Measles elimination in the World Health Organization European Region in light of recent outbreaks: Spotlight on the Balkans

Abstract

No: 1446 Presentation at ESCV 2015: Oral 42 Subclass specific antibody responses to HCMV in transplant recipients and their association with constant heavy IgG chain polymorphism and virus replication S. Benedikt ∗, L. Weseslindtner, I. Gorzer, K. Pollak, E. Puchhammer-Stockl Department of Virology, Medical University Vienna, Austria Background: Human cytomegalovirus (HCMV) causes severe infections in transplant recipients. The significance of the HCMVspecific antibody (AB) response in limiting HCMV replication is so far not entirely clear. In the present study we therefore analysed the HCMV-specific subclass AB profile in lung transplant recipients (LTRs) and its association with HCMV-DNAemia. In addition, we have analyzed its association with the patients allotypes GM3 and GM17, which are expressed at the CH1 region of the constant y1 heavy chain, and differ by single genetic variations, mainly by the single nucleotide polymorphism (SNP) rs1071803 (359 a/g nucleotide variation). Methods: We determined HCMV-specific total IgG, IgG1 and IgG3 AB levels by ELISA and HCMV-DNAemia by quantitative PCR during the post-transplant follow-up in 57 LTRs, and in 44 of these the GM 359a/g variant (GM3/17) was determined by genotyping. Results: In seropositive LTRs HCMV ABs increased with HCMV viremia (p=0.0005), and this was significantly associated with development of low level DNAemia ( 1000 copies/ml: p=0.0516). Only IgG3 but no IgG1 increase was observed with viremia (IgG3: p=0.0004). IgG1 levels were significantly lower in patients with the 359g/g (GM3/3) than in those with the 359a/g (GM3/17) variant (p<0.0001). The IgG3 increase with viremia was significant especially in patients carrying the IgG1 low level 359g/g variant (p<0.0002). Conclusions: The present data suggest that the HCMV specific AB response significantly contributes to limit HCMV replication after transplantation and provide evidence that the patients GM 3/17 variant is significantly associated with their HCMV IgG subclass profile. http://dx.doi.org/10.1016/j.jcv.2015.07.052 Abstract No: 1477 Presentation at ESCV 2015: Oral 43 Measles elimination in the World Health Organization European Region in light of recent outbreaks: Spotlight on the Balkans J.M. Hubschen1,∗, I. Salimovic-Besic2,1, A. Dedeic-Ljubovic2,1, S. Rakic Adrovic3,1, A. Sausy1, C.P. Muller1 1 Department of Immunology, Luxembourg Institute of Health/Laboratoire National de Sante, Esch-Sur-Alzette, France 2 University Clinical Centre – Sarajevo, Department for Clinical Microbiology, Sarajevo, BiH, Bosnia and Herzegovina 3 Institute of Virology, Vaccine and Sera “Torlak”, Belgrade, Serbia Background: The World Health Organization European Region (WHO-EURO) has adopted the goal to eliminate measles by 2015, but in light of current case numbers and epidemics it is clear that this target will not bemet. Elimination is defined on a country level as the absence of endemic cases for at least 12months. To interrupt endemic transmission, a very high vaccination coverage overall in the country but also in the different regions and cohorts is required. TheWHOEURO region is very heterogeneous and has a multiplicity of challenges and problems. In 2014, more than 16,000 measles cases were registered in WHO-EURO and outbreaks were reported from many different countries including Bosnia and Herzegovina and Serbia. Methods: The currently ongoing outbreaks in Bosnia and Herzegovina and in Serbia are investigated combining clinical, epidemiological and laboratory data. The mainly affected cohorts are identified and special emphasis is placed on differences in outbreak causes and patterns and virus exportations from the Balkans to other countries within and outside of WHO-EURO. Results: The results of the outbreak investigations are used as a basis to discuss current challenges and threats to the WHOEURO measles elimination goal such as migrant populations, anti-vaccination groups, vaccination gaps resulting from political instability or inadequate planning, insufficient routine immunization coverage, lack of political and financial commitment, etc. Conclusion: To achievemeasles elimination in theWHOEURO region, each country has to address its specific problems and challenges, identify and immunize susceptible population groups, react quickly and efficiently in outbreak situations, and renew and reenforce its commitment to attain the elimination goal. http://dx.doi.org/10.1016/j.jcv.2015.07.053