Abstract

Measles is an acute and highly contagious but vaccine-preventable infectious disease. Despite years of being considered eliminated, decreased vaccination rates have produced virus reemergence in several countries, including Brazil. Measles can be controlled through immunization programs, through which aim to achieve 95% coverage with two doses of the vaccine. Measles can also be controlled if suspected cases can be properly identified in order to contain outbreaks. This cross-sectional study determined the prevalence of measles antibodies and their correlation with rubella antibodies (resulting from the combination vaccine used in Brazil’s public immunization program) in individuals aged higher 10 years old in São José do Rio Preto, São Paulo State, Brazil, participants of a prospective cohort of arbovirosis surveillance before virus reemergence in the country. Our findings presented that 32.9% of individuals aged 10–40 years old had not antibodies against measles; 39.3% of total individuals with documented evidence of measles vaccination did not have anti-measles IgG, though only 20.2% of individuals with documented evidence of rubella vaccination lacked anti-rubella IgG. Besides, the most of measles cases reported in the city, following the virus spreading in the country, occurred especially in groups defined by us as susceptible. Because the combination MMR vaccine is part of Brazil’s national vaccine schedule, the possible reasons for this relatively high rate of seronegativity need to be investigated further, once that it reflects outbreak risk.

Highlights

  • Measles is a highly contagious but vaccine-preventable disease

  • Between epidemiological week (EW) 1 in 2018 and EW 31 in 2019 in Brazil, 11,371 measles cases were confirmed out of 22,654 suspected cases, 12 of which resulted in death[13]

  • Other arboviruses have been detected in this region, including Saint Louis encephalitis virus (SLEV)[17], Zika virus (ZIKV)[18], and coinfections therein[19]

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Summary

Introduction

Measles is a highly contagious but vaccine-preventable disease. Its symptoms include acute rash, cough, and enanthem (including Koplik’s spots) on the oral mucosa[1,2]. The current measles cases in the Americas has been caused mainly by genotype D8, which was first reported in Venezuela in 2017. Between epidemiological week (EW) 1 in 2018 and EW 31 in 2019 in Brazil, 11,371 measles cases were confirmed out of 22,654 suspected cases, 12 of which resulted in death[13]. From 2019 epidemiological week (EW) 1 to EW 31 in São Paulo State, 967 measles cases were confirmed out of 4,138 suspected cases; there were no deaths, and the most highly affected age group (45% of cases) was that of individuals between 15 and 29 years of age (45%)[14]. In 2019, following the measles spreading in the country, 74 measles-confirmed cases were reported in the city (

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