Summer music and arts festivals as hot spots for measles transmission: experience from England and Wales, June to October 2016

Waroux, Olivier le Polain de; Saliba, Vanessa; Cottrell, Simon; Perry, Malorie; Bukasa, Antoaneta; Ramsay, Mary; Brown, Kevin E.; Amirthalingam, Gayatri

doi:10.2807/1560-7917.es.2016.21.44.30390

Cited by 17 publications

(15 citation statements)

References 4 publications

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“…The use of triangulation also enabled us to determine that, despite good coverage overall, there was a high proportion of susceptible individuals among those born between 1998 and 2004 (who were aged between 15 and 22 years in 2019), even after adjusting for coverage under-ascertainment. This finding was consistent with disease incidence data, which showed that most cases and outbreaks in recent years occurred in this age group 24 . In England, where vaccine coverage is assessed using various methods, our synthesis of data from two different vaccine coverage sources led to insights into the vaccination status of the population.…”

Section: Discussionsupporting

confidence: 87%

Triangulation of measles vaccination data in the United Kingdom of Great Britain and Northern Ireland

Edelstein

White

Bukasa

et al. 2019

Bull. World Health Organ.

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ObjectiveTo illustrate how data triangulation involving routine data sources can optimize data usage and provide insights into vaccine programme effectiveness by considering measles vaccination and disease incidence data in England.MethodsWe obtained data on measles, mumps and rubella (MMR) vaccine coverage in birth cohorts from 1985 to 2016 from child health records and adjusted for under-ascertainment and catch-up campaigns. We assumed that the population had no natural immunity and that vaccine effectiveness was 95% for one dose and 99.75% for two doses. Vaccinations done outside the routine schedule and in people who entered England after the age of immunization were identified from primary care records. Measles susceptibility was defined as the percentage of individuals who were not immune despite all vaccination activities. We triangulated measles susceptibility and incidence data.FindingsMedian susceptibility was 4.6% (range: 1.2–9.2). Among cohorts eligible for two MMR vaccine doses, those born between 1998 and 2004 were most susceptible. Measles incidence was highest in these cohorts. Data from primary care and child health records were comparable for cohorts after 2000, suggesting that little supplementary vaccination took place. For cohorts before 2000, primary care data quality was insufficient for accurately estimating coverage.ConclusionTriangulating routine data on measles vaccination coverage and disease surveillance provided new insights into population immunity and helped identify vulnerable groups, which was useful for prioritizing public health actions to close gaps in immunity. This approach could be applied in any country that routinely records vaccine coverage and disease incidence.

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Section: Discussionsupporting

confidence: 87%

Triangulation of measles vaccination data in the United Kingdom of Great Britain and Northern Ireland

Edelstein

White

Bukasa

et al. 2019

Bull. World Health Organ.

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“…Indeed, at the time of writing (August 2016), there are already cases of measles in teenagers and young people linked to music festivals in the UK where this age group is predominant and mixing patterns are intense. 25 26 Moreover, children from this age group who go on to enter employment in educational or healthcare settings may mix with highly vulnerable infants too young to be vaccinated.…”

Section: Discussionmentioning

confidence: 99%

Measles outbreaks in the UK, is it when and where, rather than if? A database cohort study of childhood population susceptibility in Liverpool, UK

et al. 2017

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ObjectivesThere was a large outbreak of measles in Liverpool, UK, in 2012–2013, despite measles, mumps and rubella (MMR) immunisation uptake rates that were higher than the national average. We estimated measles susceptibility of a cohort of children born in Liverpool between 1995 and 2012 to understand whether there was a change in susceptibility before and after the outbreak and to inform vaccination strategy.DesignRetrospective cohort study.SettingThe city of Liverpool, North West UK.ParticipantsAll children born in Liverpool (72 101) between 1995 and 2012 inclusive who were identified using the Child Health Information System (CHIS) and were still resident within Liverpool in 2014.Primary and secondary outcome measuresWe estimated cohort age-disaggregated and neighbourhood-disaggregated measles susceptibility according to WHO thresholds before and after the outbreak for children aged 1–17 years.ResultsSusceptibility to measles was above WHO elimination thresholds before and after the measles outbreak in the 10+ age group. The proportion of children susceptible before and after outbreak, respectively: age 1–4 years 15.0% before and 14.9% after; age 5–9 years 9.9% before and 7.7% after; age 10+ years 8.6% before and 8.5% after. Despite an intensive MMR immunisation catch-up campaign after the 2012–2013 measles outbreak, the overall proportion of children with no MMR remains high at 6.1% (4390/72 351). Across all age groups and before and after the outbreak, measles susceptibility was clustered by neighbourhood, with deprived areas having the greatest proportion of susceptible children.ConclusionsThe risk of sustained measles outbreaks remains, especially as large pools of susceptible older children will start leaving secondary education and continue to aggregate in higher education, employment and other community settings and institutions resulting in the potential for a propagated measles outbreak.

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“…Forty-two were not vaccinated. Nine cases were not fully vaccinated, or their immunization status was unknown [83].…”

Section: Others Religious Meetingsmentioning

confidence: 99%

Infectious Diseases and Mass Gatherings

Hoang

Gautret

2018

Curr Infect Dis Rep

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In the context of Hajj, one of the largest religious MGs at Mecca, Saudi Arabia, respiratory tract infections are the leading cause of infectious diseases in pilgrims with a prevalence of 50-93%. The most commonly acquired respiratory viruses were human rhinovirus, followed by human coronaviruses and influenza A virus, in decreasing order. Haemophilus influenzae, Staphylococcus aureus, and Streptococcus pneumoniae were the predominant bacteria. The prevalence of Hajj-related diarrhea ranged from 1.1 to 23.3% and etiologies included Salmonella spp., and Escherichia coli, with evidence of acquisition of antimicrobial-resistant bacteria. In other MGs such as Muslim, Christian, and Hindu religious events, sports events, and large-scale open-air festivals, outbreaks have been reported less frequently. The most common outbreaks at these events involved diseases preventable by vaccination, notably measles and influenza. Gastrointestinal infections caused by a variety of pathogens were also recorded. Because social distancing and contact avoidance are difficult measures to implement in the context of many MGs, individual preventive measures including vaccination, use of face mask, disposable handkerchief and hand hygiene may be recommended. Nevertheless, the effectiveness of these measures has been poorly investigated in the context of MGs.

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Summer music and arts festivals as hot spots for measles transmission: experience from England and Wales, June to October 2016

Cited by 17 publications

References 4 publications

Triangulation of measles vaccination data in the United Kingdom of Great Britain and Northern Ireland

Triangulation of measles vaccination data in the United Kingdom of Great Britain and Northern Ireland

Measles outbreaks in the UK, is it when and where, rather than if? A database cohort study of childhood population susceptibility in Liverpool, UK

Infectious Diseases and Mass Gatherings

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