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Challenging measles case definition: three measles outbreaks in three Health Regions of Portugal, February to April 2018
- Gonçalo Figueiredo Augusto1 , Diogo Cruz1 , Andreia Silva1 , Natália Pereira1 , Bárbara Aguiar1 , Ana Leça1 , Elisabete Serrada1 , Paula Valente1 , Teresa Fernandes1 , Fernando Guerra1 , Paula Palminha2 , Elsa Vinagre2 , Sílvia Lopo2 , Rita Cordeiro2 , Emma Sáez-López2,3 , Maria Neto4 , Paulo Jorge Nogueira1 , Graça Freitas1
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View Affiliations Hide AffiliationsAffiliations: 1 Directorate-General of Health, Lisbon, Portugal 2 National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal 3 European Public Health Microbiology Training (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden 4 North Region Health Administration (SNS), Porto, PortugalPaulo Nogueirapaulo.nogueira dgs.min-saude.pt
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Citation style for this article: Augusto Gonçalo Figueiredo, Cruz Diogo, Silva Andreia, Pereira Natália, Aguiar Bárbara, Leça Ana, Serrada Elisabete, Valente Paula, Fernandes Teresa, Guerra Fernando, Palminha Paula, Vinagre Elsa, Lopo Sílvia, Cordeiro Rita, Sáez-López Emma, Neto Maria, Nogueira Paulo Jorge, Freitas Graça. Challenging measles case definition: three measles outbreaks in three Health Regions of Portugal, February to April 2018. Euro Surveill. 2018;23(28):pii=1800328. https://doi.org/10.2807/1560-7917.ES.2018.23.28.1800328 Received: 20 Jun 2018; Accepted: 12 Jul 2018
Abstract
We report three simultaneous measles outbreaks with 112 confirmed cases in three Health Regions of Portugal, from February to April 2018. The mean age of cases was 30 years, 79% worked in a healthcare setting and 87% were vaccinated. Genotype B3 was identified in 84 cases from the three outbreaks. Primary cases in each outbreak were imported. Several cases presented with modified measles, highlighting the importance of rethinking the measles case definition for vaccinated cases.
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References
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European Commission. Commission Implementing Decision of 8 August 2012 amending Decision 2002/253/EC laying down case definitions for reporting communicable diseases to the Community network under Decision No 2119/98/EC of the European Parliament and of the Council. Luxembourg: Publications Office of the European Union. L262 Sep 27, 2012. Available from: http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=OJ%3AL%3A2012%3A262%3ATOC
-
Republic of Portugal. Despacho N.° 15385-A/2016 [Dispatch No. 15385-A/2016]. In Diário da República [Government Gazette], Serie II; 21 December 2016. [Portugese]. Available from: https://dre.pt/home/-/dre/105574339/details/maximized?serie=II&dreId=105574337
-
World Health Organization (WHO). Eliminating Measles and rubella - Framework for the verification process in the WHO European Region 2014. Copenhagen: WHO; 2014. Available from: http://www.euro.who.int/__data/assets/pdf_file/0009/247356/Eliminating-measles-and-rubella-Framework-for-the-verification-process-in-the-WHO-European-Region.pdf
-
National Institute of Health Dr Ricardo Jorge (INSA). Inquérito Serológico Nacional 2015-16 [National Serological Survey 2015-16]. Lisbon: INSA; 2017. Available from: http://repositorio.insa.pt/handle/10400.18/5401
-
French Public Health Agency. Rougeole: Bulletin épidémiologique Semaine 19, 16/05/2018 [Measles: Epidemiological Bulletin Week 19, 16/05/2018]. Paris: Public Health Agency; 2018. [French]: available from: http://invs.santepubliquefrance.fr/content/download/146828/534556/version/18/file/Bulletin_rougeole_S19.pdf
-
Directorate-General of Health (DGS). Programa Nacional para a Eliminação do Sarampo [National Measles Elimination Programme]. Lisbon: DGS; March 2013. Available from: https://www.dgs.pt/documentos-e-publicacoes/programa-nacional-de-eliminacao-do-sarampo-jpg.aspx
-
Sá Machado R, Perez Duque M, Almeida S, Cruz I, Sottomayor A, Almeida I, et al. Measles outbreak in a tertiary level hospital, Porto, Portugal, 2018: challenges in the post-elimination era. Euro Surveill. 2018;23(20):18-00224. https://doi.org/10.2807/1560-7917.ES.2018.23.20.18-00224 PMID: 29790461
