1
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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2
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Hueppe K, Ortman J, Gauselmann H, Santibanez S, Mankertz A. Measles vaccination - An underestimated prevention measure: Analyzing a fatal case in Hildesheim, Germany. Int J Med Microbiol 2024; 314:151608. [PMID: 38335886 DOI: 10.1016/j.ijmm.2024.151608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/16/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
Measles and rubella are targeted for elimination in the WHO region Europe. To reach the elimination goal, vaccination coverage of 95% must be achieved and sustained, the genotype information has to be provided for 80% of all outbreaks and transmission chains of a certain variant must not be detected for >12 months. The latter information is collected at Germany's National Reference Center Measles, Mumps, Rubella (NRC MMR). We describe here an outbreak of measles occurring in Hildesheim. The outbreak comprised 43 cases and lasted 14 weeks. Surprisingly, a high number of vaccination failures was observed since 11 cases had received two doses of the MMR vaccine and 4 additional cases were vaccinated once. A 33-year-old woman passed away during the outbreak. She was the mother of 5 children between 4 and 16 years of age. Two schoolchildren contracted measles and passed it on to the rest of the family. Due to delivery bottlenecks, the vaccination of the mother was delayed. She developed measles-like symptoms 3 days after vaccination and was found dead on the morning of day 8 after vaccination. A post-mortem examination was done to identify the cause of death. Moreover, molecular characterization of the virus was performed to analyze whether she was infected by the wildtype virus circulating at that time in Hildesheim or whether the vaccine may have been a concomitant and aggravating feature of her death. The result showed that the samples taken from her at the time of death and during necropsy contained the wildtype measles virus variant corresponding to MVs/Gir Somnath.IND/42.16 (WHO Seq-ID D8-4683) that fueled the Hildesheim outbreak and circulated in Germany from March 2018 to March 2020. The vaccine virus was not detected. Moreover, two aspects uncovered by the post-mortem examination were remarkable; the woman died from giant cell pneumonia, which is a complication seen in immune-suppressed individuals and she was actively using cannabis. THC is known to influence the immune system, but literature reports describing the effects are limited.
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Affiliation(s)
- Katharina Hueppe
- Local Health Authority, Hildesheim, Ludolfingerstr. 2, 31137 Hildesheim, Germany
| | - Jan Ortman
- Institute for Forensic Medicine, Medizinische Hochschule Hannover, Hannover, Germany
| | - Hannah Gauselmann
- Brandenburgisches Landesinstitut für Rechtsmedizin, Potsdam, Germany
| | - Sabine Santibanez
- National Reference Center Measles, Mumps, Rubella; Robert Koch-Institute; Seestr. 10, 13353 Berlin, Germany
| | - Annette Mankertz
- National Reference Center Measles, Mumps, Rubella; Robert Koch-Institute; Seestr. 10, 13353 Berlin, Germany.
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3
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Krumova S, Santibanez S, Andonova I, Stefanova R, Mankertz A, Kantardjiev T. Detection of measles virus in Bulgaria from 2012 to 2018. Croat Med J 2022; 63. [PMID: 36325672 PMCID: PMC9648082 DOI: 10.3325/cmj.2022.63.475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIM To determine the circulation patterns of measles virus in Bulgaria from 2012 to 2018 after a large measles outbreak in the country (2009-2011). METHODS Three types of clinical material were collected: serum samples, urine samples, and nasal swabs. Enzyme-linked immunosorbent assay (ELISA) was used to detect specific viral immunoglobulin (Ig) M/IgG antibodies. Viral RNA was extracted from all urine and nasal swabs. RESULTS In the investigated period, 102 patients were confirmed to have measles (age range: two months to 55 years). A total of 101 samples (99%) were measles-IgM positive. Most of them were detected in 2017 (73%, 74/101), when a measles outbreak in the country was reported. The majority of patients were unvaccinated children aged under 13 months. Out of 101 measles serum samples confirmed by ELISA, 18 (20.45%) were measles-IgG positive and 15 (17.05%) were borderline. Thirty-three positive PCR products were sequenced and genotyped. In 2013, 2016, 2017, and 2018, three different measles viral genotypes were detected: D8, H1, and B3. Most patients were unvaccinated or insufficiently vaccinated. CONCLUSION Preventive measures are indispensable to limit the infection in different regions of Bulgaria and its spread to other countries. As vaccination coverage against measles and other vaccine-preventable infections, including SARS-Co2, is low, it is necessary to perform molecular identification of viruses to monitor their circulation and pathogenicity.
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Affiliation(s)
- Stefka Krumova
- Department of Virology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Sabine Santibanez
- National Reference Center for Measles, Mumps, Rubella, Robert Koch Institute, Berlin, Germany
| | - Ivona Andonova
- Department of Virology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Radostina Stefanova
- Department of Virology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Annette Mankertz
- National Reference Center for Measles, Mumps, Rubella, Robert Koch Institute, Berlin, Germany
| | - Todor Kantardjiev
- National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria
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4
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Bühl D, Staudacher O, Santibanez S, Rossi R, Girschick H, Stephan V, Schmidt B, Hundsdoerfer P, von Moers A, Lange M, Barker M, Mall MA, Heininger U, Matysiak-Klose D, Mankertz A, von Bernuth H. Corrigendum: Specifically increased rate of infections in children post measles in a high resource setting. Front Pediatr 2022; 10:1005990. [PMID: 36160808 PMCID: PMC9493371 DOI: 10.3389/fped.2022.1005990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fped.2022.896086.].
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Affiliation(s)
- Daniel Bühl
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Olga Staudacher
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Immunology, Labor Berlin GmbH, Berlin, Germany
| | - Sabine Santibanez
- National Reference Center for Measles, Mumps, Rubella, Robert Koch Institute, Berlin, Germany
| | - Rainer Rossi
- Department of Pediatrics, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Hermann Girschick
- Children's Hospital, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Volker Stephan
- Department of Pediatrics, Sana Klinikum Lichtenberg, Berlin, Germany
| | - Beatrix Schmidt
- St. Joseph's Center for Pediatric and Adolescent Medicine, St. Joseph Krankenhaus, Berlin, Germany
| | - Patrick Hundsdoerfer
- Department of Pediatric and Adolescent Medicine, Helios-Klinikum Berlin-Buch, Berlin, Germany
| | - Arpad von Moers
- Department of Pediatrics and Neuropediatrics, DRK Kliniken Berlin Westend, Berlin, Germany
| | - Michael Lange
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Berlin, Germany
| | - Michael Barker
- Department of Pediatrics, Helios Klinikum Emil von Behring, Berlin, Germany
| | - Marcus A Mall
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany.,German Center for Lung Research (DZL), Berlin, Germany
| | - Ulrich Heininger
- Infectious Diseases and Vaccinology, University of Basel Children's Hospital, Basel, Switzerland
| | - Dorothea Matysiak-Klose
- Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch Institute, Berlin, Germany
| | - Annette Mankertz
- National Reference Center for Measles, Mumps, Rubella, Robert Koch Institute, Berlin, Germany
| | - Horst von Bernuth
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Immunology, Labor Berlin GmbH, Berlin, Germany.,Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany.,Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Berlin, Germany
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5
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Bühl D, Staudacher O, Santibanez S, Rossi R, Girschick H, Stephan V, Schmidt B, Hundsdoerfer P, von Moers A, Lange M, Barker M, Mall MA, Heininger U, Matysiak-Klose D, Mankertz A, von Bernuth H. Specifically Increased Rate of Infections in Children Post Measles in a High Resource Setting. Front Pediatr 2022; 10:896086. [PMID: 35813375 PMCID: PMC9261986 DOI: 10.3389/fped.2022.896086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Post-measles increased susceptibility to subsequent infections seems particularly relevant in low-resource settings. We tested the hypothesis that measles causes a specifically increased rate of infections in children, also in a high-resource setting. METHODS We conducted a retrospective cohort study on a large measles outbreak in Berlin, Germany. All children with measles who presented to hospitals in Berlin were included as cases, children with non-infectious and children with non-measles infectious diseases as controls. Repeat visits within 3 years after the outbreak were recorded. RESULTS We included 250 cases, 502 non-infectious, and 498 infectious disease controls. The relative risk for cases for the diagnosis of an infectious disease upon a repeat visit was 1.6 (95% CI 1.4-2.0, p < 0.001) vs. non-infectious and 1.3 (95% CI 1.1-1.6, p = 0.002) vs. infectious disease controls. 33 cases (27%), 35 non-infectious (12%) and 57 (18%) infectious disease controls presented more than three times due to an infectious disease (p = 0.01, and p = 0.02, respectively). This results in a relative risk of more than three repeat visits due to an infection for measles cases of 1.8 (95% CI 1.3-2.4, p = 0.01), and 1.4 (95% CI 1.0-1.9, p = 0.04), respectively. CONCLUSION Our study demonstrates for the first time in a high-resource setting, that increased post-measles susceptibility to subsequent infections in children is measles-specific-even compared to controls with previous non-measles infections.
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Affiliation(s)
- Daniel Bühl
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Olga Staudacher
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Immunology, Labor Berlin GmbH, Berlin, Germany
| | - Sabine Santibanez
- National Reference Center for Measles, Mumps, Rubella, Robert Koch Institute, Berlin, Germany
| | - Rainer Rossi
- Department of Pediatrics, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Hermann Girschick
- Children's Hospital, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Volker Stephan
- Department of Pediatrics, Sana Klinikum Lichtenberg, Berlin, Germany
| | - Beatrix Schmidt
- St. Joseph's Center for Pediatric and Adolescent Medicine, St. Joseph Krankenhaus, Berlin, Germany
| | - Patrick Hundsdoerfer
- Department of Pediatric and Adolescent Medicine, Helios-Klinikum Berlin-Buch, Berlin, Germany
| | - Arpad von Moers
- Department of Pediatrics and Neuropediatrics, DRK Kliniken Berlin Westend, Berlin, Germany
| | - Michael Lange
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Berlin, Germany
| | - Michael Barker
- Department of Pediatrics, Helios Klinikum Emil von Behring, Berlin, Germany
| | - Marcus A Mall
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany.,German Center for Lung Research (DZL), Berlin, Germany
| | - Ulrich Heininger
- Infectious Diseases and Vaccinology, University of Basel Children's Hospital, Basel, Switzerland
| | - Dorothea Matysiak-Klose
- Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch Institute, Berlin, Germany
| | - Annette Mankertz
- National Reference Center for Measles, Mumps, Rubella, Robert Koch Institute, Berlin, Germany
| | - Horst von Bernuth
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Immunology, Labor Berlin GmbH, Berlin, Germany.,Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany.,Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Berlin, Germany
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6
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Wittwer K, Anderson DE, Pfeffermann K, Cox RM, Wolf JD, Santibanez S, Mankertz A, Plesker R, Sticher ZM, Kolkykhalov AA, Natchus MG, Pfaller CK, Plemper RK, von Messling V. Small-molecule polymerase inhibitor protects non-human primates from measles and reduces shedding. Nat Commun 2021; 12:5233. [PMID: 34475387 PMCID: PMC8413292 DOI: 10.1038/s41467-021-25497-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 08/12/2021] [Indexed: 01/26/2023] Open
Abstract
Measles virus (MeV) is a highly contagious pathogen that enters the human host via the respiratory route. Besides acute pathologies including fever, cough and the characteristic measles rash, the infection of lymphocytes leads to substantial immunosuppression that can exacerbate the outcome of infections with additional pathogens. Despite the availability of effective vaccine prophylaxis, measles outbreaks continue to occur worldwide. We demonstrate that prophylactic and post-exposure therapeutic treatment with an orally bioavailable small-molecule polymerase inhibitor, ERDRP-0519, prevents measles disease in squirrel monkeys (Saimiri sciureus). Treatment initiation at the onset of clinical signs reduced virus shedding, which may support outbreak control. Results show that this clinical candidate has the potential to alleviate clinical measles and augment measles virus eradication. Measles virus is highly contagious and outbreaks occur worldwide. Here the authors show that the orally bioavailable small-molecule polymerase inhibitor ERDRP-0519 prevents measles disease in squirrel monkeys and reduces virus shedding.
