History Of Measles Vaccination Research Articles

Breakthrough Measles among Vaccinated Adults Born during the Post-Soviet Transition Period in Mongolia.

Mongolia experienced a nationwide measles outbreak during 1 March 2015-31 December 2016, with 49,077 cases reported to the WHO; many were among vaccinated young adults, suggesting a possible role of vaccine failure. Advanced laboratory methods, coupled with detailed epidemiological investigations, can help classify cases as vaccine failure, failure to vaccinate, or both. In this report, we conducted a study of cases to identify risk factors for breakthrough infection for a subset of laboratory-confirmed measles cases. Of the 193 cases analyzed, only 19 (9.8%) reported measles vaccination history, and 170 (88%) were uncertain. Measles-specific IgG avidity testing classified 120 (62%) cases as low IgG avidity, indicating no prior exposure to measles. Ten of these cases with low IgG avidity had a history of measles vaccination, indicating primary vaccine failure. Overall, sixty cases (31%) had high IgG avidity, indicating breakthrough infection after prior exposure to measles antigen through vaccination or natural infection, but the IgG avidity results were highly age-dependent. This study found that among young children aged 9 months-5 years, breakthrough infection was rare (4/82, 5%); however, among young adults aged 15-25 years, breakthrough infection due to secondary vaccine failure (SVF) occurred on a large scale during this outbreak, accounting for the majority of cases (42/69 cases, 61%). The study found that large-scale secondary vaccine failure occurred in Mongolia, which highlights the potential for sustained outbreaks in post-elimination settings due to "hidden" cohorts of young adults who may have experienced waning immunity. This phenomenon may have implications for the sustainability of measles elimination in countries that remain vulnerable to the importation of the virus from areas where it is still endemic. Until global measles elimination is achieved, enhanced surveillance and preparedness for future outbreaks in post- or peri-elimination countries may be required.

Implications of Measles Inclusion by Commercial Syndromic Polymerase Chain Reaction Panels - United States, May 2022-April 2023.

Syndromic polymerase chain reaction (PCR) panels are used to test for pathogens that can cause rash illnesses, including measles. Rash illnesses have infectious and noninfectious causes, and approximately 5% of persons experience a rash 7-10 days after receipt of a measles, mumps, and rubella (MMR) vaccine. MMR vaccine includes live attenuated measles virus, which is detectable by PCR tests. No evidence exists of person-to-person transmission of measles vaccine virus, and illness does not typically result among immunocompetent persons. During September 2022-January 2023, the Tennessee Department of Health received two reports of measles detected by syndromic PCR panels. Both reports involved children (aged 1 and 6 years) without known risk factors for measles, who were evaluated for rash that occurred 11-13 days after routine MMR vaccination. After public health responses in Tennessee determined that both PCR panels had detected measles vaccine virus, six state health departments collaborated to assess the frequency and characteristics of persons receiving a positive measles PCR panel test result in the United States. Information was retrospectively collected from a commercial laboratory testing for measles in syndromic multiplex PCR panels. During May 2022-April 2023, among 1,548 syndromic PCR panels, 17 (1.1%) returned positive test results for measles virus. Among 14 persons who received a positive test result and for whom vaccination and case investigation information were available, all had received MMR vaccine a median of 12 days before specimen collection, and none had known risk factors for acquiring measles. All positive PCR results were attributed to detection of measles vaccine virus. Increased awareness among health care providers about potential measles detection by PCR after vaccination is needed. Any detection of measles virus by syndromic PCR testing should be immediately reported to public health agencies, which can use measles vaccination history and assessment of risk factors to determine the appropriate public health response. If a person recently received MMR vaccine and has no risk factors for acquiring measles, additional public health response is likely unnecessary.

Investigation of the Seroprevalence of Antimeasles Immunoglobulin G Antibody in Students at Shiraz University of Medical Sciences.

