
- Department of Child Health Care, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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Dhalaria P, Kumar P, Verma A, Priyadarshini P, Kumar Singh A, Tripathi B, Taneja G. Exploring landscape of measles vaccination coverage: A step towards measles elimination goal in India. Vaccine 2024; 42:3637-3646. [PMID: 38704248 PMCID: PMC11165302 DOI: 10.1016/j.vaccine.2024.04.075] [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: 12/07/2023] [Revised: 04/23/2024] [Accepted: 04/23/2024] [Indexed: 05/06/2024]
Abstract
INTRODUCTION Measles remains a critical public health concern causing significant morbidity and mortality globally. Despite the success of measles vaccination programs, challenges persist, particularly in India. This study investigates dose-wise measles vaccination coverage and explores gaps in immunization focusing on zero-dose, one-dose, and two-dose coverage among children aged 24-35 months. DATA SOURCES AND METHODOLOGY The National Family Health Survey 2019-21 (NFHS-5) served as the data source and the study analyzed information from 43,864 children aged 24-35 months. Sociodemographic variables such as birth order, wealth quintile, gender, social group, religion, residence, mother education, delivery-related factors, and media exposure were considered. Statistical analysis involved weighted estimates, chi-square tests, and multivariate multinomial logistic regression. RESULTS The study revealed that challenges persist in achieving optimal measles vaccination coverage. Analysis by sociodemographic factors highlighted disparities in coverage, with variations in zero dose prevalence across states and districts. The percentage of zero-dose children was significantly higher, with 11.5% of children in India remaining to receive any measles vaccination. Factors influencing vaccine coverage include birth order, age, wealth quintile, social group, religion, residence, maternal education, place of delivery, media exposure, and mode of delivery. The findings from the spatial analysis show the clustering of zero-dose children is high in the northeastern states of India. DISCUSSION Measles zero-dose children pose a significant obstacle to achieving elimination goals. Spatial analysis identifies clusters of unvaccinated populations guiding targeted interventions. The study aligns with global initiatives such as the Immunization Agenda 2030 emphasizing equitable vaccine access and discusses how India can tailor its strategies to achieve the goal. Lessons from polio eradication efforts inform strategies for measles elimination, stressing the importance of high-quality data and surveillance. The study underscores the urgency of addressing last-mile measles vaccination gaps in India. Spatially targeted interventions informed by sociodemographic factors can enhance immunization coverage. Achieving measles elimination requires sustained efforts and leveraging lessons from successful vaccination campaigns. The study findings have the potential to contribute to informed decision-making, supporting India's roadmap for the measles and rubella elimination goal.
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Affiliation(s)
- Pritu Dhalaria
- Immunization Technical Support Unit, Ministry of Health & Family Welfare, Government of India, New Delhi 110070, India
| | - Pawan Kumar
- Immunization Division, Ministry of Health & Family Welfare, New Delhi 110011, India
| | - Ajay Verma
- Department of Economics, Banaras Hindu University, Varanasi, Uttar Pradesh 221005, India
| | - Pretty Priyadarshini
- Immunization Technical Support Unit, Ministry of Health & Family Welfare, Government of India, New Delhi 110070, India
| | - Ajeet Kumar Singh
- Immunization Technical Support Unit, Ministry of Health & Family Welfare, Government of India, New Delhi 110070, India.
| | | | - Gunjan Taneja
- Bill & Melinda Gates Foundation, New Delhi 110067, India
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Maves RC, Cawcutt KA. A practical approach to preparing your ICU for epidemics and pandemics. Curr Opin Crit Care 2024:00075198-990000000-00180. [PMID: 38841920 DOI: 10.1097/mcc.0000000000001174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
PURPOSE OF REVIEW Major outbreaks of infectious diseases, including epidemics and pandemics, are increasing in scope and frequency, threatening public health and straining the capacity of health systems worldwide. High-consequence infectious diseases (HCIDs), including highly pathogenic respiratory viruses and viral hemorrhagic fevers, are both contagious and virulent, and these pathogens thus are topics of special concern for pandemic planning. RECENT FINDINGS The COVID-19 pandemic demonstrated how a major disease outbreak can negatively impact all aspects of hospital functioning. Identification of patients with HCIDs needs careful clinical evaluation and coordination with public health authorities. Staff safety and patient care require appropriate infection prevention precautions, including personal protective equipment. Surges of ill patients may lead to significant strain, with increased ICU patient mortality. Strategies to reduce the impact of surge appear to reduce mortality, such as tiered staffing models and load-leveling across health systems. SUMMARY Pandemics and HCIDs are a significant threat to global health, and ICUs play a major role in the care of affected patients. Critical care professionals must work to ensure that our hospitals are prepared to identify and care for these patients in advance of the next emergency.