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Affiliation(s)
- Kevin Wittwer
- Veterinary Medicine Division, Paul-Ehrlich-Institute, Langen, Germany
| | - Danielle E Anderson
- Programme in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
| | | | - Robert M Cox
- Institute for Biomedical Sciences, Georgia State University, Atlanta, GA, USA
| | - Josef D Wolf
- Institute for Biomedical Sciences, Georgia State University, Atlanta, GA, USA
| | - Sabine Santibanez
- WHO European Regional Reference Laboratory for Measles and Rubella, Robert Koch-Institute, Berlin, Germany
| | - Annette Mankertz
- WHO European Regional Reference Laboratory for Measles and Rubella, Robert Koch-Institute, Berlin, Germany
| | - Roland Plesker
- Veterinary Medicine Division, Paul-Ehrlich-Institute, Langen, Germany
| | - Zachary M Sticher
- Emory Institute for Drug Development, Emory University, Atlanta, GA, USA
| | | | - Michael G Natchus
- Emory Institute for Drug Development, Emory University, Atlanta, GA, USA
| | | | - Richard K Plemper
- Institute for Biomedical Sciences, Georgia State University, Atlanta, GA, USA.
| | - Veronika von Messling
- Veterinary Medicine Division, Paul-Ehrlich-Institute, Langen, Germany.,Life Sciences Unit, Federal Ministry of Education and Research, Berlin, Germany
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7
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Friedrich N, Poethko-Müller C, Kuhnert R, Matysiak-Klose D, Koch J, Wichmann O, Santibanez S, Mankertz A. Seroprevalence of Measles-, Mumps-, and Rubella-specific antibodies in the German adult population - cross-sectional analysis of the German Health Interview and Examination Survey for Adults (DEGS1). Lancet Reg Health Eur 2021; 7:100128. [PMID: 34557838 PMCID: PMC8454806 DOI: 10.1016/j.lanepe.2021.100128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND The WHO European Region targets the elimination of measles, rubella, and the congenital rubella syndrome and welcomes mumps elimination via the joint MMR vaccine. In a push towards this elimination goal, Germany introduced a recommendation on MMR vaccination for adults in 2010 to prevent increasing numbers of measles cases among adults and to strengthen herd immunity. METHODS The prevalence of anti-measles, -mumps, and -rubella IgG antibodies was analysed in 7,115 participants between the ages of 18 and 79 years in the German Health Interview and Examination Survey. Risk factors of seronegativity of adults born 1970 or later were determined. FINDINGS The seroprevalence of anti-measles IgG antibodies was more than 97% in adults born before 1965 and less than 90% in adults born afterwards. Prevalence and GMTs declined with later years of birth. Seronegativity was associated with two-sided migration background and region of residence in East Germany. For anti-mumps IgG antibodies, the seroprevalence was less than 90% in almost all age groups. Prevalence and GMTs declined with later years of birth. Seronegativity was not associated with any socio-demographic factor. Anti-rubella IgG seropositivity was found in more than 90% of adults born before 1985. GMTs declined in younger age groups. Seronegativity was associated with birth between 1980 and 1993 and male gender. High socio-economic status lowered the odds of being seronegative. INTERPRETATION These data reinforce the implementation of the vaccination recommendation for adults and provide the basis for further evaluation of this measure. FUNDING The Federal Ministry of Health, Germany.
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Affiliation(s)
- Nicole Friedrich
- National Reference Centre Measles, Mumps, Rubella, Robert Koch Institute, Seestraße 10, 13353 Berlin, Germany
| | | | - Ronny Kuhnert
- Epidemiological Data Centre, Robert Koch Institute, General-Pape-Straße 62-66, 12101 Berlin, Germany
| | | | - Judith Koch
- Immunization Unit, Robert Koch Institute, Seestraße 10, 13353 Berlin, Germany
| | - Ole Wichmann
- Immunization Unit, Robert Koch Institute, Seestraße 10, 13353 Berlin, Germany
| | - Sabine Santibanez
- National Reference Centre Measles, Mumps, Rubella, Robert Koch Institute, Seestraße 10, 13353 Berlin, Germany
| | - Annette Mankertz
- National Reference Centre Measles, Mumps, Rubella, Robert Koch Institute, Seestraße 10, 13353 Berlin, Germany
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8
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Bühl D, Santibanez S, Kallinich T, Mankertz A, von Bernuth H. Wie schützen wir Säuglinge gegen Masern? Monatsschr Kinderheilkd 2020. [DOI: 10.1007/s00112-020-00980-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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9
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Düx A, Lequime S, Patrono LV, Vrancken B, Boral S, Gogarten JF, Hilbig A, Horst D, Merkel K, Prepoint B, Santibanez S, Schlotterbeck J, Suchard MA, Ulrich M, Widulin N, Mankertz A, Leendertz FH, Harper K, Schnalke T, Lemey P, Calvignac-Spencer S. Measles virus and rinderpest virus divergence dated to the sixth century BCE. Science 2020; 368:1367-1370. [PMID: 32554594 DOI: 10.1126/science.aba9411] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/30/2020] [Indexed: 12/11/2022]
Abstract
Many infectious diseases are thought to have emerged in humans after the Neolithic revolution. Although it is broadly accepted that this also applies to measles, the exact date of emergence for this disease is controversial. We sequenced the genome of a 1912 measles virus and used selection-aware molecular clock modeling to determine the divergence date of measles virus and rinderpest virus. This divergence date represents the earliest possible date for the establishment of measles in human populations. Our analyses show that the measles virus potentially arose as early as the sixth century BCE, possibly coinciding with the rise of large cities.
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Affiliation(s)
- Ariane Düx
- Epidemiology of Highly Pathogenic Microorganisms Project Group, Robert Koch Institute, Berlin, Germany.,Viral Evolution Project Group, Robert Koch Institute, Berlin, Germany
| | - Sebastian Lequime
- Laboratory of Clinical and Evolutionary Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute, Katholieke Universiteit (KU) Leuven, Leuven, Belgium
| | - Livia Victoria Patrono
- Epidemiology of Highly Pathogenic Microorganisms Project Group, Robert Koch Institute, Berlin, Germany.,Viral Evolution Project Group, Robert Koch Institute, Berlin, Germany
| | - Bram Vrancken
- Laboratory of Clinical and Evolutionary Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute, Katholieke Universiteit (KU) Leuven, Leuven, Belgium
| | - Sengül Boral
- Institute for Pathology, Charité, Berlin, Germany
| | - Jan F Gogarten
- Epidemiology of Highly Pathogenic Microorganisms Project Group, Robert Koch Institute, Berlin, Germany.,Viral Evolution Project Group, Robert Koch Institute, Berlin, Germany
| | - Antonia Hilbig
- Epidemiology of Highly Pathogenic Microorganisms Project Group, Robert Koch Institute, Berlin, Germany
| | - David Horst
- Institute for Pathology, Charité, Berlin, Germany
| | - Kevin Merkel
- Epidemiology of Highly Pathogenic Microorganisms Project Group, Robert Koch Institute, Berlin, Germany.,Viral Evolution Project Group, Robert Koch Institute, Berlin, Germany
| | - Baptiste Prepoint
- Viral Evolution Project Group, Robert Koch Institute, Berlin, Germany.,Département de Biologie, Ecole Normale Supérieure, PSL Université Paris, Paris, France
| | - Sabine Santibanez
- National Reference Centre for Measles, Mumps, and Rubella, Robert Koch Institute, Berlin, Germany
| | | | - Marc A Suchard
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.,Department of Biomathematics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.,Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Markus Ulrich
- Epidemiology of Highly Pathogenic Microorganisms Project Group, Robert Koch Institute, Berlin, Germany
| | - Navena Widulin
- Berlin Museum of Medical History, Charité, Berlin, Germany
| | - Annette Mankertz
- National Reference Centre for Measles, Mumps, and Rubella, Robert Koch Institute, Berlin, Germany
| | - Fabian H Leendertz
- Epidemiology of Highly Pathogenic Microorganisms Project Group, Robert Koch Institute, Berlin, Germany
| | - Kyle Harper
- Department of Classics and Letters, University of Oklahoma, Norman, OK, USA
| | | | - Philippe Lemey
- Laboratory of Clinical and Evolutionary Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute, Katholieke Universiteit (KU) Leuven, Leuven, Belgium
| | - Sébastien Calvignac-Spencer
- Epidemiology of Highly Pathogenic Microorganisms Project Group, Robert Koch Institute, Berlin, Germany. .,Viral Evolution Project Group, Robert Koch Institute, Berlin, Germany
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10
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Groß R, Bauer R, Krüger F, Rücker-Braun E, Olari LR, Ständker L, Preising N, Rodríguez AA, Conzelmann C, Gerbl F, Sauter D, Kirchhoff F, Hagemann B, Gačanin J, Weil T, Ruiz-Blanco YB, Sanchez-Garcia E, Forssmann WG, Mankertz A, Santibanez S, Stenger S, Walther P, Wiese S, Spellerberg B, Münch J. A Placenta Derived C-Terminal Fragment of β-Hemoglobin With Combined Antibacterial and Antiviral Activity. Front Microbiol 2020; 11:508. [PMID: 32328038 PMCID: PMC7153485 DOI: 10.3389/fmicb.2020.00508] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 03/09/2020] [Indexed: 01/08/2023] Open
Abstract
The placenta acts as physical and immunological barrier against the transmission of viruses and bacteria from mother to fetus. However, the specific mechanisms by which the placenta protects the developing fetus from viral and bacterial pathogens are poorly understood. To identify placental peptides and small proteins protecting from viral and bacterial infections, we generated a peptide library from 10 kg placenta by chromatographic means. Screening the resulting 250 fractions against Herpes-Simplex-Virus 2 (HSV-2), which is rarely transmitted through the placenta, in a cell-based system identified two adjacent fractions with significant antiviral activity. Further rounds of chromatographic purification and anti-HSV-2 testing allowed to purify the bioactive peptide. Mass spectrometry revealed the presence of a 36-mer derived from the C-terminal region of the hemoglobin β subunit. The purified and corresponding chemically synthesized peptide, termed HBB(112–147), inhibited HSV-2 infection in a dose-dependent manner, with a mean IC50 in the median μg/ml range. Full-length hemoglobin tetramer had no antiviral activity. HBB(112–147) did not impair infectivity by direct targeting of the virions but prevented HSV-2 infection at the cell entry level. The peptide was inactive against Human Immunodeficiency Virus Type 1, Rubella and Zika virus infection, suggesting a specific anti-HSV-2 mechanism. Notably, HBB(112–147) has previously been identified as broad-spectrum antibacterial agent. It is abundant in placenta, reaching concentrations between 280 and 740 μg/ml, that are well sufficient to inhibit HSV-2 and prototype Gram-positive and -negative bacteria. We here additionally show, that HBB(112–147) also acts potently against Pseudomonas aeruginosa strains (including a multi-drug resistant strain) in a dose dependent manner, while full-length hemoglobin is inactive. Interestingly, the antibacterial activity of HBB(112–147) was increased under acidic conditions, a hallmark of infection and inflammatory conditions. Indeed, we found that HBB(112–147) is released from the hemoglobin precursor by Cathepsin D and Napsin A, acidic proteases highly expressed in placental and other tissues. We propose that upon viral or bacterial infection, the abundant hemoglobin precursor is proteolytically processed to release HBB(112–147), a broadly active antimicrobial innate immune defense peptide.