Measles is an acute, highly contagious disease with a high mortality rate in children. Although vaccination has reduced measles incidence, outbreaks still occur. Therefore, in this study, we aimed to investigate the frequency of antimeasles immunoglobulin G (IgG) antibody (Ab) among students at Shiraz University of Medical Sciences (SUMS). Four hundred fifty SUMS students were enrolled in this cross-sectional study. Information on demographics and measles vaccination history was collected using a questionnaire. Participants were divided into two groups, including A and B, according to routine doses of measles vaccine and the national measles/rubella immunization program. The antimeasles IgG Abs were tested using a commercial Enzyme-Linked Immunosorbent Assay Kit. Participants ranged in age from 18 to 48 years, with a mean age of 22.2 (±4.3). Fifty percent of the subjects were male. Our results showed that 63.6% of the cases were positive for antimeasles IgG Abs. The seroprevalence of IgG Abs between groups A and B did not differ significantly (p = 0.612). There was also no significant correlation between the seroprevalence of antimeasles IgG Abs and the age (p = 0.43) or sex (p = 0.24) of the subjects. The results showed that the frequency of antimeasles IgG Abs is lower than required to prevent the measles virus from circulating. Therefore, a booster vaccination may be necessary.

A Measles Outbreak in a Local Children's Hospital in Korea, 2019.

A measles outbreak with 20 confirmed cases occurred at a local children's hospital in Daejeon from March 28 to April 21, 2019. The index patient was a 7-month-old girl with a recent history of travel to Vietnam. Contact tracing, active surveillance, and post-exposure prophylaxis were conducted by health authorities. Among the 20 patients, 11 (55%) were infants (0-11 months of age), three (15%) were aged 1-3 years, one (5%) was aged 4 years, and five (25%) were adults. Fifteen (75%) patients did not have a history of measles vaccination, and five (25%) had received only one vaccine dose. This study described the importance of prompt application of infection control measures in susceptible environments, including hospitals. Age-appropriate vaccination and providing information on infectious diseases to international travelers and multicultural families in Korea is vital.

Analysis of Factors Hindering the Measles Elimination among Children at a Tertiary Care Hospital in South India

Introduction: Measles is a highly infectious acute viral disease that can lead to serious complications and death. Effective immunisation coverage for measles will play a pivotal role in its elimination strategy. So, the global commitment, strengthening of health infrastructure and effective vaccine coverage are essential to achieve a world that will be free of measles. Aim: To assess the factors associated with the occurrence of measles and to determine the factors responsible for non compliance to measles vaccination. Materials and Methods: A cross-sectional study was conducted in the Department of Paediatrics at Niloufer Hospital, Hyderabad, India, during the period from October 2019 to March 2020 among the children clinical diagnosed with measles. The patients were evaluated for fever, rash, respiratory and other clinical symptoms associated with measles. History of measles vaccination and vitamin A administration were taken. Blood samples of patients were collected and measles specific IgM antibody detection test was done by Enzyme-linked Immunosorbent Assay (ELISA). Data was statistically analysed and presented as numbers and percentages were calculated. Results: Among 129 children, clinically diagnosed of measles, the predominant age group children effected was 1-6 years 68 (52.71%). Overall, 38 (29.5%) were vaccinated and 85 (65.9%) were unvaccinated during routine immunisation schedule. Measles-Containing Vaccine (MCV) coverage during Supplementary Immunisation Activities (SIAs) was also very limited (19.3%). Out of 129 cases, 121 (93.7%) were confirmed positive by measles IgM ELISA, 5 (3.8%) samples gave equivocal results and 3 (2.3%) were negative for the test. Conclusion: Inspite of the availability of effective and inexpensive measles vaccine for decades, vaccination coverage remains inadequate across the globe. So, effective implementation of vaccine services and monitoring of its surveillance system are needed for eradication of measles.