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Affiliation(s)
- Ryan C Maves
- Section of Infectious Diseases, Department of Internal Medicine
- Section of Critical Care Medicine, Department of Anesthesiology, Wake Forest University School of Medicine
- Center for Bioethics, Health, and Society, Wake Forest University, Winston-Salem, North Carolina
| | - Kelly A Cawcutt
- Divisions of Infectious Diseases & Pulmonary and Critical Care Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Gressick K, Nham A, Filardo TD, Anderson K, Black SR, Boss K, Chavez-Torres M, Daniel-Wayman S, Dejonge P, Faherty E, Funk M, Kerins J, Kim DY, Kittner A, Korban C, Pacilli M, Schultz A, Sloboda A, Zelencik S, Barnes A, Geltz JJ, Morgan J, Quinlan K, Reid H, Chatham-Stephens K, Lanzieri TM, Leung J, Lutz CS, Nyika P, Raines K, Ramachandran S, Rivera MI, Singleton J, Wang D, Rota PA, Sugerman D, Gretsch S, Borah BF. Measles Outbreak Associated with a Migrant Shelter - Chicago, Illinois, February-May 2024. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2024; 73:424-429. [PMID: 38753539 PMCID: PMC11115429 DOI: 10.15585/mmwr.mm7319a1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Measles, a highly contagious respiratory virus with the potential to cause severe complications, hospitalization, and death, was declared eliminated from the United States in 2000; however, with ongoing global transmission, infections in the United States still occur. On March 7, 2024, the Chicago Department of Public Health (CDPH) confirmed a case of measles in a male aged 1 year residing in a temporary shelter for migrants in Chicago. Given the congregate nature of the setting, high transmissibility of measles, and low measles vaccination coverage among shelter residents, measles virus had the potential to spread rapidly among approximately 2,100 presumed exposed shelter residents. CDPH immediately instituted outbreak investigation and response activities in collaboration with state and local health departments, health care facilities, city agencies, and shelters. On March 8, CDPH implemented active case-finding and coordinated a mass vaccination campaign at the affected shelter (shelter A), including vaccinating 882 residents and verifying previous vaccination for 784 residents over 3 days. These activities resulted in 93% measles vaccination coverage (defined as receipt of ≥1 recorded measles vaccine dose) by March 11. By May 13, a total of 57 confirmed measles cases associated with residing in or having contact with persons from shelter A had been reported. Most cases (41; 72%) were among persons who did not have documentation of measles vaccination and were considered unvaccinated. In addition, 16 cases of measles occurred among persons who had received ≥1 measles vaccine dose ≥21 days before first known exposure. This outbreak underscores the need to ensure high vaccination coverage among communities residing in congregate settings.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Chicago Department of Public Health Measles Response Team
- Epidemic Intelligence Service, CDC; Chicago Department of Public Health, Chicago, Illinois; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC; Career Epidemiology Field Officer Program, CDC; Illinois Department of Public Health; Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC; Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, CDC
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Coulborn RM, Danet C, Alsalhani A. Measles and rubella vaccine microneedle patch: new hope to reach the unreached children. Lancet 2024; 403:1825-1827. [PMID: 38697172 DOI: 10.1016/s0140-6736(24)00749-9] [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: 03/27/2024] [Accepted: 04/09/2024] [Indexed: 05/04/2024]
Affiliation(s)
| | - Corinne Danet
- Médecins Sans Frontières, Medical Department, Paris, France
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Song J, Zhu Z, Wang H, Hu M, Xia B, Zhang Y. M-F noncoding region sequences of H1 genotype measles virus provide higher resolution for virus transmission tracing. Virology 2024; 596:110104. [PMID: 38761640 DOI: 10.1016/j.virol.2024.110104] [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: 12/11/2023] [Accepted: 05/06/2024] [Indexed: 05/20/2024]
Abstract
As countries and regions move toward measles elimination, extended sequence window including noncoding region located between the matrix and fusion protein genes (M - F NCR) was considered to be used in molecular surveillance. The molecular resolution of M - F NCR was evaluated with 192 genotype H1 strains circulating during 2011-2018 in China. Phylogenetic analyses of the N450 and M - F NCR targets indicated that both two targets could confirm epi-linked outbreak, while M - F NCR target could further improve resolution of the molecular characterization: (1) it could differentiate the strains with identical N450 circulated in one county within one month of disease onset; (2) different transmission chains could be distinguished for strains with identical N450; (3) better spatial-temporal consistency with topology could be provided among sporadic cases with inconsistent N450. Accordingly, M - F NCR could be used to complement the information from N450 to address the specific questions in tracking the virus transmission chains.
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Affiliation(s)
- Jinhua Song
- WHO Western Pacific Regional Measles/Rubella Reference Laboratory, National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhen Zhu
- WHO Western Pacific Regional Measles/Rubella Reference Laboratory, National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huiling Wang
- WHO Western Pacific Regional Measles/Rubella Reference Laboratory, National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Manli Hu
- WHO Western Pacific Regional Measles/Rubella Reference Laboratory, National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Baicheng Xia
- WHO Western Pacific Regional Measles/Rubella Reference Laboratory, National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yan Zhang
- WHO Western Pacific Regional Measles/Rubella Reference Laboratory, National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
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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.
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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.)