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Affiliation(s)
- Rüdiger Groß
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | - Richard Bauer
- Institute of Medical Microbiology and Hygiene, Ulm University Medical Center, Ulm, Germany
| | - Franziska Krüger
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | - Elke Rücker-Braun
- Department of Medicine I, University Hospital of Dresden, Dresden, Germany
| | - Lia-Raluca Olari
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | - Ludger Ständker
- Core Facility Functional Peptidomics, Ulm University Medical Center, Ulm, Germany
| | - Nico Preising
- Core Facility Functional Peptidomics, Ulm University Medical Center, Ulm, Germany
| | - Armando A Rodríguez
- Core Facility Functional Peptidomics, Ulm University Medical Center, Ulm, Germany.,Core Unit of Mass Spectrometry and Proteomics, Ulm University, Ulm, Germany
| | - Carina Conzelmann
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | - Fabian Gerbl
- Institute of Medical Microbiology and Hygiene, Ulm University Medical Center, Ulm, Germany
| | - Daniel Sauter
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | - Frank Kirchhoff
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | - Benjamin Hagemann
- Institute of Medical Microbiology and Hygiene, Ulm University Medical Center, Ulm, Germany
| | - Jasmina Gačanin
- Max Planck Institute for Polymer Research, Mainz, Germany.,Institute of Inorganic Chemistry I, University of Ulm, Ulm, Germany
| | - Tanja Weil
- Max Planck Institute for Polymer Research, Mainz, Germany.,Institute of Inorganic Chemistry I, University of Ulm, Ulm, Germany
| | - Yasser B Ruiz-Blanco
- Computational Biochemistry, Faculty of Biology, University of Duisburg-Essen, Essen, Germany
| | - Elsa Sanchez-Garcia
- Computational Biochemistry, Faculty of Biology, University of Duisburg-Essen, Essen, Germany
| | | | - Annette Mankertz
- WHO Measles/Rubella European RRL and NRC Measles, Mumps, Rubella, Robert Koch-Institute, Berlin, Germany
| | - Sabine Santibanez
- WHO Measles/Rubella European RRL and NRC Measles, Mumps, Rubella, Robert Koch-Institute, Berlin, Germany
| | - Steffen Stenger
- Institute of Medical Microbiology and Hygiene, Ulm University Medical Center, Ulm, Germany
| | - Paul Walther
- Central Facility for Electron Microscopy, Ulm University, Ulm, Germany
| | - Sebastian Wiese
- Core Unit of Mass Spectrometry and Proteomics, Ulm University, Ulm, Germany
| | - Barbara Spellerberg
- Institute of Medical Microbiology and Hygiene, Ulm University Medical Center, Ulm, Germany
| | - Jan Münch
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany.,Core Facility Functional Peptidomics, Ulm University Medical Center, Ulm, Germany
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11
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Matysiak-Klose D, Santibanez S, Schwerdtfeger C, Koch J, von Bernuth H, Hengel H, Littmann M, Terhardt M, Wicker S, Mankertz A, Heininger U. Post-exposure prophylaxis for measles with immunoglobulins revised recommendations of the standing committee on vaccination in Germany. Vaccine 2018; 36:7916-7922. [DOI: 10.1016/j.vaccine.2018.10.070] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 10/18/2018] [Accepted: 10/19/2018] [Indexed: 12/25/2022]
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12
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Werber D, Hoffmann A, Santibanez S, Mankertz A, Sagebiel D. Large measles outbreak introduced by asylum seekers and spread among the insufficiently vaccinated resident population, Berlin, October 2014 to August 2015. ACTA ACUST UNITED AC 2018; 22. [PMID: 28857043 PMCID: PMC5753442 DOI: 10.2807/1560-7917.es.2017.22.34.30599] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 02/18/2017] [Indexed: 12/03/2022]
Abstract
The largest measles outbreak in Berlin since 2001 occurred from October 2014 to August 2015. Overall, 1,344 cases were ascertained, 86% (with available information) unvaccinated, including 146 (12%) asylum seekers. Median age was 17 years (interquartile range: 4–29 years), 26% were hospitalised and a 1-year-old child died. Measles virus genotyping uniformly revealed the variant ‘D8-Rostov-Don’ and descendants. The virus was likely introduced by and initially spread among asylum seekers before affecting Berlin’s resident population. Among Berlin residents, the highest incidence was in children aged < 2 years, yet most cases (52%) were adults. Post-exposure vaccinations in homes for asylum seekers, not always conducted, occurred later (median: 7.5 days) than the recommended 72 hours after onset of the first case and reached only half of potential contacts. Asylum seekers should not only have non-discriminatory, equitable access to vaccination, they also need to be offered measles vaccination in a timely fashion, i.e. immediately upon arrival in the receiving country. Supplementary immunisation activities targeting the resident population, particularly adults, are urgently needed in Berlin.
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Affiliation(s)
- Dirk Werber
- These authors contributed equally to this work.,State Office for Health and Social Affairs, Berlin, Germany
| | - Alexandra Hoffmann
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,Postgraduate Training for Applied Epidemiology (PAE), Robert Koch Institute, Berlin, Germany.,These authors contributed equally to this work.,State Office for Health and Social Affairs, Berlin, Germany
| | - Sabine Santibanez
- National Reference Center for Measles, Mumps, Rubella, Robert Koch Institute, Berlin, Germany
| | - Annette Mankertz
- National Reference Center for Measles, Mumps, Rubella, Robert Koch Institute, Berlin, Germany
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13
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Santibanez S, Hübschen JM, Ben Mamou MC, Muscat M, Brown KE, Myers R, Donoso Mantke O, Zeichhardt H, Brockmann D, Shulga SV, Muller CP, O'Connor PM, Mulders MN, Mankertz A. Molecular surveillance of measles and rubella in the WHO European Region: new challenges in the elimination phase. Clin Microbiol Infect 2017; 23:516-523. [PMID: 28712666 DOI: 10.1016/j.cmi.2017.06.030] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/14/2017] [Accepted: 06/15/2017] [Indexed: 01/24/2023]
Abstract
BACKGROUND The WHO European Region (EUR) has adopted the goal of eliminating measles and rubella but individual countries perform differently in achieving this goal. Measles virus spread across the EUR by mobile groups has recently led to large outbreaks in the insufficiently vaccinated resident population. As an instrument for monitoring the elimination process and verifying the interruption of endemic virus transmission, molecular surveillance has to provide valid and representative data. Irrespective of the country's specific situation, it is required to ensure the functionality of the laboratory surveillance that is supported by the WHO Global Measles and Rubella Laboratory Network. AIMS To investigate whether the molecular surveillance in the EUR is adequate for the challenges in the elimination phase, we addressed the quality assurance of molecular data, the continuity and intensity of molecular monitoring, and the analysis of transmission chains. SOURCES Published articles, the molecular External Quality Assessment Programme of the WHO, the Centralized Information System for Infectious Diseases of the WHO EUR and the WHO Measles and Rubella Nucleotide Surveillance databases served as information sources. CONTENT Molecular proficiency testing conducted by the WHO in 2016 has shown that the expertise for measles and rubella virus genotyping exists in all parts of the EUR. The analysis of surveillance data reported nationally to the WHO in 2013-2016 has revealed some countries with outbreaks but not sufficiently representative molecular data. Long-lasting supranational MV transmission chains were identified. IMPLICATIONS A more systematic molecular monitoring and recording of the transmission pattern for the whole EUR could help to create a meaningful picture of the elimination process.
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Affiliation(s)
- S Santibanez
- WHO European Regional Reference Laboratory for Measles and Rubella, Robert Koch-Institut, Berlin, Germany.