Epidemiologic characteristics of measles and influencing factors in Baiyun district, Guangzhou, 2009–2019

Objective To analyze the epidemiologic characteristics of measles and related influencing factors in Baiyun district of Guangzhou from 2009 to 2019 and provide evidence for measles prevention and control. Methods The measles surveillance system was used to carry out descriptive analysis on confirmed measles cases in Baiyun district from 2009 to 2019 and discuss the influencing factors. Results From 2009 to 2019, a total of 1430 confirmed measles cases were reported in Baiyun district, with an average annual incidence of 6.74/100 000, the cases mainly occurred during April – July, but the seasonality has been less obvious in recent years. The cases were mainly children aged Conclusion Measles mainly occurred sporadically in Baiyun district, the incidence showed a single peak pattern and decline trend. Children aged 20 years in floating population were the key populations in measles prevention and control. It is necessary to strengthen the active case finding in floating population, vaccination certificate check for the entrancement of private schools, active measles surveillance in medical institutions and encourage young migrant workers with unknown measles vaccination history to receive MCV, conduct accurate supplementary vaccination and take multiple measures to prevent periodic measles epidemic.

Descriptive epidemiology of measles cases in Bauchi State, 2013\u20132018

BackgroundMeasles accounts for high morbidity and mortality in children, especially in developing countries. In 2017, about 11,190 measles cases were recorded in Nigeria, including Bauchi State. The aim of this study was to describe the trend and burden of measles in Bauchi State, Nigeria.MethodWe analyzed secondary data of measles cases extracted from the Measles Surveillance data system in Bauchi State from January 2013 to June 2018. The variables extracted included age, sex, doses of vaccination, case location and outcome. Data were analyzed using descriptive statistics, logistic regression, and multiplicative time series model (α = 0.05).ResultsA total of 4935 suspected measles cases with an average annual incidence rate of 15.3 per 100,000 population and 57 deaths (Case Fatality Rate, CFR: 1.15%) were reported. Among the reported cases, 294 (6%;) were laboratory-confirmed, while clinically compatible and epi-linked cases were 402 (8%) and 3879 (70%), respectively. Of the 4935 measles cases, 2576 (52%) were males, 440 (9%) were under 1 year of age, and 3289 (67%) were between 1 and 4 years. The average annual incidence rate among the 1–4 year age-group was 70.3 per 100,000 population. The incidence rate was lowest in 2018 with 2.1 per 100,000 and highest in 2015 with 26.2 per 100,000 population. The measles cases variation index per quarter was highest in quarter 1 (198.86), followed by quarter 2 (62.21) and least in quarter 4 (10.37) of every year. Only 889 (18%) of the measles cases received at least one dose of measles vaccine, 2701 (54.7%) had no history of measles vaccination while 1346 (27.3%) had unknown vaccination status. The fatality of measles in Bauchi State were significantly associated with being under 5 years (AOR = 5.58; 95%CI: 2.19–14.22) and not having at least a dose of MCV (OR = 7.14; 95%CI: 3.70–14.29).ConclusionMeasles burden remains high in Bauchi State despite a decrease in its incidence over the study years. Most of the cases occurred in the first quarter of every year. Improved routine measles surveillance for prompt case management could reduce the burden of the disease in Bauchi State.

Epidemiological Survey of Measles Cases in the South of Kerman Province during 2014-2015

Introduction: Due to the global burden of measles, many measures have always been taken to control and eradicate this disease. However, epidemics of this disease still sometimes occur in some parts of the world and Iran. The aim of this study was to investigate the epidemiology of measles cases in the south of Kerman Province during 2014-2015. Methods: This descriptive cross-sectional study was performed on 326-suspected cases of measles using a checklist and review forms. Data were analyzed by SPSS software version 16. Results: During the years of 2004 and 2005, out of the total number of suspected cases (n=326), 23% were laboratory confirmed. The highest percentage of measles was in the age group of 1 to 4 years (45.3%) and above 10 years (30.7%) and the highest cases of measles were among males (61.3%). Most cases of definite measles were in people without a history of vaccination (61.3%), in Iranians (81.3%) and in rural areas (73.3%). Conclusion: According to the results of the study, there is a need to pay attention to additional immunization in remote areas and in places of gathering of foreign nationals. The highest prevalence of measles were among people who did not have a history of measles vaccination, it seems that the measles vaccination program has not been very successful in the cities covered by the Jiroft University of Medical Sciences. It is recommended that additional studies be performed to determine the risk factors for measles.