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Mathis AD, Raines K, Masters NB, Filardo TD, Kim G, Crooke SN, Bankamp B, Rota PA, Sugerman DE. Measles - United States, January 1, 2020-March 28, 2024. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2024; 73:295-300. [PMID: 38602886 PMCID: PMC11008791 DOI: 10.15585/mmwr.mm7314a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Measles is a highly infectious febrile rash illness and was declared eliminated in the United States in 2000. However, measles importations continue to occur, and U.S. measles elimination status was threatened in 2019 as the result of two prolonged outbreaks among undervaccinated communities in New York and New York City. To assess U.S. measles elimination status after the 2019 outbreaks and to provide context to understand more recent increases in measles cases, CDC analyzed epidemiologic and laboratory surveillance data and the performance of the U.S. measles surveillance system after these outbreaks. During January 1, 2020-March 28, 2024, CDC was notified of 338 confirmed measles cases; 97 (29%) of these cases occurred during the first quarter of 2024, representing a more than seventeenfold increase over the mean number of cases reported during the first quarter of 2020-2023. Among the 338 reported cases, the median patient age was 3 years (range = 0-64 years); 309 (91%) patients were unvaccinated or had unknown vaccination status, and 336 case investigations included information on ≥80% of critical surveillance indicators. During 2020-2023, the longest transmission chain lasted 63 days. As of the end of 2023, because of the absence of sustained measles virus transmission for 12 consecutive months in the presence of a well-performing surveillance system, U.S. measles elimination status was maintained. Risk for widespread U.S. measles transmission remains low because of high population immunity. However, because of the increase in cases during the first quarter of 2024, additional activities are needed to increase U.S. routine measles, mumps, and rubella vaccination coverage, especially among close-knit and undervaccinated communities. These activities include encouraging vaccination before international travel and rapidly investigating suspected measles cases.
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Affiliation(s)
- Adria D. Mathis
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Kelley Raines
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Nina B. Masters
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Thomas D. Filardo
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Gimin Kim
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Stephen N. Crooke
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Bettina Bankamp
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - Paul A. Rota
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
| | - David E. Sugerman
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC
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Liu J, Qi Q, Liu Y, Ni P, Zhan X, Bao Y, Li Y, Liu L, Yang Q, Liu Y, Zhang K. A paired measles-rubella catch-up campaign in Sichuan China to stop an outbreak and strengthen local immunization programs. Vaccine 2024; 42:2155-2160. [PMID: 38485639 DOI: 10.1016/j.vaccine.2024.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/07/2024] [Accepted: 03/07/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND China has been working towards measles elimination, but in 2017, measles outbreaks occurred in Ganzi and Aba prefectures of Sichuan province, representing 95% of all provincial cases and jeopardizing measles elimination. METHODS During March and April 2017, high-performing prefectures were paired with outbreak and other interested counties to jointly conduct a measles-rubella (MR) catch-up campaign, build population immunity, and strengthen the counties' programs. RESULTS House-to-house search identified 88,383 children in Ganzi that lacked MCV vaccination; 85,144 (96.34%) were vaccinated. Search identified 33,683 children in Aba who were not vaccinated against measles; 33,074 (98.19%) were vaccinated. The supporting prefectures helped install Immunization Information Systems and enroll unvaccinated children into the immunization program.The outbreak ended within a month and incidence has remained low for the subsequent six years. CONCLUSION A paired catch-up campaign represents an effective model of using measles elimination strategies to strengthen local immunization programs for long-term program effectiveness.
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Affiliation(s)
- Jiajie Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, China.
| | - Qi Qi
- Sichuan Center for Disease Control and Prevention, Chengdu, China.
| | - Yu Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Ping Ni
- Ganzi Tibetan Autonomous Prefecture Center for Disease Control and Prevention, Ganzi, China
| | - Xuhua Zhan
- Aba Tibetan Autonomous Prefecture Center for Disease Control and Prevention, Aba, China
| | - Ying Bao
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Yinqiao Li
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Lijin Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Qing Yang
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Yi Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Kai Zhang
- Sichuan Center for Disease Control and Prevention, Chengdu, China
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11
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Nampota-Nkomba N, Keita AM, Juma J, Sidibe D, Kourouma N, Sissoko S, Haidara FC, Traore CT, Traore CB, Traore A, Gaume B, Sow SO, Kotloff KL, Tapia MD. An Upsurge of Measles Cases in Mali-a Consequence of Pandemic-associated Disruption in Routine Immunization. Open Forum Infect Dis 2024; 11:ofae154. [PMID: 38617075 PMCID: PMC11010308 DOI: 10.1093/ofid/ofae154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/18/2024] [Indexed: 04/16/2024] Open
Abstract
Measles deaths highlight immunization program gaps. In the Child Health and Mortality Prevention Surveillance study in Mali, we observed a rise in under-5 measles-related deaths in 2022 that corresponded with increased measles cases at the same time and a decline in measles vaccine coverage in Mali in 2020.