| | - J M Hübschen
- WHO European Regional Reference Laboratory for Measles and Rubella, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette and Laboratoire National de Santé, Dudelange, Luxembourg
| | - M C Ben Mamou
- Vaccine-preventable Diseases and Immunization, WHO Regional Office for Europe, Copenhagen, Denmark
| | - M Muscat
- Vaccine-preventable Diseases and Immunization, WHO Regional Office for Europe, Copenhagen, Denmark
| | - K E Brown
- WHO Global Specialized Laboratory for Measles and Rubella, Virus Reference Department, Public Health England, London, UK
| | - R Myers
- WHO Global Specialized Laboratory for Measles and Rubella, Virus Reference Department, Public Health England, London, UK
| | - O Donoso Mantke
- INSTAND e.V. - Gesellschaft zur Förderung der Qualitätssicherung in medizinischen Laboratorien e.V., Düsseldorf, Germany
| | - H Zeichhardt
- INSTAND e.V. - Gesellschaft zur Förderung der Qualitätssicherung in medizinischen Laboratorien e.V., Düsseldorf, Germany; Institut für Virologie, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Germany; Institut für Qualitätssicherung in der Virusdiagnostik - IQVD, Berlin, Germany
| | - D Brockmann
- Epidemiological Modelling of Infectious Diseases, Robert Koch-Institut, Berlin, Germany; Institute for Theoretical Biology, Department of Biology, Humboldt University of Berlin, Berlin, Germany
| | - S V Shulga
- WHO European Regional Reference Laboratory for Measles and Rubella, Gabrichevsky Research Institute for Epidemiology and Microbiology, Moscow, Russia
| | - C P Muller
- WHO European Regional Reference Laboratory for Measles and Rubella, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette and Laboratoire National de Santé, Dudelange, Luxembourg
| | - P M O'Connor
- Vaccine-preventable Diseases and Immunization, WHO Regional Office for Europe, Copenhagen, Denmark
| | - M N Mulders
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - A Mankertz
- WHO European Regional Reference Laboratory for Measles and Rubella, Robert Koch-Institut, Berlin, Germany
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14
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Hübschen JM, Bork SM, Brown KE, Mankertz A, Santibanez S, Ben Mamou M, Mulders MN, Muller CP. Challenges of measles and rubella laboratory diagnostic in the era of elimination. Clin Microbiol Infect 2017; 23:511-515. [PMID: 28412379 DOI: 10.1016/j.cmi.2017.04.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 04/03/2017] [Accepted: 04/05/2017] [Indexed: 11/26/2022]
Abstract
The Member States of the WHO European Region adopted the goal of measles and rubella elimination more than 10 years ago, but so far only 21 of 53 countries have reached this target. Laboratory investigation of suspected cases is essential to support disease elimination efforts. Therefore, WHO maintains a network of accredited laboratories providing high-quality testing. Laboratory investigation heavily relies on specific IgM serology and increasingly on virus detection by reverse transcription (RT)-PCR, but other methods such as IgG avidity testing and genetic characterization of virus strains have gained in importance. In elimination settings, often few samples from suspected cases are available for testing, but testing proficiency must be maintained. The predictive value of an IgM-positive result decreases and other rash-fever disease aetiologies become more important. In addition, cases with a rash after measles/rubella vaccination or with mild disease after waning of vaccine-induced antibodies are seen more often. Thus, it is necessary to perform comprehensive and potentially time-consuming and costly investigations of every suspected case using quality-controlled laboratory methods. At the same time rapid feedback to public health officers is required for timely interventions. The introduction of new laboratory methods for comprehensive case investigations requires training of staff under the supervision of WHO-accredited reference laboratories and the definition of appropriate test algorithms. Clinical, laboratory, and epidemiological data are essential for final case classification and investigation of chains of transmission in the endgame of measles and rubella elimination.
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Affiliation(s)
- J M Hübschen
- WHO European Regional Reference Laboratory for Measles and Rubella, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette and Laboratoire National de Santé, Dudelange, Luxembourg
| | - S M Bork
- WHO European Regional Reference Laboratory for Measles and Rubella, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette and Laboratoire National de Santé, Dudelange, Luxembourg
| | - K E Brown
- WHO Global Specialized Laboratory for Measles and Rubella, Virus Reference Department, Public Health England, London, UK
| | - A Mankertz
- WHO European Regional Reference Laboratory for Measles and Rubella, Robert Koch Institute, Berlin, Germany
| | - S Santibanez
- WHO European Regional Reference Laboratory for Measles and Rubella, Robert Koch Institute, Berlin, Germany
| | - M Ben Mamou
- Vaccine-Preventable Diseases and Immunization, WHO Regional Office for Europe, Copenhagen, Denmark
| | - M N Mulders
- Expanded Programme on Immunization, Department of Immunization, Vaccines, and Biologicals, WHO, Geneva, Switzerland
| | - C P Muller
- WHO European Regional Reference Laboratory for Measles and Rubella, Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette and Laboratoire National de Santé, Dudelange, Luxembourg.
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15
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Lazar M, Abernathy E, Chen MH, Icenogle J, Janta D, Stanescu A, Pistol A, Santibanez S, Mankertz A, Hübschen JM, Mihaescu G, Necula G, Lupulescu E. Epidemiological and molecular investigation of a rubella outbreak, Romania, 2011 to 2012. ACTA ACUST UNITED AC 2017; 21:30345. [PMID: 27684329 PMCID: PMC5073198 DOI: 10.2807/1560-7917.es.2016.21.38.30345] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 06/16/2016] [Indexed: 11/20/2022]
Abstract
We describe a rubella outbreak that occurred in Romania between September 2011 and December 2012. During this period 24,627 rubella cases, 41.1% (n=10,134) of which female, were notified based on clinical criteria, and a total of 6,182 individuals were found serologically positive for IgM-specific rubella antibody. The median age of notified cases was 18 years (range: <1-65) and the most affected age group 15 to 19 years (n=16,245 cases). Of all notified cases, 24,067 cases (97.7%) reported no history of vaccination. Phylogenetic analysis of 19 sequences (739 nucleotides each), from 10 districts of the country revealed that the outbreak was caused by two distinct rubella virus strains of genotype 2B, which co-circulated with both temporal and geographical overlap. In addition to the 6,182 IgM-positive rubella cases, 28 cases of congenital rubella syndrome (CRS) were identified, including 11 neonatal deaths and one stillbirth. The outbreak underscores the need to encourage higher vaccination uptake in the population, particularly in women of reproductive age, and to strengthen epidemiological and laboratory investigations of suspected rubella cases. Genetic characterisation of wild-type rubella virus is an essential component to enhance surveillance and here we report rubella virus sequences from Romania.
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Affiliation(s)
- Mihaela Lazar
- National Institute of Research-Development for Microbiology and Immunology "Cantacuzino", Bucharest, Romania
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16
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Lejeune A, Martin L, Santibanez S, Thee S, Gratopp A, Späth P, Mankertz A, Kallinich T, von Bernuth H. Postexposure prophylaxis with intravenous immunoglobulin G prevents infants from getting measles. Acta Paediatr 2017; 106:174-177. [PMID: 27748542 DOI: 10.1111/apa.13634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 09/07/2016] [Accepted: 10/13/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Alice Lejeune
- Kinderklinik mit Schwerpunkt Pneumologie; Immunologie und Intensivmedizin; Charité Universitätsmedizin Berlin; Berlin Germany
| | - Luise Martin
- Kinderklinik mit Schwerpunkt Pneumologie; Immunologie und Intensivmedizin; Charité Universitätsmedizin Berlin; Berlin Germany
| | - Sabine Santibanez
- Nationales Referenzzentrum Masern, Mumps, Röteln; Robert Koch-Institut; Berlin Germany
| | - Stephanie Thee
- Kinderklinik mit Schwerpunkt Pneumologie; Immunologie und Intensivmedizin; Charité Universitätsmedizin Berlin; Berlin Germany
| | - Alexander Gratopp
- Kinderklinik mit Schwerpunkt Pneumologie; Immunologie und Intensivmedizin; Charité Universitätsmedizin Berlin; Berlin Germany
| | - Peter Späth
- Institut für Pharmakologie der Universität Bern; Inselspital; Bern Switzerland
| | - Annette Mankertz
- Nationales Referenzzentrum Masern, Mumps, Röteln; Robert Koch-Institut; Berlin Germany
| | - Tilmann Kallinich
- Kinderklinik mit Schwerpunkt Pneumologie; Immunologie und Intensivmedizin; Charité Universitätsmedizin Berlin; Berlin Germany
- Sozialpädiatrisches Zentrum; Charité Universitätsmedizin Berlin; Berlin Germany
| | - Horst von Bernuth
- Kinderklinik mit Schwerpunkt Pneumologie; Immunologie und Intensivmedizin; Charité Universitätsmedizin Berlin; Berlin Germany
- Sozialpädiatrisches Zentrum; Charité Universitätsmedizin Berlin; Berlin Germany
- Fachbereich Immunologie; Labor Berlin GmbH; Berlin Germany
- Berlin-Brandenburger Centrum für Regenerative Medizin (BCRT); Charité Universitätsmedizin Berlin; Berlin Germany
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17
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Muscat M, Marinova L, Mankertz A, Gatcheva N, Mihneva Z, Santibanez S, Kunchev A, Filipova R, Kojouharova M. The measles outbreak in Bulgaria, 2009-2011: An epidemiological assessment and lessons learnt. ACTA ACUST UNITED AC 2016; 21:30152. [PMID: 26967661 DOI: 10.2807/1560-7917.es.2016.21.9.30152] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 06/12/2015] [Indexed: 11/20/2022]
Abstract
Measles re-emerged in a nationwide outbreak in Bulgaria from 2009 to 2011 despite reported high vaccination coverage at national level. This followed an eight-year period since the last indigenous cases of measles were detected. The Bulgarian National Centre of Infectious and Parasitic Diseases collated measles surveillance data for 2009-2011. We analysed data for age group, sex, ethnicity, diagnosis confirmation, vaccination, hospitalisation, disease complications, and death and describe the outbreak control measures taken. The outbreak started in April 2009 following an importation of measles virus and affected 24,364 persons, predominantly Roma. Most cases (73%) were among children < 15 years old. Vaccination status was available for 52% (n = 12,630) of cases. Of children 1-14 years old, 22% (n = 1,769) were unvaccinated and 70% (n = 5,518) had received one dose of a measles-containing vaccine. Twenty-four measles-related deaths were reported. The Roma ethnic group was particularly susceptible to measles. The magnitude of the outbreak resulted primarily from the accumulation of susceptible children over time. This outbreak serves as a reminder that both high vaccination coverage and closing of immunity gaps across all sections of the population are crucial to reach the goal of measles elimination.
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Affiliation(s)
- Mark Muscat
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
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18
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Mankertz A, Beutel U, Schmidt FJ, Borgmann S, Wenzel JJ, Ziegler P, Weißbrich B, Santibanez S. Laboratory-based investigation of suspected mumps cases submitted to the German National Reference Centre for Measles, Mumps, and Rubella, 2008 to 2013. Int J Med Microbiol 2015; 305:619-26. [PMID: 26358914 DOI: 10.1016/j.ijmm.2015.08.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
From 2008 to 2013, sample sets from 534 patients displaying clinical symptoms of mumps were submitted to the German Reference Centre for Measles, Mumps and Rubella. Mumps virus infection was confirmed in 216 cases (40%) by PCR and/or serology. Confirmed cases were more frequently seen in male than in female patients (128 vs. 81); the age group predominantly affected was 15 to 29 years old (65%, median age: 26.4 years). The majority of the confirmed cases had a remote history of vaccination with one or two doses of a mumps-containing vaccine (69%). Our results indicate that mumps virus caused two outbreaks in Bavaria in 2008 and 2010/2011 and a third one in Lower Saxony in 2011. Mumps virus genotype G was preponderantly detected from 2008 to 2013. For 107 of the 216 patients with a confirmed mumps infection, we correlated the results from PCR and serology. PCR detected cases during the first week after onset of symptoms (74% positive results). PCR worked best with throat swabs and oral fluids (61% and 60% positive results, respectively). IgM was more reliable with a longer time after onset of symptoms (67%), but indirect IgM serology was of insufficient sensitivity for vaccinated mumps cases (30%); the IgM μ-capture assay detected more cases in this group. Mumps virus is able to initiate an infection in vaccinated patients (secondary vaccine failure, SVF) although it is unclear to what extent. Since SVF does occur in highly vaccinated populations and IgM will not increase to detectable levels in all SVF patients, we strongly recommend using PCR plus serology tests to avoid false-negative diagnoses in vaccinated individuals with clinical signs of mumps.
