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.
Highlights
Measles is a highly communicable viral disease causing substantial morbidity and mortality globally, mostly in low-income countries [1]
We evaluated timeliness and completeness of postexposure vaccinations in asylum seeker homes between October 2014 and February 2015
Of 1,359 cases notified during the outbreak period, 15 were considered unrelated to the outbreak; six because of genotypes other than D8 and nine because infection was considered imported, among them three asylum seekers
Summary
Measles is a highly communicable viral disease causing substantial morbidity and mortality globally, mostly in low-income countries [1]. Vaccination can safely and effectively prevent measles disease and measles virus (MV)-induced immunosuppression, thereby preventing all-cause secondary infectious diseases [2]. The World Health Organization (WHO) has targeted measles and rubella for Regional elimination, and Germany has committed to this goal [3]. The key strategy for elimination is to achieve and sustain a population coverage of ≥ 95% with two doses of a MV-containing vaccine [4,5]. Elimination has only been reached in the Americas [6,7]. The WHO European Region failed to achieve the target date for elimination in 2015 [8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