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Affiliation(s)
- Nginache Nampota-Nkomba
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | | | - Jane Juma
- Centre pour le Développement des Vaccins-Mali, Bamako, Mali
| | | | - Nana Kourouma
- Centre pour le Développement des Vaccins-Mali, Bamako, Mali
| | - Seydou Sissoko
- Centre pour le Développement des Vaccins-Mali, Bamako, Mali
| | | | - Cheick Tidiane Traore
- Direction Générale de la Santé et de l’Hygiène Publique, Ministry of Health and Social Development, Bamako, Mali
| | | | - Awa Traore
- Centre pour le Développement des Vaccins-Mali, Bamako, Mali
| | - Brigitte Gaume
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | | | - Karen L Kotloff
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Milagritos D Tapia
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Gungor K, Bukavaz S, Ekuklu G. Measles outbreak in the adult age group: Clinical, laboratory, and epidemiological features of the 11 patients admitted to the hospital. J Med Virol 2024; 96:e29583. [PMID: 38576266 DOI: 10.1002/jmv.29583] [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: 02/24/2024] [Revised: 03/18/2024] [Accepted: 03/23/2024] [Indexed: 04/06/2024]
Abstract
The measles virus, also known as the morbillivirus, or MV, is a virus that infects humans. The goal of this research is to assess to adult cases of measles. Eleven patients thought to be confirmed cases of measles were enrolled in the investigation. Following the identification of symptoms of tiredness, fever, and rash in one soldier, the results of 10 more troops from the pertinent military group were assessed. The diagnosis was made based on the presence of serum immunoglobulin M (IgM) and positive polymerase chain reaction (PCR) results. When the control IgM, immunoglobulin G, and PCR findings were evaluated a fortnight after hospitalization, a cluster of 11 incidents was found. It is now necessary to address the issue of the cautious stance towards vaccination or the anti-vaccination sentiment that has grown increasingly popular, particularly in light of the COVID-19 pandemic, for both our nation and the entire world.
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Affiliation(s)
- Kultural Gungor
- Department of Infectious Diseases, Edirne Sultan 1. Murat State Hospital, Edirne, Turkey
| | - Sebnem Bukavaz
- Health and Vocational School, Trakya University, Edirne, Turkey
| | - Galip Ekuklu
- Department of Public Health, Trakya University, Edirne, Turkey
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13
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Ly H. Measles disease outbreaks and vaccination impacting global public health. J Med Virol 2024; 96:e29593. [PMID: 38572935 DOI: 10.1002/jmv.29593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 03/23/2024] [Accepted: 03/25/2024] [Indexed: 04/05/2024]
Affiliation(s)
- Hinh Ly
- Department of Veterinary & Biomedical Sciences, College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA
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Williams PM, Pratt RH, Walker WL, Price SF, Stewart RJ, Feng PJI. Tuberculosis - United States, 2023. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2024; 73:265-270. [PMID: 38547024 PMCID: PMC10986816 DOI: 10.15585/mmwr.mm7312a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
After 27 years of declining U.S. tuberculosis (TB) case counts, the number of TB cases declined considerably in 2020, coinciding with the COVID-19 pandemic. For this analysis, TB case counts were obtained from the National TB Surveillance System. U.S. Census Bureau population estimates were used to calculate rates overall, by jurisdiction, birth origin, race and ethnicity, and age group. Since 2020, TB case counts and rates have increased each year. During 2023, a total of 9,615 TB cases were provisionally reported by the 50 U.S. states and the District of Columbia (DC), representing an increase of 1,295 cases (16%) as compared with 2022. The rate in 2023 (2.9 per 100,000 persons) also increased compared with that in 2022 (2.5). Forty states and DC reported increases in 2023 in both case counts and rates. National case counts increased among all age groups and among both U.S.-born and non-U.S.-born persons. Although TB incidence in the United States is among the lowest in the world and most U.S. residents are at minimal risk, TB continues to cause substantial global morbidity and mortality. This postpandemic increase in U.S. cases highlights the importance of continuing to engage communities with higher TB rates and their medical providers in TB elimination efforts and strengthening the capacity in public health programs to carry out critical disease control and prevention strategies.
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Kegele Lignani L, de Vasconcellos Carvalhaes de Oliveira R, Matos Dos Santos E, Antonio Bastos Camacho L, Reis Xavier J, Regina da Silva E Sá G, Mendonça Siqueira M, Marques Vieira da Silva A, Gil Melgaço J, Dos Santos Alves N, de Lourdes de Sousa Maia M, Caetano Prates Melo E. Neutralizing antibody titers against D8 genotype and persistence of measles humoral and cell-mediated immunity eight years after the first dose of measles, mumps, and rubella vaccine in Brazilian children. Vaccine 2024; 42:2065-2071. [PMID: 38413280 DOI: 10.1016/j.vaccine.2024.02.060] [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: 11/22/2023] [Revised: 02/02/2024] [Accepted: 02/20/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVE Assess the level of measles vaccine-induced neutralizing antibodies against the D8 genotype and the persistence of humoral and cell-mediated immunity in children who received their first dose of the measles, mumps, and rubella vaccine eight years previously. METHODS Measles-specific IgG and neutralizing antibodies were determined in serum using ELISA and plaque reduction neutralization test, respectively. Cellular response was evaluated from peripheral blood mononuclear cells (PBMC). IFN-γ-secreting cells, memory B and T cells, and immunological mediators were assayed by ELISpot, flow cytometry, and multiplex liquid microarray assay, respectively. RESULTS Antibody concentrations declined over time; however, the vaccine-induced neutralizing antibodies' effect against D8 and vaccinal genotypes persisted. PBMC stimulated with the vaccine virus exhibited specific IFN- γ-measles-secreting responses in most participants. Participants with high levels of neutralizing antibodies showed a higher proportion of activated B cells compared to participants with low levels of neutralizing antibodies, while proportions of memory CD4+ and CD8+ T cells were similar between these groups. PBMC supernatant cytokine levels showed a significant difference between stimulated and non-stimulated conditions for IL-2, TNF-α, IL-10, and CXCL10. CONCLUSION Despite the decline in antibody concentrations over time, the participants still demonstrated neutralizing capacity against the measles D8 genotype five to eight years after the second dose of the measles, mumps, and rubella vaccine. Additionally, most of the enrolled children exhibited cell-mediated immunity responses to measles virus stimulation.