Risk of Absence of Measles Antibody in Healthcare Personnel and Efficacy of Booster Vaccination

We aimed to identify the presence of the measles IgG antibody (mIgG-Ab) in healthcare personnel and finding out who needs the measles vaccination. The history of measles vaccination was obtained from the national vaccine registry. A baseline mIgG-Ab test was performed, and the measles vaccine was administered to participants who tested negative or equivocal for mIgG-Abs. During the study, 2885 (87.3%) of the 3303 employees were tested for measles serostatus. The baseline seropositivity rate for mIgG-Abs was 91.9%. Among the 234 seronegative cases, 82.9% were born after 1985. The seroprevalence rate was lower in those who received the measles–mumps–rubella (MMR) vaccine >10 years before the testing time, especially if they were born after 1985 and if there was only one previous record of vaccination. Among the 234 seronegative cases, MMR vaccination was administered in 174 cases, of which serostatus was evaluated in 146 cases. After the first dose, positive seroconversion was achieved in 126 participants (86.3%). After a second dose, 15 achieved (75.0%) positive seroconversion. In healthcare personnel born after the period when measles incidence significantly decreased, it may be necessary to reassess their immune status for measles if more than 10 years have elapsed since the last vaccination.

Measles and rubella serosusceptibity among population vaccinated with different schedules: the potential impact on measles-rubella elimination in Iran

BackgroundIranian children were vaccinated with the scheduled two doses of monovalent measles vaccine (mMV) from 1984. In December 2003, a nationwide campaign of measles-rubella (MR) immunization was established to vaccinate 5–25 year- old individuals. In 2004, the mMV was replaced with measles- mumps- rubella (MMR) vaccine. Despite the high vaccination coverage, the outbreaks of measles still occur in the country. In this Study, the MR immunity status of various age groups, vaccinated with different schedules was investigated, and the immunologic response of seronegative subjects to revaccination was examined.MethodsThis cross-sectional study was conducted among 7–33-year-old healthy individuals with a documented history of measles vaccination from November 2017 to June 2018. The subjects were categorized as follows: group A, including 20–33 year-old individuals; vaccinated with 1–2 doses of mMV at ages 9 and 15 months, and revaccinated with MR, group B, including 15–19-year-old individuals, vaccinated with two doses of mMV at 9 and 15 months of age, and received additional dose of MMR upon school entrance, group C, including 11–14 year-old individuals, vaccinated with two-doses of MMR at the ages of 15 months and 6 years, and group D, including 7–10 year-old individuals vaccinated with two-doses of MMR vaccine at the ages 12 and 18 months, respectively. Levels of antimeasles- antirubella IgG antibodies in the collected sera were measured. Also antimeasles- antirubella IgM and IgG of seronegative individuals were reexamined at 4–6 weeks after MMR revaccination. The collected data were analyzed using descriptive statistical methods.ResultsA total of 635 individuals were investigated in this study. Group A, 98; group B, 295; group C, 139; and group D, 103 persons. Overall, 12.3 and 18.4% of the population were seronegative for measles and rubella antibodies. This rate varied greatly between the 4 groups: group A, 0/0–2%; group B,15.2–25.0%; group C,11.5–17.2%; and groupD,14.6–18.4%. After revaccination, 92 and 94.9% of seronegative individuals showed IgG response to measles and rubella vaccines, respectively.ConclusionDespite the high coverage rate of M-R containing vaccines, a significant number of vaccinated subjects were seronegative for measles and rubella, possibly because of secondary vaccine failure; this may negatively affect measles-rubella elimination targets in the country. If these findings are confirmed in similar future studies, a more robust regional/national supplementary immunization activity will be considered.

Proportion of children aged 9-59 months reached by the 2017 measles supplementary immunization activity among the children with or without history of measles vaccination in Lilongwe district, Malawi.

