Abstract
Purpose: Emergence of measles virus continues to be a major public health concern despite improvements in vaccination programs and efforts for elimination. In 2013, a major outbreak of measles occurred starting second quarter of 2013, which peaked in first quarter of 2014. Likewise, outbreak occurred in late 2017, 3 years following a major outbreak. Molecular analysis of measles viruses (MV) will provide vital information on outbreak linkages and transmission pathways. This reports the sustained MV transmission causing subsequent outbreaks in the Philippines Methods & Materials: Emergence of measles virus continues to be a major public health concern despite improvements in vaccination programs and efforts for elimination. In the Philippines, measles virus outbreaks occurs every 2 to 3 years interval. In 2013, a major outbreak of measles occurred starting second quarter of 2013, which peaked in first quarter of 2014. Likewise, another outbreak occurred in late 2017, 3 years after a major outbreak. Molecular analysis of measles viruses (MV) will provide vital information on outbreak linkages and transmission pathways that can be helpful in the implementation of appropriate control programs. This reports the sustained MV transmission causing subsequent outbreaks in the Philippines Results: A total of 40, 860 samples were received in 2013 while 3,048 in 2017 with 20,000 samples tested from both outbreaks. 80% of the samples positive for Measles anti-IgM. Of 1,405 swabs received, 33% were positive and further tested for partial N gene. In 2013, majority of the isolates were B3 with one case of D9, while only B3 was isolated from 2017 outbreak. Phylogenetic analysis revealed that both 2013 and 2017 B3 strains from a single clade with highest homology from isolates found in Ibadan, Nigeria. Conclusion: Measles virus activity in the country remains high despite global efforts towards elimination. The same wild-type strains (B3) were found during both 2013 and 2017 indicating authocthonous transmission. Low vaccination coverage and high birth rate prevented the complete interruption of Measles virus in the country. Significant efforts should be made to improve routine immunization program and continue molecular surveillance of MV to track transmission pathways and epidemic links of MV.
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