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Affiliation(s)
- Letícia Kegele Lignani
- Fundação Oswaldo Cruz, Instituto de Tecnologia em Imunobiológicos/Bio-Manguinhos, Avenida Brasil, 4365, Manguinhos, CEP 21041-250 Rio de Janeiro, Brazil.
| | | | - Eliane Matos Dos Santos
- Fundação Oswaldo Cruz, Instituto de Tecnologia em Imunobiológicos/Bio-Manguinhos, Avenida Brasil, 4365, Manguinhos, CEP 21041-250 Rio de Janeiro, Brazil
| | - Luiz Antonio Bastos Camacho
- Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sérgio Arouca, Rua Leopoldo Bulhões, 1480, Manguinhos, CEP 21040-360 Rio de Janeiro, Brazil
| | - Janaína Reis Xavier
- Fundação Oswaldo Cruz, Instituto de Tecnologia em Imunobiológicos/Bio-Manguinhos, Avenida Brasil, 4365, Manguinhos, CEP 21041-250 Rio de Janeiro, Brazil
| | - Gloria Regina da Silva E Sá
- Universidade Federal do Estado do Rio de Janeiro, Instituto de Saúde Coletiva, Rua Professor Gabizo, 264, 3° andar, Tijuca, CEP 20271-062 Rio de Janeiro, Brazil
| | - Marilda Mendonça Siqueira
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Vírus Respiratórios, Exantemáticos, Enterovírus e Emergências Virais, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, CEP 21041-250 Rio de Janeiro, Brazil
| | - Andréa Marques Vieira da Silva
- Fundação Oswaldo Cruz, Instituto de Tecnologia em Imunobiológicos/Bio-Manguinhos, Avenida Brasil, 4365, Manguinhos, CEP 21041-250 Rio de Janeiro, Brazil
| | - Juliana Gil Melgaço
- Fundação Oswaldo Cruz, Instituto de Tecnologia em Imunobiológicos/Bio-Manguinhos, Avenida Brasil, 4365, Manguinhos, CEP 21041-250 Rio de Janeiro, Brazil
| | - Nathalia Dos Santos Alves
- Fundação Oswaldo Cruz, Instituto de Tecnologia em Imunobiológicos/Bio-Manguinhos, Avenida Brasil, 4365, Manguinhos, CEP 21041-250 Rio de Janeiro, Brazil
| | - Maria de Lourdes de Sousa Maia
- Fundação Oswaldo Cruz, Instituto de Tecnologia em Imunobiológicos/Bio-Manguinhos, Avenida Brasil, 4365, Manguinhos, CEP 21041-250 Rio de Janeiro, Brazil
| | - Enirtes Caetano Prates Melo
- Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sérgio Arouca, Rua Leopoldo Bulhões, 1480, Manguinhos, CEP 21040-360 Rio de Janeiro, Brazil
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16
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Senin A, Noordin NM, Sani JAM, Mahat D, Donadel M, Scobie HM, Omar A, Chem YK, Zahari MI, Ismail F, Rahman RA, Hussin HM, Selvanesan S, Aziz ZA, Arifin WNAWM, Bakar RSA, Rusli N, Zailani MH, Soo P, Lo YR, Grabovac V, Rota PA, Mulders MN, Featherstone D, Warrener L, Brown DW. A measles IgM rapid diagnostic test to address challenges with national measles surveillance and response in Malaysia. PLoS One 2024; 19:e0298730. [PMID: 38483868 PMCID: PMC10939268 DOI: 10.1371/journal.pone.0298730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/29/2024] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION A lateral flow rapid diagnostic test (RDT) enables detection of measles specific immunoglobulin M (IgM) antibody in serum, capillary blood, and oral fluid with accuracy consistent with enzyme immunoassay (EIA). The objectives of the study were: 1) to assess measles RDT inter-reader agreement between two clinic staff; 2) to assess the sensitivity and specificity of the measles RDT relative to standard surveillance testing in a low transmission setting; 3) to evaluate the knowledge, attitudes, and practices of staff in clinics using the RDT; and 4) to assess the impact of RDT testing on the measles public health response in Malaysia. MATERIALS AND METHODS The clinic-based prospective evaluation included all suspected measles cases captured by routine measles surveillance at 34 purposely selected clinics in 15 health districts in Malaysia between September 2019 and June 2020, following day-long regional trainings on RDT use. Following informed consent, four specimens were collected from each suspected case, including those routinely collected for standard surveillance [serum for EIA and throat swabs for quantitative reverse transcriptase polymerase chain reaction (RT-qPCR)] together with capillary blood and oral fluid tested with RDTs during the study. RDT impact was evaluated by comparing the rapidity of measles public health response between the pre-RDT implementation (December 2018 to August 2019) and RDT implementation periods (September 2019 to June 2020). To assess knowledge, attitudes, and practices of RDT use, staff involved in the public health management of measles at the selected sites were surveyed. RESULTS Among the 436 suspect cases, agreement of direct visual readings of measles RDT devices between two health clinic staff was 99% for capillary blood (k = 0.94) and 97% for oral fluid (k = 0.90) specimens. Of the total, 45 (10%) were positive by measles IgM EIA (n = 44, including five also positive by RT-qPCR) or RT-qPCR only (n = 1), and 38 were positive by RDT (using either capillary blood or oral fluid). Using measles IgM EIA or RT-qPCR as reference, RDT sensitivity using capillary blood was 43% (95% CI: 30%-58%) and specificity was 98% (95% CI: 96%-99%); using oral fluid, sensitivity (26%, 95% CI: 15%-40%) and specificity (97%, 95% CI: 94%-98%) were lower. Nine months after training, RDT knowledge was high among staff involved with the public health management of measles (average quiz score of 80%) and was highest among those who received formal training (88%), followed by those trained during supervisory visits (83%). During the RDT implementation period, the number of days from case confirmation until initiation of public response decreased by about 5 days. CONCLUSION The measles IgM RDT shows >95% inter-reader agreement, high retention of RDT knowledge, and a more rapid public health response. However, despite ≥95% RDT specificity using capillary blood or oral fluid, RDT sensitivity was <45%. Higher-powered studies using highly specific IgM assays and systematic RT-qPCR for case confirmation are needed to establish the role of RDT in measles elimination settings.