The measles Supplementary Immunization Activity (SIA) was implemented in June, 2017 to close immunity gaps by providing an additional opportunity to vaccinate children aged between 9 months and up to 14 years in Lilongwe District, Malawi. This study was conducted to determine the proportion of eligible children that were reached by the 2017 measles SIA among those children with or without history of measles vaccination, and possible reasons for non-vaccination. A cross-sectional survey using mixed methods was conducted. Caretakers of children who were eligible for the 2017 measles SIA were sampled from 19 households from each of the 25 clusters (villages) that were randomly selected in Lilongwe District. A child was taken to have been vaccinated if the caretaker was able to explain when and where the child was vaccinated. Eight Key Informant Interviews (KIIs) were conducted with planners and health care workers who were involved in the implementation of the 2017 measles SIA. Modified Poisson regression was used to examine the association between non-vaccination and child, caretaker and household related factors. A thematic analysis of transcripts from KIIs was also conducted to explore health system factors associated with non-vaccination of eligible children in this study. A total of 476 children and their caretakers were surveyed. The median age of the children was 52.0 months. Overall, 41.2% [95% CI 36.8-45.7] of the children included in the study were not vaccinated during the SIA. Only 59.6% of children with previous measles doses received SIA dose; while 77% of those without previous measles vaccination were reached by the SIA. Low birth order, vaccination history under routine services, low level of education among caretakers, unemployment of the household head, younger household head, provision of insufficient information by health authorities about the SIA were significantly associated with non-vaccination among eligible children during the 2017 measles SIA. Qualitative findings revealed strong beliefs against vaccinations, wrong perceptions about the SIA (from caretakers' perspectives), poor delivery of health education, logistical and human resource challenges as possible reasons for non-vaccination. Many children (41%) were left unvaccinated during the SIA and several factors were found to be associated with this finding. The Lilongwe District Health Team should endeavor to optimize routine immunization program; and community mobilization should be intensified as part of SIA activities.

An evaluation of the clinical features of measles virus infection for diagnosis in children within a limited resources setting

BackgroundMeasles is a recurrent health problem in both advanced and developed countries. The World Health Organization (WHO) recommends anti-measles immunoglobulin M (Ig M) as the standard method of detecting the virus; however, many areas still present the inability to perform a serology test of anti-measles IgM. Therefore, a typical clinical feature is necessary to establish the diagnosis of measles. The objective of this study was to evaluate hyperpigmented rash and other clinical features as the diagnostic tools with respect to measles, especially in an outbreak setting.MethodsIn this observational diagnostic study, the inclusion criteria were as follows: between 6 and 144 months of age, fever, maculopapular rash for 3 days or more, accompanied by a cough, or coryza, or conjunctivitis. Those with a prior history of measles vaccination (1–6 weeks) were excluded, in addition to those with histories of corticosteroid for 2 weeks or more and immunocompromised conditions. The samples were taken from Dr. Soetomo General Academic Hospital in Surabaya, Indonesia. We evaluated the sensitivity, specificity, the positive predictive value, and the negative predictive value of such clinical features. Hyperpigmented rash was validated using Kappa and Mc Nemar tests. Anti-measles Ig M was considered as the gold standard.ResultsThis study gathered 82 participants. The clinical manifestations of all subjects included fever, cough, coryza, conjunctivitis, Koplik spots, and maculopapular rash (which turns into hyperpigmented rash along the course of the illness). Most maculopapular rashes turn out to be hyperpigmented (89%). Sensitivity, specificity, positive predictive value, and negative predictive values ​​of the combination of fever, maculopapular rash, and hyperpigmented rash were found to be at 90.7, 28.6, 93.2, and 22.2%, respectively. The Mc Nemar and Kappa tests showed p values of 0.774 and 0.119, respectively.ConclusionThe combination of fever, maculopapular rash, and hyperpigmented rash can be used as a screening tool regarding measles infection in an outbreak setting, which can then be confirmed by anti-measles Ig M. Cough, coryza, and Koplik’s spot can be added to this combination, albeit with a slight reduction of sensitivity value.

