A measles outbreak in a middle school with high vaccination coverage and evidence of prior immunity among cases, Beijing, P.R. China

Ma, Rui; Lü, Li; Zhangzhu, Jiazi; Meng, Chen; Yu, Xiaoyan; Wang, Fengshuang; Peng, Xiaoran; Wu, Jiang

doi:10.1016/j.vaccine.2015.11.006

Cited by 16 publications

(7 citation statements)

References 21 publications

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“…9 In China, a measles outbreak in a middle school in 2014 demonstrated the transmission probably due to a secondary immunization failure patient with the documented receipts of three doses measles-containing vaccine (MCV), but the direct laboratory testing evidence was not acquired. 10 Recently, SVF attracts more public attention gradually and it is necessary to understand the characteristics of SVF patients and how they transmit for guiding elimination of measles.…”

Section: Introductionmentioning

confidence: 99%

Outbreak of measles among persons with secondary vaccine failure, China, 2018

Zhang

Chen

et al. 2019

Human Vaccines & Immunotherapeutics

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Although the incidence of measles has been dramatically reduced by the highly effective measles vaccine, cases of measles and outbreaks continue to occur in vaccinated population because of immunization failure. We report on an outbreak in which two cases had previous evidence of measles immunity and then one of them transmitted measles infection to an unvaccinated contact. The cases and contacts exposed during the outbreak were investigated. Clinical information and epidemiological information were obtained. Serum samples were collected for measles-specific immunoglobulin M (IgM), immunoglobulin G (IgG) and IgG avidity. Throat swabs were obtained to test for measles virus RNA. Two measles cases (case 1 and case 2) who have received one dose of MCV in past 5 years, and both working at a hospital in Beijing, occurred in 18 th and 20 nd of January, respectively. Out of the 102 contacts, one additional case (case 3) who had a close, long-term co-exposure with case 1 was reported subsequently. No additional cases of measles occurred among 15 contacts of case 3. The index case was not ascertained through the outbreak review. All three cases had laboratory confirmation of measles infection. Both case 1 and case 2 had high-avidity IgG antibody characteristic of a secondary immune response and developed a modified clinical presentation. This report confirms that a vaccinated individual with documented secondary vaccine failure (SVF) could transmit measles and is the second report since a New York City outbreak (the first report in China). The outbreak represented a series of rare events, so we can conclude that the SVF individuals in the transmission chain of measles are unlikely to threaten measles elimination. The importance of the herd immunity in preventing transmission and sensitive surveillance activities in case of misdiagnosis is emphasized.

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Section: Introductionmentioning

confidence: 99%

Outbreak of measles among persons with secondary vaccine failure, China, 2018

Zhang

Chen

et al. 2019

Human Vaccines & Immunotherapeutics

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“…14 The second dose of MCV is critical in preventing the primary vaccination failure and boosting antibody titers for ensuring continuous protection. 15 According to the evaluation of MCV coverage through Zhejiang provincial immunization information system (ZJIIS) among children age 7 years, the coverage of MCV1 was 98.6% while the coverage of MCV2 was 82.8%, 16 much lower than the 95% threshold level of stopping measles transmission. The CACIP recommends the fourth diphtheria-pertussis-tetanus combined vaccine (DPT4) and the hepatitis A live attenuated vaccine (HAV) at the same age with MCV2 of 18 months.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of potentially achievable vaccination coverage of the second dose of measles containing vaccine with simultaneous administration and risk factors for missed opportunities among children in Zhejiang province, east China

Chen

Wang

et al. 2018

Human Vaccines & Immunotherapeutics

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The findings in this study suggest that fully utilization of all opportunities for simultaneous administration of all age-eligible vaccine doses at the same vaccination visit is critical for achieving the coverage target of 95% for MCV2. Future interventions focusing on the group with risk factors observed could substantially eliminate MOs for simultaneous administration of MCV2, further to improve the coverage of fully immunization of MCV, and finally achieve the goal of eliminating measles.

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“…This might have happened because Portugal has a low incidence of measles, therefore, HCW and clinicians do not commonly see measles in clinical practice and thus it may not have been their first diagnosis. In addition, atypical clinical presentation in vaccinated individuals could have been a contributing factor [16].…”

Section: Discussionmentioning

confidence: 99%

Measles outbreak in a tertiary level hospital, Porto, Portugal, 2018: challenges in the post-elimination era

Machado¹,

Duque²,

Almeida

et al. 2018

Eurosurveillance

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A measles outbreak has been occurring in a healthcare setting in Porto, Portugal, since early March 2018, posing public health challenges for a central hospital and the community. Up to 22 April, 96 cases were confirmed, 67 in vaccinated healthcare workers, mostly between 18-39 years old. Following identification of the first cases, control measures were rapidly implemented. Concomitantly, other measles cases were notified in the Northern Region of the country. No common epidemiological link was identified.

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A measles outbreak in a middle school with high vaccination coverage and evidence of prior immunity among cases, Beijing, P.R. China

Cited by 16 publications

References 21 publications

Outbreak of measles among persons with secondary vaccine failure, China, 2018

Outbreak of measles among persons with secondary vaccine failure, China, 2018

Evaluation of potentially achievable vaccination coverage of the second dose of measles containing vaccine with simultaneous administration and risk factors for missed opportunities among children in Zhejiang province, east China

Measles outbreak in a tertiary level hospital, Porto, Portugal, 2018: challenges in the post-elimination era

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