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Affiliation(s)
- A’aisah Senin
- Disease Control Division, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Noorliza M. Noordin
- Disease Control Division, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Jamiatul A. M. Sani
- Disease Control Division, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Diana Mahat
- Disease Control Division, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Morgane Donadel
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Heather M. Scobie
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Aziyati Omar
- National Public Health Laboratory, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Yu K. Chem
- National Public Health Laboratory, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Mohamad I. Zahari
- Disease Control Division, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Fatanah Ismail
- Family Health Development Division, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Rozita A. Rahman
- Family Health Development Division, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Hani M. Hussin
- Disease Control Division, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Sengol Selvanesan
- National Public Health Laboratory, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Zirwatul A. Aziz
- National Public Health Laboratory, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | | | - Rehan S. A. Bakar
- National Public Health Laboratory, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Norhayati Rusli
- Disease Control Division, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - M. Hanif Zailani
- Disease Control Division, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Paul Soo
- Office of the World Health Organization Representative to Malaysia, Brunei Darussalam and Singapore, Cyberjaya, Malaysia
| | - Ying-Ru Lo
- Office of the World Health Organization Representative to Malaysia, Brunei Darussalam and Singapore, Cyberjaya, Malaysia
| | - Varja Grabovac
- World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Paul A. Rota
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Mick N. Mulders
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | | | - Lenesha Warrener
- Public Health Microbiology Division, United Kingdom Health Security Agency (UKHSA), London, United Kingdom
| | - David W. Brown
- Public Health Microbiology Division, United Kingdom Health Security Agency (UKHSA), London, United Kingdom
- Laboratório de Vírus Respiratórios e do Sarampo, Instituto Oswaldo Cruz/Fiocruz, Rio de Janeiro, Rio de Janeiro, Brazil
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Bemis K, Frias M, Giovanni S, Shackour T, Reid HD, Morgan J, TeKippe M, Christiansen D. Notes from the Field: Measles Outbreak - Cook County, Illinois, October-November 2023. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2024; 73:229-230. [PMID: 38483848 PMCID: PMC10948190 DOI: 10.15585/mmwr.mm7310a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
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18
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Parums DV. A Review of the Resurgence of Measles, a Vaccine-Preventable Disease, as Current Concerns Contrast with Past Hopes for Measles Elimination. Med Sci Monit 2024; 30:e944436. [PMID: 38525549 PMCID: PMC10946219 DOI: 10.12659/msm.944436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 03/11/2024] [Indexed: 03/26/2024] Open
Abstract
On 22 February 2024, the World Health Organization (WHO) stated that, following the recent resurgence of measles cases in Europe, more than half the world's countries could expect significant measles outbreaks this year. Measles is a highly infectious virus with a primary case reproduction number (R0) of 12-18. Measles infection can be severe, resulting in pneumonia, and also more rarely in subacute sclerosing panencephalitis (SSPE), which occurs in 1 child out of every 1,000 and can be fatal. Until the 1990s, the hope of eliminating measles seemed possible following the successful development of effective vaccines, given individually or in the combined measles, mumps, and rubella (MMR) vaccine. Vaccine hesitancy due to misinformation about possible vaccine side effects, reduced vaccine uptake during and after the COVID-19 pandemic, and lack of awareness of the severe consequences of measles infection have contributed to low vaccine uptake, resulting in vulnerable communities. This article aims to review the recent resurgence of measles cases in the US, Europe, and the UK, to provide a reminder of the potential severity of measles, and to consider the causes of the failure to eliminate this vaccine-preventable viral infection.