Current and Prospect on Measles Outbreak

Measles is a highly contagious infectious disease characterized by fever, rash, cough, coryza, and conjunctivitis. The causative organism is the measles virus transmitted via the respiratory route. Before the introduction of an effective vaccine, measles was one of most prevalent diseases worldwide. Mortality may occur in patients with complications, including pneumonia, which is the most common cause of measles-associated death. The diagnosis of measles is based on clinical symptoms and laboratory tests, including the detection of measles virus-specific antibodies or measles virus ribonucleic acid and cultured viruses. The treatment for measles is primarily supportive care. In Korea, availability of the measles vaccine has substantially reduced the incidence and mortality of the disease. The World Health Organization verified the elimination of measles in March 2014; however, small outbreaks continue to be reported. Although a large proportion of measles cases occur in infants less than 1 year old, the disease has been reported in young adults with a history of measles vaccination. Here, we review the current literature on measles and discuss the importance of measles prevention in Korean adults. (Korean J Med 2019;94:237-245)

Measles outbreak in Gothenburg urban area, Sweden, 2017 to 2018: low viral load in breakthrough infections

In an outbreak of measles in Gothenburg, Sweden, breakthrough infections (i.e. infections in individuals with a history of vaccination) were common. The objective of this study was to compare measles RNA levels between naïve (i.e. primary) and breakthrough infections. We also propose a fast provisional classification of breakthrough infections. Medical records were reviewed and real-time PCR-positive samples genotyped. Cases were classified as naïve, breakthrough or vaccine infections. We compared clinical symptoms and measles RNA cycle threshold (Ct) values between breakthrough and naïve infections. Sixteen of 28 confirmed cases of measles in this outbreak were breakthrough infections. A fast provisional classification, based on previous history of measles vaccination and detectable levels of measles IgG in acute serum, correctly identified 14 of the 16 breakthrough infections, confirmed by IgG avidity testing. Measles viral load was significantly lower in nasopharyngeal samples from individuals with breakthrough compared with naïve infections (median Ct-values: 32 and 19, respectively, p < 0.0001). No onward transmission from breakthrough infections was identified. Our results indicate that a high risk of onward transmission is limited to naïve infections. We propose a fast provisional classification of breakthrough measles that can guide contact tracing in outbreak settings.

Importance of real-time RT-PCR to supplement the laboratory diagnosis in the measles elimination program in China.

In addition to high vaccination coverage, timely and accurate laboratory confirmation of measles cases is critical to interrupt measles transmission. To evaluate the role of real-time reverse transcription-polymerase chain reaction (RT-PCR) in the diagnosis of measles cases, 46,363 suspected measles cases with rash and 395 suspected measles cases without rash were analyzed in this study; the cases were obtained from the Chinese measles surveillance system (MSS) during 2014–2017 and simultaneously detected by measles-specific IgM enzyme-linked immunosorbent assay (ELISA) and real-time RT-PCR. However, some IgM-negative measles cases were identified by real-time RT-PCR. The proportion of these IgM-negative and viral nucleic acid-positive measles cases was high among measles cases with measles vaccination history, cases without rash symptoms, and cases within 3 days of specimen collection after onset. The proportion of IgM-negative and viral nucleic acid-positive measles cases in the 0–3 day group was up to 14.4% for measles cases with rash and 40% for measles cases without rash. Moreover, the proportions of IgM-negative and nucleic acid-positive measles cases gradually increased with the increase in the measles vaccination dose. Therefore, integrated with IgM ELISA, real-time RT-PCR would greatly improve the accurate diagnosis of measles cases and avoid missing the measles cases, especially for measles cases during the first few days after onset when the patients were highly contagious and for measles cases with secondary vaccine failure. In conclusion, our study reconfirmed that IgM ELISA is the gold-standard detection assay for measles cases confirmation. However, real-time RT-PCR should be introduced and used to supplement the laboratory diagnosis, especially in the setting of pre-elimination and/or elimination wherever appropriate.

