Measles: is it still a threat?

Moten, Maliha; A, Phillips; Saliba, Vanessa; Harding, Nick; Sibal, Bharat

doi:10.3399/bjgp18x697961

Cited by 7 publications

(8 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Asking about unwell contacts may lead to the diagnosis: a key consideration not only for scarlet fever, but also for other infections presenting with fever, rash and upper respiratory symptoms of major clinical and public health concern (such as measles and rubella). 14 …”

Section: Discussionmentioning

confidence: 99%

Clinical management and impact of scarlet fever in the modern era: findings from a cross-sectional study of cases in London, 2018–2019

et al. 2021

View full text Add to dashboard Cite

ObjectivesIn response to increasing incidence of scarlet fever and wider outbreaks of group A streptococcal infections in London, we aimed to characterise the epidemiology, symptoms, management and consequences of scarlet fever, and to identify factors associated with delayed diagnosis.Design and settingCross-sectional community-based study of children with scarlet fever notified to London’s three Health Protection Teams, 2018–2019.ParticipantsFrom 2575 directly invited notified cases plus invitations via parental networks at 410 schools/nurseries with notified outbreaks of confirmed/probable scarlet fever, we received 477 responses (19% of those directly invited), of which 412 met the case definition. Median age was 4 years (range <1 to 16), 48% were female, and 70% were of white ethnicity.Outcome measuresPreplanned measures included quantitative description of case demographics, symptoms, care-seeking, and clinical, social, and economic impact on cases and households. After survey completion, secondary analyses of factors associated with delayed diagnosis (by logistic regression) and consequences of delayed diagnosis (by Cox’s regression), and qualitative analysis of free text comments were added.ResultsRash was reported for 89% of cases, but followed onset of other symptoms for 71%, with a median 1-day delay. Pattern of onset varied with age: sore throat was more common at onset among children 5 years and older (OR3.1, 95% CI 1.9 to 5.0). At first consultation, for 28%, scarlet fever was not considered: in these cases, symptoms were frequently attributed to viral infection (60%, 64/106). Delay in diagnosis beyond first consultation occurred more frequently among children aged 5+ who presented with sore throat (OR 2.8 vs 5+without sore throat; 95% CI 1.3 to 5.8). Cases with delayed diagnosis took, on average, 1 day longer to return to baseline activities.ConclusionsScarlet fever may be initially overlooked, especially among older children presenting with sore throat. Raising awareness among carers and practitioners may aid identification and timely treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical management and impact of scarlet fever in the modern era: findings from a cross-sectional study of cases in London, 2018–2019

et al. 2021

View full text Add to dashboard Cite

show abstract

“…In conclusion, this challenging and protracted measles outbreak in West Midlands was resolved through effective work done through multi-agency engagement. Several areas for improvement were identified following the outbreak [20]. These include: improving the identification and communication with hard-to-reach, under-vaccinated local communities; clarifying roles & responsibilities in response teams; increasing awareness amongst GPs of measles guidance, case management and IPC procedures in healthcare settings [21], and improving the availability of vaccine coverage data in sub-groups of the population to allow for targeted public health action in responding to and preventing future outbreaks.…”

Section: Discussionmentioning

confidence: 99%

A large outbreak of measles in the West Midlands, England, 2017–2018: descriptive epidemiology, control measures and lessons learnt

Mulchandani

Sibal

et al. 2021

Epidemiol. Infect.

View full text Add to dashboard Cite

In November 2017, eight confirmed measles cases were reported to Public Health England from a hospital in the West Midlands. A multidisciplinary incident management team (IMT) was established to determine the extent of the problem and coordinate an outbreak response. Between 01 November 2017 and 04 June 2018, a total of 116 confirmed and 21 likely measles cases were linked to this outbreak; just under half (43%) were aged over 15 years of age. 55 of the confirmed cases were hospitalised (48%) and no deaths were reported. At the start of the outbreak, cases were mostly individuals of Romanian origin; the outbreak subsequently spread to the wider population. Over the 8-month response, the IMT conducted the following control measures: extensive contact tracing, immediate provision of post-exposure prophylaxis, community engagement amongst specific high-risk groups, MMR awareness raising including catch-up campaigns and enhanced vaccination services at selected GP surgeries. Key challenges to the effective control measures included: language difficulties limiting community engagement; delays in diagnosis, notification and appropriate isolation of cases; limited resources for contact tracing across multiple high-risk settings (including GPs and hospitals) and lack of timely data on vaccine coverage in sub-groups of the population to guide public health action. Key results A large and challenging outbreak of measles in the West Midlands region of England occurred between November 2017 and June 2018, with 116 confirmed and 21 likely measles cases. Key challenges to effective control were community engagement in under-vaccinated populations, delays in diagnosis, notification and appropriate isolation of cases and lack of timely data on vaccine coverage in sub-groups of the population. Strong local and national oversight, co-ordination, and communication between multiagency stakeholders were essential in controlling the outbreak.

show abstract

“…The subcohorts with subjects younger than 20 years of age included only individuals who were born after the MMR vaccine became routine in Brazil and were therefore likely to have been seroconverted only after immunization rather than natural infection. Because of the lack of previous studies on seroconversion after natural infection or immunization and of studies with data organized by age, which would be required to estimate the expected prevalence rate of antibodies, we considered the known population (10,815 individuals in the study area) and a tolerable sample error of 4% to establish the minimum sample number for this study.…”

Section: Discussionmentioning

confidence: 99%

“…Its basic reproduction number (R-naught, or R0) is from 12 to 18, which means that each measles-infected person may spread the virus to 12 to 18 other individuals in a susceptible population 9 . To effective measles control, programs should achieve 95% coverage with two doses of the vaccine and promptly identify suspected cases in order to contain outbreaks 10 .…”

mentioning

confidence: 99%

Prevalence of Measles Antibodies in São José do Rio Preto, São Paulo, Brazil: A serological survey model

Estofolete¹,

Milhim²,

França³

et al. 2020

Sci Rep

View full text Add to dashboard Cite

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.

show abstract

Measles: is it still a threat?

Cited by 7 publications

References 0 publications

Clinical management and impact of scarlet fever in the modern era: findings from a cross-sectional study of cases in London, 2018–2019

Clinical management and impact of scarlet fever in the modern era: findings from a cross-sectional study of cases in London, 2018–2019

A large outbreak of measles in the West Midlands, England, 2017–2018: descriptive epidemiology, control measures and lessons learnt

Prevalence of Measles Antibodies in São José do Rio Preto, São Paulo, Brazil: A serological survey model

Contact Info

Product

Resources

About