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Zemella A, Beer K, Ramm F, Wenzel D, Düx A, Merkel K, Calvignac-Spencer S, Stern D, Dorner MB, Dorner BG, Widulin N, Schnalke T, Walter C, Wolbert A, Schmid BG, Mankertz A, Santibanez S. Vaccine-induced neutralizing antibodies bind to the H protein of a historical measles virus. Int J Med Microbiol 2024; 314:151607. [PMID: 38367508 DOI: 10.1016/j.ijmm.2024.151607] [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: 12/20/2023] [Revised: 01/18/2024] [Accepted: 01/18/2024] [Indexed: 02/19/2024] Open
Abstract
Measles is a highly contagious airborne viral disease. It can lead to serious complications and death and is preventable by vaccination. The live-attenuated measles vaccine (LAMV) derived from a measles virus (MV) isolated in 1954 has been in use globally for six decades and protects effectively by providing a durable humoral and cell-mediated immunity. Our study addresses the temporal stability of epitopes on the viral surface glycoprotein hemagglutinin (H) which is the major target of MV-neutralizing antibodies. We investigated the binding of seven vaccine-induced MV-H-specific monoclonal antibodies (mAbs) to cell-free synthesized MV-H proteins derived from the H gene sequences obtained from a lung specimen of a fatal case of measles pneumonia in 1912 and an isolate from a current case. The binding of four out of seven mAbs to the H protein of both MV strains provides evidence of epitopes that are stable for more than 100 years. The binding of the universally neutralizing mAbs RKI-MV-12b and RKI-MV-34c to the H protein of the 1912 MV suggests the long-term stability of highly conserved epitopes on the MV surface.
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Affiliation(s)
- Anne Zemella
- Fraunhofer Institute for Cell Therapy and Immunology (IZI), Branch Bioanalytics and Bioprocesses (IZI-BB), Am Mühlenberg 13, D-14476 Potsdam, Germany
| | - Kerstin Beer
- WHO Measles/Rubella European RRL and NRC Measles, Mumps, Rubella, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany
| | - Franziska Ramm
- Fraunhofer Institute for Cell Therapy and Immunology (IZI), Branch Bioanalytics and Bioprocesses (IZI-BB), Am Mühlenberg 13, D-14476 Potsdam, Germany
| | - Dana Wenzel
- Fraunhofer Institute for Cell Therapy and Immunology (IZI), Branch Bioanalytics and Bioprocesses (IZI-BB), Am Mühlenberg 13, D-14476 Potsdam, Germany
| | - Ariane Düx
- Viral Evolution, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany; Helmholtz Institute for One Health, Helmholtz-Centre for Infection Research (HZI), 17489 Greifswald, Germany
| | - Kevin Merkel
- Viral Evolution, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany
| | - Sebastien Calvignac-Spencer
- Viral Evolution, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany; Helmholtz Institute for One Health, Helmholtz-Centre for Infection Research (HZI), 17489 Greifswald, Germany; Faculty of Mathematics and Natural Sciences, University of Greifswald, 17489 Greifswald, Germany
| | - Daniel Stern
- Biological Toxins (ZBS3), Centre for Biological Threats and Special Pathogens, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany
| | - Martin B Dorner
- Biological Toxins (ZBS3), Centre for Biological Threats and Special Pathogens, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany
| | - Brigitte G Dorner
- Biological Toxins (ZBS3), Centre for Biological Threats and Special Pathogens, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany
| | | | | | - Cornelia Walter
- WHO Measles/Rubella European RRL and NRC Measles, Mumps, Rubella, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany
| | - Anne Wolbert
- WHO Measles/Rubella European RRL and NRC Measles, Mumps, Rubella, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany
| | - Bernhard G Schmid
- WHO Measles/Rubella European RRL and NRC Measles, Mumps, Rubella, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany
| | - Annette Mankertz
- WHO Measles/Rubella European RRL and NRC Measles, Mumps, Rubella, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany
| | - Sabine Santibanez
- WHO Measles/Rubella European RRL and NRC Measles, Mumps, Rubella, Robert Koch-Institut, Seestr. 10, D-13353 Berlin, Germany.
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20
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Pinchon E, Henry S, Leon F, Fournier-Wirth C, Foulongne V, Cantaloube JF. Rapid Detection of Measles Virus Using Reverse Transcriptase/Recombinase Polymerase Amplification Coupled with CRISPR/Cas12a and a Lateral Flow Detection: A Proof-of-Concept Study. Diagnostics (Basel) 2024; 14:517. [PMID: 38472989 DOI: 10.3390/diagnostics14050517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/18/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
The measles virus is highly contagious, and efforts to simplify its diagnosis are essential. A reverse transcriptase/recombinase polymerase amplification assay coupled with CRISPR/Cas12a and an immunochromatographic lateral flow detection (RT-RPA-CRISPR-LFD) was developed for the simple visual detection of measles virus. The assay was performed in less than 1 h at an optimal temperature of 42 °C. The detection limit of the assay was 31 copies of an RNA standard in the reaction tube. The diagnostic performances were evaluated on a panel of 27 measles virus RT-PCR-positive samples alongside 29 measles virus negative saliva samples. The sensitivity and specificity were 96% (95% CI, 81-99%) and 100% (95% CI, 88-100%), respectively, corresponding to an accuracy of 98% (95% CI, 94-100%; p < 0.0001). This method will open new perspectives in the development of the point-of-care testing diagnosis of measles.