Development of a robust and standardized immunoserological assay for detection of anti-measles IgG antibodies in human sera

Because of measles outbreaks there is a need for continuous monitoring of immunological protection against infection at population level. For such monitoring to be feasible, a cost-effective, reliable and high-throughput assay is necessary. Herein we describe an ELISA protocol for assessment of anti-measles antibody levels in human serum samples that fulfills the above criteria and is easily adaptable by various laboratories. A serum bank of anonymous patient sera was established (N > 3000 samples). Sera were grouped based on measles immunization schedules and/or changes in vaccine components since the introduction of the first measles vaccine in Hungary in 1969. Newly designed ELISA was performed by using Siemens BEP 2000 Advance System and data were confirmed using commercially available kits. Our indirect ELISA was compared to indirect immunfluoresence and to anti-measles nucleocapsid (N) monoclonal antibody-based sandwich ELISA. The results obtained are in high agreement with the confirmatory methods, and reflect measles vaccination history in Hungary ranging from pre-vaccination era, through the initial period of measles vaccination, to present. Based on measurement of 1985 sera, the highest ratio of low/questionable antibody level samples was detected in cluster ‘1978–1987’ (~25.4%), followed by cluster ‘1969–1977’ (~15.4%).Our assay is suitable for assessment of anti-measles immunity in a large cohort of subjects. The assay is cost-effective, allows high-throughput screening and has superior signal-to-noise ratio. This assay can serve as a first step in assessment of the effectiveness of all three components of the MMR vaccine.

Impact of measles supplementary immunization activities on reaching children missed by routine programs

BackgroundMeasles supplementary immunization activities (SIAs) are vaccination campaigns that supplement routine vaccination programs with a recommended second dose opportunity to children of different ages regardless of their previous history of measles vaccination. They are conducted every 2–4 years and over a few weeks in many low- and middle-income countries. While SIAs have high vaccination coverage, it is unclear whether they reach the children who miss their routine measles vaccine dose. Determining who is reached by SIAs is vital to understanding their effectiveness, as well as measure progress towards measles control. MethodsWe examined SIAs in low- and middle-income countries from 2000 to 2014 using data from the Demographic and Health Surveys. Conditional on a child’s routine measles vaccination status, we examined whether children participated in the most recent measles SIA. ResultsThe average proportion of zero-dose children (no previous routine measles vaccination defined as no vaccination date before the SIA) reached by SIAs across 14 countries was 66%, ranging from 28% in São Tomé and Príncipe to 91% in Nigeria. However, when also including all children with routine measles vaccination data, this proportion decreased to 12% and to 58% when imputing data for children with vaccination reported by the mother and vaccination marks on the vaccination card across countries. Overall, the proportions of zero-dose children reached by SIAs declined with increasing household wealth. ConclusionsSome countries appeared to reach a higher proportion of zero-dose children using SIAs than others, with proportions reached varying according to the definition of measles vaccination (e.g., vaccination dates on the vaccination card, vaccination marks on the vaccination card, and/or self-reported data). This suggests that some countries could improve their targeting of SIAs to children who miss other measles vaccine opportunities. Across all countries, SIAs played an important role in reaching children from poor households.

Evaluation of humoral immunity against measles virus in Al-Najaf Governorate /Iraq.

This study was conducted to evaluate the anti-measles IgG antibody (AMAb) titers of measles vaccinated and non vaccinated normal individuals in Al-Najaf Governorate. "ELISA" test was applied to test 375 collected sera samples during April to November 2006. Individuals included with age range (1-30) years; 335 of them were vaccinated, and 40 non vaccinated (control group).Age, sex, residency and history of measles vaccination were recorded for each individual. The results revealed; that the highest IgG titer (234.82) had been seen in age group (A, age rang 1-6 year) and the titer was decreasing with increasing of age and reaching to the lowest IgG titer (6.6087) in age group (E, age range 25-30 year). The residency and sex of individuals was showed no significant differences(p &gt;0.01) in AMAb IgG titers.