-
Directorate-General of Health (DGS). Sarampo – Procedimentos em unidades de saúde – Programa Nacional Eliminação Sarampo [Measles – Procedures in Healthcare Units – National Measles elimination Programme. Informations to Schools]. Lisbon: DGS; March 2018. Normative Document No. 004/2017 updated on 16 March 2018. [Portuguese]. Available from: https://www.dgs.pt/paginas-de-sistema/saude-de-a-a-z/sarampo1/normas-e-orientacoes.aspx
-
Directorate-General of Health (DGS). Sarampo: Controlo de Infeção em unidades de saúde [Measles: Infection Control in Healthcare Units]. Lisbon: DGS; March 2018. Guideline No. 001/2018. [Portuguese]. Available from: https://www.dgs.pt/paginas-de-sistema/saude-de-a-a-z/sarampo1/normas-e-orientacoes.aspx
-
World Health Organization (WHO). International Health Regulations (2005) 3rd ed. Geneva: WHO; 2005. Available from: http://www.who.int/ihr/publications/9789241596664/en/
-
George F, Valente J, Augusto GF, Silva AJ, Pereira N, Fernandes T, et al. Measles outbreak after 12 years without endemic transmission, Portugal, February to May 2017. Euro Surveill. 2017;22(23):30548. https://doi.org/10.2807/1560-7917.ES.2017.22.23.30548 PMID: 28661392
-
Directorate-General of Health (DGS). Sarampo - Declaração de fim de surto [Measles - Outbreak Statement]. Lisbon: DGS; 2018. Available from: https://www.dgs.pt/a-direccao-geral-da-saude/comunicados-e-despachos-do-director-geral/sarampo-declaracao-de-fim-de-surto-pdf.aspx
-
Christenson B, Böttiger M. Measles antibody: comparison of long-term vaccination titres, early vaccination titres and naturally acquired immunity to and booster effects on the measles virus. Vaccine. 1994;12(2):129-33. https://doi.org/10.1016/0264-410X(94)90049-3 PMID: 8147093
-
Directorate-General of Health (DGS). Boletim do Programa Nacional de Vacinação [National Immunisation Programme Bulletin]. Lisbon: DGS; May 2018. [Portuguese]. Available from: https://www.dgs.pt/documentos-e-publicacoes/avaliacao-do-programa-nacional-de-vacinacao-2017-pdf.aspx
-
Porretta A, Quattrone F, Aquino F, Pieve G, Bruni B, Gemignani G, et al. A nosocomial measles outbreak in Italy, February-April 2017. Euro Surveill. 2017;22(33):30597. https://doi.org/10.2807/1560-7917.ES.2017.22.33.30597 PMID: 28840827
-
Komitova R, Kunchev A, Mihneva Z, Marinova L. Nosocomial transmission of measles among healthcare workers, Bulgaria, 2010. Euro Surveill. 2011;16(15):19842. https://doi.org/10.2807/ese.16.15.19842-en PMID: 21507322
-
Amendola A, Bianchi S, Frati ER, Ciceri G, Faccini M, Senatore S, et al. Ongoing large measles outbreak with nosocomial transmission in Milan, northern Italy, March-August 2017. Euro Surveill. 2017;22(33):30596. https://doi.org/10.2807/1560-7917.ES.2017.22.33.30596 PMID: 28840825
-
Hahné SJ, Nic Lochlainn LM, van Burgel ND, Kerkhof J, Sane J, Yap KB, et al. Measles Outbreak Among Previously Immunized Healthcare Workers, the Netherlands, 2014. J Infect Dis. 2016;214(12):1980-6. https://doi.org/10.1093/infdis/jiw480 PMID: 27923955
-
Kang HJ, Han YW, Kim SJ, Kim YJ, Kim AR, Kim JA, et al. An increasing, potentially measles-susceptible population over time after vaccination in Korea. Vaccine. 2017;35(33):4126-32. https://doi.org/10.1016/j.vaccine.2017.06.058 PMID: 28669617
-
Rota JS, Hickman CJ, Sowers SB, Rota PA, Mercader S, Bellini WJ. Two case studies of modified measles in vaccinated physicians exposed to primary measles cases: high risk of infection but low risk of transmission. J Infect Dis. 2011;204(Suppl 1):S559-63. https://doi.org/10.1093/infdis/jir098 PMID: 21666213
-
Lee NY, Lee HC, Chang CM, Wu CJ, Ko NY, Ko WC. Modified measles in a healthcare worker after return from travel. Infect Control Hosp Epidemiol. 2008;29(4):380-1. https://doi.org/10.1086/529031 PMID: 18462155
-
World Health Organization (WHO). Manual for the laboratory diagnosis of measles and rubella virus infection. (2nd Ed). Geneva: WHO; 2007. Available from: http://www.who.int/ihr/elibrary/manual_diagn_lab_mea_rub_en.pdf
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