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Affiliation(s)
- Elena Pinchon
- Pathogénèse et Contrôle des Infections Chroniques et Emergentes, Etablissement Français du Sang, Université de Montpellier, Inserm, 34184 Montpellier, France
| | - Steven Henry
- Pathogénèse et Contrôle des Infections Chroniques et Emergentes, Etablissement Français du Sang, Université de Montpellier, Inserm, 34184 Montpellier, France
| | - Fanny Leon
- Pathogénèse et Contrôle des Infections Chroniques et Emergentes, Etablissement Français du Sang, Université de Montpellier, Inserm, 34184 Montpellier, France
| | - Chantal Fournier-Wirth
- Pathogénèse et Contrôle des Infections Chroniques et Emergentes, Etablissement Français du Sang, Université de Montpellier, Inserm, 34184 Montpellier, France
| | - Vincent Foulongne
- Pathogénèse et Contrôle des Infections Chroniques et Emergentes, Etablissement Français du Sang, Université de Montpellier, Inserm, 34184 Montpellier, France
| | - Jean-François Cantaloube
- Pathogénèse et Contrôle des Infections Chroniques et Emergentes, Etablissement Français du Sang, Université de Montpellier, Inserm, 34184 Montpellier, France
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21
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Bedford H, Elliman D. Measles rates are rising again. BMJ 2024; 384:q259. [PMID: 38320782 DOI: 10.1136/bmj.q259] [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] [Indexed: 02/15/2024]
Affiliation(s)
- Helen Bedford
- UCL Great Ormond Street Institute of Child Health, London, UK
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22
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Sharma S, Dhamne C, Bhosale S, Parambil B, Divatia J, Chinnaswamy G, Patil V, Joshi R, Epari S, Mahadevan A, Vaidya S, Kulkarni S, Kulkarni A, Patil V, Srinivasan S, Gollamudi VRM, Roy Moulik N, Prasad M, Narula G, Banavali S. Epilepsia Partialis Continua as a Sequelae of Measles Infection in Children With Hematolymphoid Malignancies. JCO Glob Oncol 2024; 10:e2300399. [PMID: 38422460 PMCID: PMC10914244 DOI: 10.1200/go.23.00399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/27/2023] [Accepted: 01/16/2024] [Indexed: 03/02/2024] Open
Abstract
PURPOSE To share our clinical experience with the diagnosis and management of children with hematolymphoid malignancies presenting with epilepsia partialis continua (EPC) as a sequelae of measles infection. MATERIALS AND METHODS In December 2022, a series of children in our hemato-oncology unit presented with focal status epilepticus with no conclusive evidence pointing toward any underlying etiology. One such child had a typical measles rash a few weeks before the onset of this focal status epilepticus. After a series of cases with a similar presentation, a clinical pattern suspicious for measles became evident. cerebrospinal fluid polymerase chain reaction was positive for measles virus with measles immunoglobin M detected in the serum. This led to the diagnosis of measles inclusion-body encephalitis in a series of children who presented with EPC over a period of 3 months. EPC is a rare manifestation of measles that is seen only in immunocompromised patients. RESULTS Among the 18 children reported in this series, only 10 had a history of rashes. The rash was mostly transient and elicited only on retrospective history taking. Five of the 18 children who did not lose consciousness during the prolonged seizure episode survived the disease but had residual neurologic sequelae. Among the 18 children, two were unimmunized and immunization status could not be confirmed in three other children. CONCLUSION This case series highlights the threats posed by measles infection in children with cancer who are immunosuppressed because of the underlying disease and ongoing chemotherapy. Loss of herd immunity because of declining measles immunization rates secondary to vaccine hesitancy and COVID-19 lockdown pose a greater risk of measles infection and its complications for patients with deficient immune systems.
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Affiliation(s)
- Sudivya Sharma
- Division of Critical Care Medicine, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Chetan Dhamne
- Department of Pediatric Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Shilpushp Bhosale
- Division of Critical Care Medicine, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Badira Parambil
- Department of Pediatric Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Jigeeshu Divatia
- Division of Critical Care Medicine, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Girish Chinnaswamy
- Department of Pediatric Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Vasundhara Patil
- Department of Radiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | | | - Sridhar Epari
- Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Anita Mahadevan
- Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Sunil Vaidya
- Virus Registry and Virus Repository, National Institute of Virology, Pune, India
| | - Shilpa Kulkarni
- Department of Neurology, Wadia Children's Hospital, Mumbai, India
| | - Atul Kulkarni
- Division of Critical Care Medicine, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Vijaya Patil
- Division of Critical Care Medicine, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Shyam Srinivasan
- Department of Pediatric Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | | | - Nirmalya Roy Moulik
- Department of Pediatric Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Maya Prasad
- Department of Pediatric Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Gaurav Narula
- Department of Pediatric Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Shripad Banavali
- Department of Pediatric Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
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23
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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
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24
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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.
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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
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25
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Tanne JH. Measles cases and deaths are increasing worldwide, say WHO and CDC. BMJ 2023; 383:2733. [PMID: 37984983 DOI: 10.1136/bmj.p2733] [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] [Indexed: 11/22/2023]
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