Measles outbreak among Pakistani community living in Qatar, Spring 2015

Background: Measles is a highly contagious respiratory disease caused by a virus that can be serious in all age groups. However, measles complications more like to occur in children younger than five years and adult older than 20 years. Qatar is one of the Eastern Mediterranean (EMR) countries that are committed to achieving measles elimination target by 2015. However, Qatar has been experiencing a measles outbreak mainly due to a unique population characteristic, which includes highly transient expatriate population. Objectives: To describe the incidence and morbidity to measles outbreak among the Pakistani community living in Abu Hamour area in spring 2015. Methods: Data collection was done through the system of mandatory notification of the Health Protection and communicable disease control department (HP&amp;CDC). All notified cases were interviewed with standardized questionnaire that are distributed to the families during the vaccination campaign. The information about disease complications was obtained from Health care facilities. Clinical case definition was adopted from world health organization (WHO). Results: A total of 36 cases were diagnosed with measles from mid-March until end of April 2015. The index case was traveled recently to Pakistan, hence this outbreak was associated with the imported virus. Most of cases were from Pakistani community living in Abu Hamour area and the age distribution of cases was more of younger age groups (especially the 1–4 year group). Concerning measles vaccination history, all reported cases never vaccinated before. Conjunctivitis (36.1%) followed by gastroenteritis (30.6%) were the most common complications. Conclusion: An accumulation of non-immune individuals led to this outbreak. Catch-up vaccination campaigns targeting a younger age group of a particular immigrant community are needed to close critical immunity gaps.

Analysis on clinical and epidemioloical characteristics of measles in hospitalized children in Shanghai in 2012

To investigate the main factors that influence measles morbidity and the genotype of measles virus, so as to provide evidence for scientific decision making to further control the prevalence of measles. A retrospective analysis included 182 children in Children's Hospital of Fudan University, diagnosed with measles from January 1, 2012 to December 31. The clinical and epidemiological characteristics, including the gender, age, the incidence of seasonal trends, measles vaccine vaccination history, contact history and other clinical manifestations, laboratory test results, and so on were analyzed. And the reverse transcription PCR (RT-PCR) was adopted to detect sputum specimens from suspected patients with measles,who were selected randomly,the sequence of the part of the PCR products was analyzed. (1) Clinical and epidemiological data: Totally were 182 children with measles (125 males, 57 females) were enrolled into this study. The age of the patients ranged from 3 months to 89 months, 127 cases were younger than 9 months (69. 8%). The prevalence season was from April to August, while the peak month was April and May (22. 5%, 23. 1%). Among 182 hospitalized children, only 11 cases underwent measles vaccination (6. 0%), and among them 5 cases were within 2 weeks before disease onset. A total of 167 cases (91. 8%) had not been vaccinated, most of whom were immigrants, and the measles vaccination history of the remaining 4 cases were unknown. There was a positive correlation between the measles vaccination ratio in children of the floating population (8. 45%, 6/71) and the settled children (29.4%, 5/17, χ =8. 11 P =0. 004). In total, 24 cases (13. 2%) had definite measles exposure history, with 153 cases (84. 1%) of unknown origin,5 cases (2.7%) without any history of contact. (2) Clinical manifestations: All the 182 patients had fever (100%) and obvious rashes (100%), among them 145 cases had body temperature higher than 39 °C (79. 7%). The fever period ranged from 2 to 38 days. Among 182 hospitalized children,165 cases (90. 7%) had typical measles,17 cases had atypical measles. Among the 17 cases, two had severe measles, one had heterotypic measles. (3) The common complica tions: 96 cases had pneumonia (52. 8%), 80 had laryngitis (44. 0%), 38 had bronchitis (20. 9%),15 had hepatic dysfunction (8. 2%), 11 had myocardial damage (6. 0%), 3 had febrile seizures (1. 6%), and no patient had encephalitis. Of the 96 cases with pneumonia, 92 received sputum test; 38 were sputum culture positive (41%). The dominant pathogens were Streptococcus pneumoniae(11/38,29%), Haemophilus influenzae (6/ 38,16%), Moraxella catarrhalis (4/38, 11%), Escherichia coli (4/38, 11%), Candida albicans (4/38, 11%), Mycoplasma pneumoniae (4/38, 11%) and Staphylococcus aureus (3/38, 8%). (4) The H1a genotype was the only one genotype in the detected sequence of 54 measles virus strains. Measles was more often seen in the children under the age of 9 months from the floating population. The morbidity peak month was from April to May in Shanghai. The H1a genotype was the only one genotype. We should try to improve vaccination coverage rate in the children who are at the age for vaccination, so as to prevent measles outbreak.