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Affiliation(s)
- Annette Mankertz
- Robert Koch-Institute, National Reference Centre Measles, Mumps, Rubella, Seestr. 10, D-13353 Berlin, Germany.
| | | | | | - Stefan Borgmann
- Klinikum Ingolstadt, Department of Clinical Infectiology and Infection Control, Ingolstadt, Germany
| | - Jürgen J Wenzel
- Institute of Clinical Microbiology and Hygiene, Regensburg University Medical Center, Regensburg, Germany
| | - Peter Ziegler
- Public Health Department Landshut, Landshut, Germany
| | - Benedikt Weißbrich
- Institute of Virology and Immunobiology, University Würzburg, Würzburg, Germany
| | - Sabine Santibanez
- Robert Koch-Institute, National Reference Centre Measles, Mumps, Rubella, Seestr. 10, D-13353 Berlin, Germany
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19
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Santibanez S, Hübschen JM, Muller CP, Freymuth F, Mosquera MM, Mamou MB, Mulders MN, Brown KE, Myers R, Mankertz A. Long-term transmission of measles virus in Central and continental Western Europe. Virus Genes 2015; 50:2-11. [DOI: 10.1007/s11262-015-1173-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 01/16/2015] [Indexed: 12/18/2022]
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20
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Santibanez S, Prosenc K, Lohr D, Pfaff G, Jordan Markocic O, Mankertz A. Measles virus spread initiated at international mass gatherings in Europe, 2011. Euro Surveill 2014; 19. [DOI: 10.2807/1560-7917.es2014.19.35.20891] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- S Santibanez
- National Reference Centre Measles, Mumps, Rubella and Regional Reference Laboratory WHO EURO, Division of Measles, Mumps, Rubella, and viruses affecting immunocompromised patients, Robert Koch Institute, Berlin, Germany
| | - K Prosenc
- Laboratory for Virology, National Institute of Public Health of Slovenia, Ljubljana, Slovenia
| | - D Lohr
- Baden-Wuerttemberg State Health Office, District of Stuttgart Government, Stuttgart, Germany
| | - G Pfaff
- Baden-Wuerttemberg State Health Office, District of Stuttgart Government, Stuttgart, Germany
| | | | - A Mankertz
- National Reference Centre Measles, Mumps, Rubella and Regional Reference Laboratory WHO EURO, Division of Measles, Mumps, Rubella, and viruses affecting immunocompromised patients, Robert Koch Institute, Berlin, Germany
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Makówka A, Paradowska-Stankiewicz I, Szenborn L, Santibanez S, Mankerz A, Litwińska B. Measles outbreak among Roma people in Wrocław, Poland, 2012. Pol J Microbiol 2014; 63:457-460. [PMID: 25804066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
A measles outbreak that affected mainly the Roma ethnic group has been observed in Wrocław, southwest Poland, in spring/summer 2012. There were 15 confirmed measles cases occurring among young Roma people aged from 0 to 16 years including a newborn infant, born by a mother who showed measles symptoms immediately after delivery. Measles virus transmission into the general Polish population was restricted to two contact cases. Initiation of the outbreak by MeV importation from Romania has been confirmed by detection of MeV variant "D4-Maramures" circulating in Romania from 2011 to 2012. The outbreak experience highlights once more the still existing prob- lem of immunity gaps in Roma groups moving throughout Europe with a high susceptibility among children and adolescents including young women of child-bearing age.
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Necula G, Lazar M, Stanescu A, Pistol A, Santibanez S, Mankertz A, Lupulescu E. Transmission and molecular characterisation of wild measles virus in Romania, 2008 to 2012. ACTA ACUST UNITED AC 2013; 18:20658. [PMID: 24342518 DOI: 10.2807/1560-7917.es2013.18.50.20658] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Molecular characterisation of measles virus is a powerful tool for tracing transmission. Genotyping may prove the absence of endemic circulation of measles virus, i.e. transmission for more than 12 months, which is one of the criteria for verifying elimination of the disease. We have genetically characterised measles viruses detected in Romania from 2008 to 2012, focusing on the recent outbreaks from 2010 to 2012 that affected mainly groups with limited access to healthcare and schools. The findings emphasise the importance of genotyping during the different phases of an outbreak. A total of 8,170 cases were notified, and 5,093 (62%) of the 7,559 possible cases were serologically confirmed. RT-PCR was performed for 104 samples: from the 101 positive samples obtained from sporadic measles cases or clusters from different counties, 73 were genotyped. Sporadic measles cases associated with D4 and D5 viruses were observed from2008 to 2009. Genotype D4-Manchester was predominant in 2011 and 2012. In addition, the related variant D4-Maramures and MVs/Limoges.FRA/17.10[D4] and a few D4-Hamburg strains were detected. The detection of several distinct MV-D4 genotypes suggests multiple virus importations to Romania. The outbreak associated with D4 genotype is the second largest outbreak in Romania in less than 10 years.
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Affiliation(s)
- G Necula
- National Reference Laboratory for Measles and Rubella and National Influenza Center, Cantacuzino Institute, Bucharest, Romania
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Roggendorf H, Santibanez S, Mankertz A, van Treeck U, Roggendorf M. Two consecutive measles outbreaks with genotypes D8 and D4 in two mainly unvaccinated communities in Germany. Med Microbiol Immunol 2012; 201:349-55. [PMID: 22570014 DOI: 10.1007/s00430-012-0240-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 04/19/2012] [Indexed: 11/29/2022]
Abstract
A measles infection in a 13-year-old student from a free progressive school was the index case for an outbreak in Essen in 2010. In this type of school, mainly unvaccinated and measles-susceptible children accumulate. This observation is confirmed by the fact that some of the recent outbreaks originated in such institutions. In Essen, this outbreak was followed by a second smaller outbreak in unvaccinated children and adults in a low socio-economic setting and migration background. Measles were diagnosed clinically and/or were serologically confirmed. Genotyping of measles isolates was performed by PCR and sequencing. Vaccination certificates were checked by the Community Health Centre (CHC) of the City of Essen. Measures to prevent the spread of the infection were implemented and enforced according to the National Protection Against Infection Act (IfSG). In total, 86 cases of measles were notified from March to July 2010. Of all infected patients, 97 % had had no vaccination and 15 % had to be hospitalised. Clinical courses showed the severity of this infection. Epidemiologic evaluation and genotyping of measles virus (MV) detected in Essen revealed the presence of two distinct chains of MV transmission by genotypes D8 and D4 causing two independent outbreaks. The outbreaks were caused by the index cases, and the spread of infection was facilitated by insufficient vaccination coverage in certain groups. Immediate suspension of non-immune children from classes for 2 weeks might have limited the outbreak in the free progressive school. Overall, high measles vaccination coverage in children and adolescents in regular schools in Essen presumably prevented a greater spread of the virus.
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Affiliation(s)
- Hedwig Roggendorf
- Department of Child and Youth Health, Community Health Centre of the City of Essen, Essen, Germany.
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Mankertz A, Mihneva Z, Gold H, Baumgarte S, Baillot A, Helble R, Roggendorf H, Bosevska G, Nedeljkovic J, Makowka A, Hutse V, Holzmann H, Aberle SW, Cordey S, Necula G, Mentis A, Korukluoğlu G, Carr M, Brown KE, Hübschen JM, Muller CP, Mulders MN, Santibanez S. Spread of measles virus D4-Hamburg, Europe, 2008-2011. Emerg Infect Dis 2011; 17:1396-401. [PMID: 21801615 PMCID: PMC3381563 DOI: 10.3201/eid1708.101994] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A new strain of measles virus, D4-Hamburg, was imported from London to Hamburg in December 2008 and subsequently spread to Bulgaria, where an outbreak of >24,300 cases was observed. We analyzed spread of the virus to demonstrate the importance of addressing hard-to-reach communities within the World Health Organization European Region regarding access to medical care and vaccination campaigns. The D4-Hamburg strain appeared during 2009-2011 in Poland, Ireland, Northern Ireland, Austria, Greece, Romania, Turkey, Macedonia, Serbia, Switzerland, and Belgium and was repeatedly reimported to Germany. The strain was present in Europe for >27 months and led to >25,000 cases in 12 countries. Spread of the virus was prevalently but not exclusively associated with travel by persons in the Roma ethnic group; because this travel extends beyond the borders of any European country, measures to prevent the spread of measles should be implemented by the region as a whole.
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Siedler A, Mankertz A, Feil F, Ahlemeyer G, Hornig A, Kirchner M, Beyrer K, Dreesman J, Scharkus S, Marcic A, Reiter S, Matysiak-Klose D, Santibanez S, Krause G, Wichmann O. Closer to the goal: efforts in measles elimination in Germany 2010. J Infect Dis 2011; 204 Suppl 1:S373-80. [PMID: 21666187 DOI: 10.1093/infdis/jir068] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Increasing 2-dose vaccination coverage has led to an interruption of endemic measles virus circulation in Germany. However, outbreaks after virus importation still occur and contribute to international transmission chains. Between 2003 and 2009, annual measles incidence ranged between 0.2 and 2.8 per 100,000 population. Immunization gaps have been identified especially in secondary-school students and young adults, which is also reflected by a shift in age distribution of reported measles cases toward older age groups. Stronger political commitment and standardized guidelines for outbreak containment were put in place in Germany in the past years, but the last step toward measles elimination cannot be made until the number of susceptible individuals has been further reduced. In addition to routine childhood vaccination, supplementary immunization activities are needed targeting school students and young adults to close critical immunization gaps. Intensification of public awareness and sound information on vaccinations are necessary to convince skeptics and remind the forgetful.
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Affiliation(s)
- Anette Siedler
- Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch Institute, Berlin, Germany.
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Mankertz A, Mulders MN, Shulga S, Kremer JR, Brown KE, Santibanez S, Muller CP, Tikhonova N, Lipskaya G, Jankovic D, Khetsuriani N, Martin R, Gavrilin E. Molecular genotyping and epidemiology of measles virus transmission in the World Health Organization European Region, 2007-2009. J Infect Dis 2011; 204 Suppl 1:S335-42. [PMID: 21666182 DOI: 10.1093/infdis/jir101] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In 2002, the World Health Organization (WHO) adopted a goal to eliminate measles in the European Region by 2010. Measles elimination is defined as the interruption of indigenous measles virus (MV) transmission. The molecular epidemiology of MV transmission in the WHO European Region was studied through the investigation of reported cases and outbreaks to monitor the region's progress toward its measles elimination goal. METHODS National and regional laboratories performed molecular characterization of MV detected between 2007 and 2009 in the WHO European Region. To document indigenous transmission and importations into the region, we analyzed genotyping results and epidemiological data on measles outbreaks reported by the member states. RESULTS Since 2007, MV genotype D6 has not been reported in the WHO European Region, suggesting that its chains of transmission have been interrupted, whereas several other MV genotypes are still circulating. Although several European countries have already interrupted indigenous MV transmission, genotyping showed that 3 endemic MV transmission chains have been reestablished in other countries. CONCLUSIONS The WHO European Region 2010 goal will not be met, as indigenous transmission of MV has not been interrupted. As the region begins to document its process of elimination verification to monitor progress toward the goal, countries will need to ensure that genotyping is performed in all measles outbreaks.
