Community Outbreak of Measles in Madrid (Spain) Caused by an Imported Case~!2009-11-06~!2009-11-10~!2010-02-16~!

Abstract

Introduction: In February 2006, the measles elimination programme of the Epidemiological Surveillance Network of the Community of Madrid (Spain) detected a case of imported, unvaccinated measles which was the index case of a community outbreak whose epidemiological characteristics we describe. Material and Methods: Descriptive study of the outbreak. Clinical, epidemiological and laboratory information was collected. Measles antibodies (IgM and Ig G) were studied and the virus was isolated and genotyped. Results: An imported case caused an outbreak of 174 cases (93.1% confirmed). The measles virus was detected by culture in 31% of cases. The genotype was determined in 90.7% of positive samples, all of which were the B3 genotype (subgenotype B3.1), with sequencing in various genes that indicated the same viral lineage. The outbreak lasted 198 days. The age range was 2 months-37 years and 84.6% of cases were Spanish-born. A total of 9.8% of cases presented complications, 37.4% required hospital admission, and 9.2% had a documented history of immunization. Twenty-four clusters were identified in families, health workers and infant schools. Conclusions: Control measures included advancing the infant MMR vaccination schedule and reinforcement vaccination in health care workers. While the measles virus still circulates, surveillance of suspected cases and maintenance of high vaccination coverages, especially in health care workers, are essential.

A global perspective of vaccination of healthcare personnel against measles: Systematic review

“…Transmission of measles from healthcare personnel to patients or to other healthcare personnel has also been documented from the United States, Australia, Korea, France, Italy, Spain, and Bulgaria [18, 22, 24, 52, 84, 100, 101, 103–107, 110, 127, 130, 131, 138, 139]. In the United States during 1985–1989, of 295 measles cases among patients and visitors to healthcare facilities who had a known source of infection, 31 (10.5%) acquired measles from healthcare personnel; additionally, 31 (9.4%) healthcare personnel acquired measles from another healthcare personnel [101].…”