Abstract:The United Kingdom achieved interrupted endemic measles transmission for 36 months in 2016. Despite this, ongoing challenges from sporadic measles cases typically imported from abroad remain. We summarise a B3 measles genotype outbreak in south-east Wales occurring between May and September 2017, linked with other European outbreaks, and lessons learnt. Seventeen confirmed cases and one probable case occurred principally in education and healthcare-settings. Six confirmed cases attended healthcare settings whe… Show more
“…There was one case of measles-associated pneumonia. The typical hospitalisation rate for measles cases is one in four [14], and hospitalisation rates for other outbreaks in Europe ranged from 15.7% to 47% [15][16][17][18]. The high hospitalisation rate in this outbreak (11/15 cases) might reflect the need for isolation, rather than severe illness.…”
In May 2018, measles was introduced in the Dubrovnik region by an adult who recently travelled to Kosovo*. Control measures and an outbreak investigation were implemented: 15 epidemiologically-linked cases met the outbreak case definition of a visitor/resident of Dubrovnik-Neretva County with laboratory-confirmed measles and symptom onset beginning on May 19. New cases were identified through hospitals and primary care physicians. Throat swabs, urine and/or serum samples were collected from outbreak cases. RT-PCR detection of viral RNA and IgM/IgG was used to confirm infection. The median age of cases was 33 years, with one 8 month-old infant. Vaccination status was unknown for 9 cases, three were unvaccinated, one case had history of one dose and two cases reported receiving two doses of measles-containing vaccine. There were 11 hospitalisations and one person developed pneumonia. Control teams undertook an extensive search of contacts and implemented a range of control measures. Despite the outbreak occurring at the beginning of the summer tourism season, it was contained and did not spread to neighbouring regions. With continuing measles transmission in Europe, even small outbreaks create a burden on the health system in countries which have eliminated measles, and illustrate the importance of maintaining high immunisation coverage.
“…There was one case of measles-associated pneumonia. The typical hospitalisation rate for measles cases is one in four [14], and hospitalisation rates for other outbreaks in Europe ranged from 15.7% to 47% [15][16][17][18]. The high hospitalisation rate in this outbreak (11/15 cases) might reflect the need for isolation, rather than severe illness.…”
In May 2018, measles was introduced in the Dubrovnik region by an adult who recently travelled to Kosovo*. Control measures and an outbreak investigation were implemented: 15 epidemiologically-linked cases met the outbreak case definition of a visitor/resident of Dubrovnik-Neretva County with laboratory-confirmed measles and symptom onset beginning on May 19. New cases were identified through hospitals and primary care physicians. Throat swabs, urine and/or serum samples were collected from outbreak cases. RT-PCR detection of viral RNA and IgM/IgG was used to confirm infection. The median age of cases was 33 years, with one 8 month-old infant. Vaccination status was unknown for 9 cases, three were unvaccinated, one case had history of one dose and two cases reported receiving two doses of measles-containing vaccine. There were 11 hospitalisations and one person developed pneumonia. Control teams undertook an extensive search of contacts and implemented a range of control measures. Despite the outbreak occurring at the beginning of the summer tourism season, it was contained and did not spread to neighbouring regions. With continuing measles transmission in Europe, even small outbreaks create a burden on the health system in countries which have eliminated measles, and illustrate the importance of maintaining high immunisation coverage.
“…The lack of a single, national database of occupational health records created difficulties in coordinating a national response to nosocomial transmission. Infected healthcare workers may have contributed to nosocomial spread, similar to other measles outbreaks in Europe [ 26 , 27 ].…”
Endemic measles transmission was interrupted for the first time in Ireland in 2015. In May 2016, a case of measles was confirmed in an adult who had travelled from Hungary to Ireland (index case). Cases subsequently arose in five of the eight public health regions around the country. There were 40 confirmed cases in Ireland between April and September 2016. All sequenced cases were genotype B3. Vaccination status was known for 34 cases, of whom 31 were unvaccinated. Median age was 8 years (range: 3 months to 40 years). Ten cases were nosocomial, and three cases were infected on separate international flights. One linked case occurred in a resident of Slovenia. Nineteen cases were hospitalised; median duration of hospitalisation was 5 days (range: 2–8 days). The primary case was a child who travelled from Romania to Ireland via Budapest, and infected the index adult case on the same flight. This was the first reported outbreak of measles genotype B3 in Ireland. This outbreak demonstrated that Ireland remains at risk of measles outbreaks due to persistent suboptimal vaccination rates.
“…Під час спалаху кору у Великобританії у 2017 р. середній вік пацієнтів був 11,5 року (від 11 місяців до 29 років). Інкубаційний період кору становив 7-21 добу [15]. Гіперлейкоцитоз (> 10,0 · 10 9 /л) - у 9 %, лейкопенія (< 4 · 10 9 /л)у 16 %, лімфопенія (< 1 · 10 9 /л) -у 87 %, тромбоцитоз (> 400 · 10 9 /л) - 46 %, гіпербілірубінемія (> 37 МО/мл)у 4 % [18].…”
Проведено огляд літератури стосовно особливостей клінічних проявів, перебігу кору за останні роки під час епідемії у країнах Європи, а також подано результати особистих досліджень щодо хворих, які лікувались у лікувальних закладах України.
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