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Affiliation(s)
- Annette Mankertz
- National Reference Centre for Measles, Mumps, and Rubella/World Health Organization European Regional Reference Laboratory, Robert Koch-Institute, Division of Viral Infection, Berlin, Germany.
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27
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Rota PA, Brown K, Mankertz A, Santibanez S, Shulga S, Muller CP, Hübschen JM, Siqueira M, Beirnes J, Ahmed H, Triki H, Al-Busaidy S, Dosseh A, Byabamazima C, Smit S, Akoua-Koffi C, Bwogi J, Bukenya H, Wairagkar N, Ramamurty N, Incomserb P, Pattamadilok S, Jee Y, Lim W, Xu W, Komase K, Takeda M, Tran T, Castillo-Solorzano C, Chenoweth P, Brown D, Mulders MN, Bellini WJ, Featherstone D. Global Distribution of Measles Genotypes and Measles Molecular Epidemiology. J Infect Dis 2011; 204 Suppl 1:S514-23. [DOI: 10.1093/infdis/jir118] [Citation(s) in RCA: 199] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Brown KE, Mulders MN, Freymuth F, Santibanez S, Mosquera MM, Cordey S, Beirnes J, Shulga S, Myers R, Featherstone D. Appearance of a novel measles G3 strain in multiple European countries within a two month period, 2010. Euro Surveill 2011. [DOI: 10.2807/ese.16.17.19852-en] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
During late 2010, a previously unrecognised strain of measles genotype G3 virus was identified in five different European countries by the World Health Organization Measles and Rubella Laboratory Network. Apart from one, none had a travel history to south-east Asia, the usual source of G3 viruses, although epidemiological links could be established between some of the cases. This case series illustrates the value of genotyping and sequencing in tracking measles infections, and identifying otherwise unrecognised chains of transmission.
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Affiliation(s)
- K E Brown
- Virus Reference Department, World Health Organization Global Specialised Laboratory for Measles and Rubella, Health Protection Agency - Colindale, London, United Kingdom
| | - M N Mulders
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - F Freymuth
- Centre National de Référence de la Rougeole et des Paramyxoviridae Respiratoires (National Reference Centre for measles and respiratory Paramyxoviridae), Laboratoire de virologie humaine et moléculaire (Laboratory of human and molecular virology), Centre Hospitalier Universitaire de Caen, France
| | - S Santibanez
- National Reference Centre Measles, Mumps, Rubella, Regional Reference Laboratory WHO EURO, Robert Koch Institute, Berlin, Germany
| | - M M Mosquera
- Centro Nacional de Microbiología (National Microbiology Centre), Instituto de Salud Carlos III, Madrid, Spain
| | - S Cordey
- Swiss National Reference Centre for Emerging Viral Diseases, Division of Infectious Diseases, University of Geneva Hospitals, Geneva, Switzerland
| | - J Beirnes
- Viral Exanthemata National Microbiology Laboratory, Winnipeg, Canada
| | - S Shulga
- World Health Organization Regional Reference Laboratory, European Region, Moscow, Russian Federation
| | - R Myers
- Virus Reference Department, World Health Organization Global Specialised Laboratory for Measles and Rubella, Health Protection Agency - Colindale, London, United Kingdom
| | - D Featherstone
- Expanded Programme on Immunization, Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
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Brown KE, Mulders MN, Freymuth F, Santibanez S, Mosquera MM, Cordey S, Beirnes J, Shulga S, Myers R, Featherstone D. Appearance of a novel measles G3 strain in multiple European countries within a two month period, 2010. Euro Surveill 2011; 16:19852. [PMID: 21543045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
During late 2010, a previously unrecognised strain of measles genotype G3 virus was identified in five different European countries by the World Health Organization Measles and Rubella Laboratory Network.Apart from one, none had a travel history to south-east Asia, the usual source of G3 viruses, although epidemiological links could be established between some of the cases. This case series illustrates the value of genotyping and sequencing in tracking measles infections, and identifying otherwise unrecognised chains of transmission.
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Affiliation(s)
- K E Brown
- Virus Reference Department, World Health Organization Global Specialised Laboratory for Measles and Rubella, Health Protection Agency - Colindale, London, United Kingdom.
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Kessler JR, Kremer JR, Shulga SV, Tikhonova NT, Santibanez S, Mankertz A, Semeiko GV, Samoilovich EO, Tamfum JJM, Pukuta E, Muller CP. Revealing new measles virus transmission routes by use of sequence analysis of phosphoprotein and hemagglutinin genes. J Clin Microbiol 2011; 49:677-83. [PMID: 21106790 PMCID: PMC3043479 DOI: 10.1128/jcm.01703-10] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Accepted: 11/17/2010] [Indexed: 11/20/2022] Open
Abstract
With improved measles virus (MV) control, the genetic variability of the MV-nucleoprotein hypervariable region (NP-HVR) decreases. Thus, it becomes increasingly difficult to determine the origin of a virus using only this part of the genome. During outbreaks in Europe and Africa, we found MV strains with identical NP-HVR sequences. However, these strains showed considerable diversity within a larger sequencing window based on concatenated MV phosphoprotein and hemagglutinin genes (P/H pseudogenes). In Belarus, Germany, Russia, and the Democratic Republic of Congo, the P/H pseudogenes provided insights into chains of transmission, whereas identical NP-HVR provided none. In Russia, for instance, the P/H pseudogene identified temporal clusters rather than geographical clusters, demonstrating the circulation and importation of independent variants rather than large local outbreaks lasting for several years, as suggested by NP-HVR. Thus, by extending the sequencing window for molecular epidemiology, a more refined picture of MV circulation was obtained with more clearly defined links between outbreaks and transmission chains. Our results also suggested that in contrast to the P gene, the H gene acquired fixed substitutions that continued to be found in subsequent outbreaks, possibly with consequences for its antigenicity. Thus, a longer sequencing window has true benefits both for the epidemiological surveillance of measles and for the better monitoring of viral evolution.
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Affiliation(s)
- Julia R. Kessler
- Institute of Immunology, Centre de Recherche Public-Santé/Laboratoire National de Santé, WHO Regional Reference Laboratory for Measles and Rubella and WHO Collaboration Centre for Measles Research, Luxembourg, Luxembourg
| | - Jacques R. Kremer
- Institute of Immunology, Centre de Recherche Public-Santé/Laboratoire National de Santé, WHO Regional Reference Laboratory for Measles and Rubella and WHO Collaboration Centre for Measles Research, Luxembourg, Luxembourg
| | - Sergey V. Shulga
- WHO Regional Reference Laboratory for Measles and Rubella, Moscow, Russian Federation
| | - Nina T. Tikhonova
- WHO Regional Reference Laboratory for Measles and Rubella, Moscow, Russian Federation
| | - Sabine Santibanez
- WHO Regional Reference Laboratory for Measles and Rubella, Berlin, Germany
| | - Annette Mankertz
- WHO Regional Reference Laboratory for Measles and Rubella, Berlin, Germany
| | - Galina V. Semeiko
- The Republican Research and Practical Centre for Epidemiology and Microbiology, WHO National Measles and Rubella Laboratory, Minsk, Belarus
| | - Elena O. Samoilovich
- The Republican Research and Practical Centre for Epidemiology and Microbiology, WHO National Measles and Rubella Laboratory, Minsk, Belarus
| | | | - Elisabeth Pukuta
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Claude P. Muller
- Institute of Immunology, Centre de Recherche Public-Santé/Laboratoire National de Santé, WHO Regional Reference Laboratory for Measles and Rubella and WHO Collaboration Centre for Measles Research, Luxembourg, Luxembourg
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Otto W, Mankertz A, Santibanez S, Saygili H, Wenzel J, Jilg W, Wieland W, Borgmann S. Ongoing outbreak of mumps affecting adolescents and young adults in Bavaria, Germany, August to October 2010. Euro Surveill 2010; 15:19748. [PMID: 21172171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Affiliation(s)
- W Otto
- Department of Urology, St. Josef Hospital, University of Regensburg, Regensburg, Germany
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32
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Otto W, Mankertz A, Santibanez S, Saygili H, Wenzel J, Jilg W, Wieland WF, Borgmann S. Ongoing outbreak of mumps affecting adolescents and young adults in Bavaria, Germany, August to October 2010. Euro Surveill 2010. [DOI: 10.2807/ese.15.50.19748-en] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Since the introduction of a two-dose MMR vaccination regime the incidence of mumps virus infections has substantially declined. However, mumps outbreaks have recently been reported from several countries. Here we report an ongoing mumps outbreak in Germany. Between 1 July and 31 October, 115 infections have been laboratory-confirmed. Reported complications include one case of meningitis and 21 cases of orchitis, suggesting a high rate of complications. We suggest a vaccination campaign for young adults in northern Bavaria to limit severe mumps infections.
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Affiliation(s)
- W Otto
- Department of Urology, St. Josef Hospital, University of Regensburg, Regensburg, Germany
| | - A Mankertz
- National Reference Centre Measles, Mumps, Rubella, Robert Koch Institute, Berlin, Germany
| | - S Santibanez
- National Reference Centre Measles, Mumps, Rubella, Robert Koch Institute, Berlin, Germany
| | - H Saygili
- Synlab Medical Care Service, Medical Care Centre Weiden, Weiden, Germany
| | - J Wenzel
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - W Jilg
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - W F Wieland
- Department of Urology, St. Josef Hospital, University of Regensburg, Regensburg, Germany
| | - S Borgmann
- Synlab Medical Care Service, Medical Care Centre Weiden, Weiden, Germany
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Pfaff G, Lohr D, Santibanez S, Mankertz A, van Treeck U, Schönberger K, Hautmann W. Spotlight on measles 2010: Measles outbreak among travellers returning from a mass gathering, Germany, September to October 2010. Euro Surveill 2010. [DOI: 10.2807/ese.15.50.19750-en] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- G Pfaff
- Baden-Wuerttemberg State Health Office, District of Stuttgart Government, Stuttgart, Germany
| | - D Lohr
- Baden-Wuerttemberg State Health Office, District of Stuttgart Government, Stuttgart, Germany
| | - S Santibanez
- National Reference Centre for Measles, Mumps and Rubella (NRC MMR), Robert Koch Institute (RKI), Berlin, Germany
| | - A Mankertz
- National Reference Centre for Measles, Mumps and Rubella (NRC MMR), Robert Koch Institute (RKI), Berlin, Germany
| | - U van Treeck
- NRW Institute of Health and Work, Düsseldorf, Germany
| | - K Schönberger
- Bavarian Health and Food Safety Agency, Oberschleißheim, Germany
| | - W Hautmann
- Bavarian Health and Food Safety Agency, Oberschleißheim, Germany
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Pfaff G, Lohr D, Santibanez S, Mankertz A, van Treeck U, Schonberger K, Hautmann W. Spotlight on measles 2010: Measles outbreak among travellers returning from a mass gathering, Germany, September to October 2010. Euro Surveill 2010; 15:19750. [PMID: 21172175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Affiliation(s)
- G Pfaff
- Baden-Wuerttemberg State Health Office, District of Stuttgart Government, Stuttgart, Germany.
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35
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Feng Y, Santibanez S, Appleton H, Lu Y, Jin L. Application of new assays for rapid confirmation and genotyping of isolates of Rubella virus. J Med Virol 2010; 83:170-7. [DOI: 10.1002/jmv.21941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Rogalska J, Santibanez S, Mankertz A, Makowka A, Szenborn L, Stefanoff P. Spotlight on measles 2010: An epidemiological overview of measles outbreaks in Poland in relation to the measles elimination goal. ACTA ACUST UNITED AC 2010; 15. [PMID: 20460084 DOI: 10.2807/ese.15.17.19549-en] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The objective of this study was to describe transmission chains of measles observed in Poland during 2008-2009. A decade ago, the incidence of measles in Poland declined and approached one case per million inhabitants one of the World Health Organization's criteria for measles elimination. Following a period of very few reported measles cases (2003 to 2005), an increase in incidence was observed in 2006. Since then, the incidence has constantly exceeded one case per million inhabitants. Of 214 measles cases reported in 2008 and 2009 in Poland, 164 (77%) were linked to 19 distinct outbreaks, with 79% of cases belonging to the Roma ethnic group. Outbreaks in the non-Roma Polish population had different dynamics compared to those in the Roma population. On average, measles outbreaks in Roma communities involved 10 individuals, seven of whom were unvaccinated, while outbreaks in the non-Roma Polish population involved five individuals, half of whom were incompletely vaccinated. The majority of outbreaks in Roma communities were related to importation of virus from the United Kingdom. In six outbreaks, the epidemiologic investigation was confirmed by identification of genotype D4 closely related to measles viruses detected in the United Kingdom and Germany. Our data indicate that Poland is approaching measles elimination, but measles virus circulation is still sustained in a vulnerable population. More efforts are needed to integrate the Roma ethnic group into the Polish healthcare system and innovative measures to reach vulnerable groups should be explored.
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Affiliation(s)
- J Rogalska
- Department of Epidemiology, National Institute of Public Health - National Institute of Hygiene (NIZP-PZH), Warsaw, Poland.
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Finsterbusch T, Wolbert A, Deitemeier I, Meyer K, Mosquera MM, Mankertz A, Santibanez S. Measles viruses of genotype H1 evade recognition by vaccine-induced neutralizing antibodies targeting the linear haemagglutinin noose epitope. J Gen Virol 2009; 90:2739-2745. [DOI: 10.1099/vir.0.013524-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The linear haemagglutinin noose epitope (HNE; aa 379–410) is a protective B-cell epitope and considered to be highly conserved in both the vaccine and the wild-type measles virus (MeV) haemagglutinin (H) proteins. Vaccine virus-derived monoclonal antibodies (mAbs) BH6 and BH216, which target the HNE, neutralized MeVs of genotypes B3, C2, D4, D5, D6, D7 and D8, and the vaccine strain Edmonston Zagreb. In the case of genotype H1, only strain Berlin.DEU/44.01 was neutralized by these mAbs, whereas strains Shenyang.CHN/22.99 and Sofia.BGR/19.05 were not. The H gene sequences of these two strains showed an exchange of proline 397 (P397) to leucine (L397). Mutated H proteins, with P397 exchanged to L and vice versa, were compared with original H proteins by indirect fluorescence assay. H proteins exhibiting P397 but not those with L397 were recognized by BH6 and BH216. This indicates that L397 leads to the loss of the neutralizing HNE. In contrast, human sera obtained from vaccinees (n=10) did not discriminate between genotype H1 variants P397 and L397. This concurs with the epidemiological observation that the live-attenuated vaccine protects against both H1 variants. Furthermore, we demonstrated that MeVs of genotype H1 also lack the neutralizing epitopes defined by the vaccine virus-induced mAbs BH15, BH125 and BH47. The loss of several neutralizing epitopes, as shown for H1 viruses currently circulating endemically in Asia, implies that epitope monitoring should be considered to be included in measles surveillance.
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Affiliation(s)
- Tim Finsterbusch
- National Reference Centre Measles, Mumps, Rubella, Division of Viral Infections (FG12), Robert Koch-Institute, Nordufer 20, 13353 Berlin, Germany
| | - Anne Wolbert
- National Reference Centre Measles, Mumps, Rubella, Division of Viral Infections (FG12), Robert Koch-Institute, Nordufer 20, 13353 Berlin, Germany
| | - Ingrid Deitemeier
- National Reference Centre Measles, Mumps, Rubella, Division of Viral Infections (FG12), Robert Koch-Institute, Nordufer 20, 13353 Berlin, Germany
| | - Kerstin Meyer
- National Reference Centre Measles, Mumps, Rubella, Division of Viral Infections (FG12), Robert Koch-Institute, Nordufer 20, 13353 Berlin, Germany
| | - Maria Mar Mosquera
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Annette Mankertz
- National Reference Centre Measles, Mumps, Rubella, Division of Viral Infections (FG12), Robert Koch-Institute, Nordufer 20, 13353 Berlin, Germany
| | - Sabine Santibanez
- National Reference Centre Measles, Mumps, Rubella, Division of Viral Infections (FG12), Robert Koch-Institute, Nordufer 20, 13353 Berlin, Germany
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38
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Manangan L, Elmore K, Lewis B, Pratt R, Armstrong L, Davison J, Santibanez S, Heetderks A, Robison V, Lee V, Navin T. Disparities in tuberculosis between Asian/Pacific Islanders and non-Hispanic Whites, United States, 1993-2006. Int J Tuberc Lung Dis 2009; 13:1077-1085. [PMID: 19723395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
SETTING The United States (US) National Tuberculosis Surveillance System (NTSS), including 50 states, District of Columbia, and New York City. OBJECTIVE To examine disparities in characteristics and rates of Asian/Pacific Islander (API) and non-Hispanic White tuberculosis (TB) patients. DESIGN Descriptive analysis and logistic regression of selected 1993-2006 NTSS data. US Census Bureau Zip Code Tabulation Areas and geographic information system were used to compare API and non-Hispanic White TB patients by population density. RESULT Of 253,299 TB cases, 19.8% were APIs and 23.2% were Whites; 94.2% APIs and 11.9% Whites were foreign-born. Factors that were most often associated with APIs were being female, age 15-24 years, extra-pulmonary TB, and drug resistance. APIs were less likely than Whites to be human immunodeficiency virus (HIV) positive, homeless, substance abusers, or on directly observed therapy. From 1993 to 2006, the API TB case rate declined by 42.9% vs. 66.6% in Whites (P < 0.01). Being foreign-born was the strongest risk factor for TB, regardless of population densities, but APIs were more likely to have TB than foreign-born Whites at lower population densities. CONCLUSION Disparities in TB exist among US APIs and non-Hispanic Whites. TB program officials should allocate programs appropriately for foreign-born APIs in lower population density areas.
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Affiliation(s)
- L Manangan
- Division of Tuberculosis Elimination, National Center for HIV, Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
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39
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Wichmann O, Siedler A, Sagebiel D, Hellenbrand W, Santibanez S, Mankertz A, Vogt G, Treeck UV, Krause G. Further efforts needed to achieve measles elimination in Germany: results of an outbreak investigation. Bull World Health Organ 2009; 87:108-15. [PMID: 19274362 PMCID: PMC2636188 DOI: 10.2471/blt.07.050187] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2007] [Revised: 06/09/2008] [Accepted: 06/09/2008] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To determine morbidity and costs related to a large measles outbreak in Germany and to identify ways to improve the country's national measles elimination strategy. METHODS We investigated a large outbreak of measles in the federal state of North Rhine-Westphalia (NRW) that occurred in 2006 after 2 years of low measles incidence (< 1 case per 100,000). WHO's clinical case definition was used, and surveillance data from 2006 and 2001 were compared. All cases notified in Duisburg, the most severely affected city, were contacted and interviewed or sent a questionnaire. Health-care provider costs were calculated using information on complications, hospitalization and physician consultations. FINDINGS In NRW, 1749 cases were notified over a 48-week period. Compared with 2001, the distribution of cases shifted to older age groups (especially the 10-14 year group). Most cases (n = 614) occurred in Duisburg. Of these, 81% were interviewed; 15% were hospitalized and two died. Of the 464 for whom information was available, 80% were reported as unvaccinated. Common reasons for non-vaccination were parents either forgetting (36%) or rejecting (28%) vaccination. The average cost per measles case was estimated at 373 euros. CONCLUSION An accumulation of non-immune individuals led to this outbreak. The shift in age distribution has implications for the effectiveness of measles control and the elimination strategy in place. Immediate nationwide school-based catch-up vaccination campaigns targeting older age groups are needed to close critical immunity gaps. Otherwise, the elimination of measles in Germany and thus in Europe by 2010 will not be feasible.
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Affiliation(s)
- Ole Wichmann
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
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40
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Richard JL, Masserey-Spicher V, Santibanez S, Mankertz A. Measles outbreak in Switzerland--an update relevant for the European football championship (EURO 2008). Euro Surveill 2008; 13:8043. [PMID: 18445414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Affiliation(s)
- J l Richard
- Division of Communicable Diseases, Swiss Federal Office of Public Health, Bern, Switzerland.
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41
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Pfaff G, Mezger B, Santibanez S, Hoffmann U, Maassen S, Wagner U, Siedler A. Measles in south-west Germany imported from Switzerland - a preliminary outbreak description. Euro Surveill 2008. [DOI: 10.2807/ese.13.08.08044-en] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- G Pfaff
- Baden-Wuerttemberg State Health Office, District of Stuttgart Government, Stuttgart, Germany
| | - B Mezger
- Baden-Wuerttemberg State Health Office, District of Stuttgart Government, Stuttgart, Germany
| | - S Santibanez
- National Reference Laboratory for Measles, Mumps and Rubella, Robert Koch Institute, Berlin, Germany
| | | | - S Maassen
- Public Health Office, Freiburg im Breisgau, Germany
| | - U Wagner
- Public Health Office, Karlsruhe, Germany
| | - A Siedler
- Robert Koch institut, Department for Infectious Disease Epidemiology, Berlin, Germany
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42
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Richard JL, Masserey-Spicher V, Santibanez S, Mankertz A. Measles outbreak in Switzerland - an update relevant for the European football championship (EURO 2008). Euro Surveill 2008. [DOI: 10.2807/ese.13.08.08043-en] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Since November 2006, Switzerland has been experiencing the largest measles outbreak registered in the country since the introduction of mandatory notification for this disease in 1999. The first eight months of this outbreak have already been described in this journal [1]. From November 2006 to 13 February 2008, 1,405 measles cases were reported by physicians or laboratories in Switzerland (1,106 of them in 2007). Of these, 976 cases (69%) occurred in the cantons of Lucerne (29% of the total), Basel-Land (16%), Zurich (11%) Bern (7%), and Aargau (7%). The incidence for the whole country and all ages, calculated for this 15-month period, was 19 cases per 100,000 inhabitants (15 cases per 100,000 for the year 2007). For children under the age of 16 years living in the canton of Lucerne, it was 500 per 100,000.
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Affiliation(s)
- J L Richard
- Division of Communicable Diseases, Swiss Federal Office of Public Health, Bern, Switzerland
| | - V Masserey-Spicher
- Division of Communicable Diseases, Swiss Federal Office of Public Health, Bern, Switzerland
| | - S Santibanez
- Division of Viral Infections, Robert-Koch Institute, Berlin, Germany
| | - A Mankertz
- Division of Viral Infections, Robert-Koch Institute, Berlin, Germany
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43
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Pfaff G, Mezger B, Santibanez S, Hoffmann U, Maassen S, Wagner U, Siedler A. Measles in south-west Germany imported from Switzerland--a preliminary outbreak description. Euro Surveill 2008; 13:8044. [PMID: 18445413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Affiliation(s)
- G Pfaff
- Baden-Wuerttemberg State Health Office, District of Stuttgart Government, Stuttgart, Germany.
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44
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Kremer JR, Brown KE, Jin L, Santibanez S, Shulga SV, Aboudy Y, Demchyshyna IV, Djemileva S, Echevarria JE, Featherstone DF, Hukic M, Johansen K, Litwinska B, Lopareva E, Lupulescu E, Mentis A, Mihneva Z, Mosquera MM, Muscat M, Naumova MA, Nedeljkovic J, Nekrasova LS, Magurano F, Fortuna C, de Andrade HR, Richard JL, Robo A, Rota PA, Samoilovich EO, Sarv I, Semeiko GV, Shugayev N, Utegenova ES, van Binnendijk R, Vinner L, Waku-Kouomou D, Wild TF, Brown DWG, Mankertz A, Muller CP, Mulders MN. High genetic diversity of measles virus, World Health Organization European Region, 2005-2006. Emerg Infect Dis 2008; 14:107-14. [PMID: 18258089 PMCID: PMC2600148 DOI: 10.3201/eid1401.070778] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
During 2005-2006, nine measles virus (MV) genotypes were identified throughout the World Health Organization European Region. All major epidemics were associated with genotypes D4, D6, and B3. Other genotypes (B2, D5, D8, D9, G2, and H1) were only found in limited numbers of cases after importation from other continents. The genetic diversity of endemic D6 strains was low; genotypes C2 and D7, circulating in Europe until recent years, were no longer identified. The transmission chains of several indigenous MV strains may thus have been interrupted by enhanced vaccination. However, multiple importations from Africa and Asia and virus introduction into highly mobile and unvaccinated communities caused a massive spread of D4 and B3 strains throughout much of the region. Thus, despite the reduction of endemic MV circulation, importation of MV from other continents caused prolonged circulation and large outbreaks after their introduction into unvaccinated and highly mobile communities.
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Affiliation(s)
- Jacques R Kremer
- World Health Organization (WHO) Regional Reference Laboratory for Measles and Rubella, Laboratoire National de Santé-Immunology 20A, rue Auguste Lumiere, Luxembourg, Luxembourg.
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45
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Makowka A, Gut W, Litwinska B, Santibanez S, Mankertz A. Genotyping of measles and rubella virus strains circulating in Poland in 2007. ACTA ACUST UNITED AC 2007; 12:E071025.2. [PMID: 17997912 DOI: 10.2807/esw.12.43.03295-en] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The elimination of measles and rubella and the prevention of congenital rubella in the European Region are objectives the World Health Organization has set to achieve by the year 2010.
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Affiliation(s)
- A Makowka
- Department of Virology, National Institute of Hygiene, Warsaw, Poland.
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46
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Abstract
Between January and June 2007, a total of 90 cases of measles were notified in Passau and Rottal-Inn, two districts of Lower Bavaria in south-east Germany sharing a border with Austria.
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Affiliation(s)
- H Bernard
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany.
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47
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Abstract
BACKGROUND In 2006, a large measles outbreak (n = 614) occurred in Duisburg city, Germany, with 54% of cases aged >9 years. An investigation was launched to determine reasons for the resurgence of measles, assess vaccination coverage and vaccine effectiveness (VE). METHODS A retrospective cohort-study was undertaken at a Duisburg public school affected early in the outbreak. We distributed questionnaires to all 1250 students aged 10-21 years and abstracted vaccination records. Cases were identified according to a standard clinical case definition. RESULTS Questionnaires were returned by 1098 (88%) students. Vaccination records were abstracted from 859 students, of whom 820 (95.4%) had received at least one, 605 (70.4%) 2, and 39 (4.5%) no dose(s) of measles-containing vaccine (MCV). Coverage with 2 doses was higher in younger students. We identified 53 cases (attack rate = 5%). Measles-virus sequencing revealed genotype D6. After excluding students vaccinated in 2006 and those with a history of measles, the attack rate was 53% in unvaccinated students, 1.0% in students with one, and 0.4% in those with 2 MCV-doses. VE was 98.1% (95% CI: 92-100%) in students with one and 99.4% (95% CI: 97-100%) with 2 MCV-doses. Based on observed attack rates in vaccinated and unvaccinated students with vaccination records and in students without vaccination records, one-dose-coverage among all participating students was estimated at 91%. CONCLUSIONS VE was high. Vaccination coverage was, however, insufficient to prevent the outbreak. Immunization gaps were found especially in older students. To prevent further outbreaks and to achieve the goal of measles elimination in Germany, vaccination coverage must be increased.
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Affiliation(s)
- Ole Wichmann
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
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48
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Rota J, Lowe L, Rota P, Bellini W, Redd S, Dayan G, van Binnendijk R, Hahné S, Tipples G, Macey J, Espinoza R, Posey D, Plummer A, Bateman J, Gudiño J, Cruz-Ramirez E, Lopez-Martinez I, Anaya-Lopez L, Holy Akwar T, Giffin S, Carrión V, de Filippis AMB, Vicari A, Tan C, Wolf B, Wytovich K, Borus P, Mbugua F, Chege P, Kombich J, Akoua-Koffi C, Smit S, Bukenya H, Bwogi J, Baliraine FN, Kremer J, Muller C, Santibanez S. Identical genotype B3 sequences from measles patients in 4 countries, 2005. Emerg Infect Dis 2007; 12:1779-81. [PMID: 17283637 PMCID: PMC3372353 DOI: 10.3201/eid1211.060635] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Surveillance of measles virus detected an epidemiologic link between a refugee from Kenya and a Dutch tourist in New Jersey, USA. Identical genotype B3 sequences from patients with contemporaneous cases in the United States, Canada, and Mexico in November and December 2005 indicate that Kenya was likely to have been the common source of virus.
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Affiliation(s)
- Jennifer Rota
- Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Mizuno Y, Wilkinson JD, Santibanez S, Dawson Rose C, Knowlton A, Handley K, Gourevitch MN. Correlates of health care utilization among HIV-seropositive injection drug users. AIDS Care 2006; 18:417-25. [PMID: 16777632 DOI: 10.1080/09540120500162247] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study sought to identify correlates of poor health care utilization among HIV-positive injection drug users (IDUs) using Andersen's behavioural health model. We used baseline data from INSPIRE, a study of HIV-positive IDUs (n=1161) to identify predisposing, enabling, and need factors related to poor utilization (defined as fewer than two outpatient visits in the past six months, or identification of emergency room (ER) as the usual place for care). Using bivariate and multivariate models, we found a number of enabling factors that could facilitate the use of health care services such as having health insurance, having seen a case manager, and better engagement with health care providers. These enabling factors could be modified through interventions targeting HIV-positive IDUs. In addition, health insurance and case management appear to be important factors to address because they contributed in making other factors (e.g. lower education, lack of stable housing) non-significant barriers to outpatient care utilization. In the future, these findings may be used to inform the development of interventions that maximize use of scarce HIV resources and improve health care utilization among HIV-positive IDUs.
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Affiliation(s)
- Y Mizuno
- Centers for Disease Control and Prevention, Atlanta, GA. USA.
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Abstract
Measles re-emerged in some counties in Germany in 2005, despite increasing vaccination coverage rates in children at school entry in recent years, which had led to decreasing incidence (with the lowest incidence ever recorded, 0.2 cases per 100 000 inhabitants in 2004).
Regional outbreaks have been detected by the mandatory reporting system in the states of Hesse and Bavaria. Although both outbreaks led to similar incidences in the affected areas (14 and 12 cases respectively per 100 000 inhabitants) they differed in age distribution, transmission patterns and measles virus genotype.
In Hesse, 223 cases were submitted, from which 160 belonged to 41 clusters mainly defined by family or household contacts. Attack rate was highest in children aged between 1-4 years (102 cases per 100 000). Results of measles virus diagnosis showed genotype D4 and identical nucleotide sequences for all analysed cases from Hesse.
In Bavaria, 279 cases were submitted, most of which had occurred in schools and preschool facilities. Age-specific attack rate was highest in children aged between 5-9 years (129 per 100 000). Laboratory diagnosed viruses were identified as genotype D6 and were identical at the nucleotide level.
In both outbreaks the vast majority of cases (95% in Hesse and 98% in Bavaria) were in unvaccinated children, but vaccination coverage differed in the affected areas and was slightly lower in Bavaria than in Hesse. Local accumulation of unvaccinated children and their concentration in schools and kindergarten preceded the outbreak in Bavaria.
Despite high average vaccination coverage levels, local variations may lead to regionally limited outbreaks.
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Affiliation(s)
- A Siedler
- Robert Koch-Institut, Berlin, Germany
| | - A Tischer
- National Reference Centre for Measles, Mumps and Rubella, Department of Viral Infections, Robert Koch-Institut, Berlin, Germany
| | - A Mankertz
- National Reference Centre for Measles, Mumps and Rubella, Department of Viral Infections, Robert Koch-Institut, Berlin, Germany
| | - S Santibanez
- National Reference Centre for Measles, Mumps and Rubella, Department of Viral Infections, Robert Koch-Institut, Berlin, Germany
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