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Abstract

Luxembourg was among the first countries in the World Health Organization (WHO) European Region documenting interruption of endemic measles transmission, but an increased incidence was registered in spring 2019. The outbreak started with an unvaccinated student who had been to a winter sports resort in a neighbouring country, where a measles outbreak was ongoing. Subsequently, 12 secondary and two tertiary cases were confirmed among students from the same school, relatives and healthcare workers, as well as six probably unrelated cases. Only 11 cases initially fulfilled the WHO definition for suspected measles cases. Fourteen of 20 cases with information on country of birth and the majority of unvaccinated cases (10/12) were born outside of Luxembourg. Measles IgM antibody results were available for 16 of the confirmed cases, and five of the eight IgM negative cases had been vaccinated at least once. All 21 cases were PCR positive, but for three previously vaccinated cases with multiple specimen types, at least one of these samples was negative. The outbreak highlighted diagnostic challenges from clinical and laboratory perspectives in a measles elimination setting and showed that people born abroad and commuters may represent important pockets of susceptible people in Luxembourg.

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/content/10.2807/1560-7917.ES.2021.26.22.2000012
2021-06-03
2024-11-23
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2021.26.22.2000012
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References

  1. Centers for Disease Control and Prevention (CDC). Measles. In: Epidemiology and Prevention of Vaccine-Preventable Diseases. Hamborsky J, Kroger A, Wolfe S, eds. 13th ed. Washington DC: Public Health Foundation; Apr 2015. Available from: https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/table-of-contents.pdf
  2. Zimmerman LA, Muscat M, Singh S, Ben Mamou M, Jankovic D, Datta S, et al. Progress Toward Measles Elimination - European Region, 2009-2018. MMWR Morb Mortal Wkly Rep. 2019;68(17):396-401.  https://doi.org/10.15585/mmwr.mm6817a4  PMID: 31048675 
  3. World Health Organization (WHO). WHO vaccine-preventable diseases: monitoring system. 2019 global summary. Luxembourg. Geneva: WHO. [Accessed: 23 Dec 2019]. Available from: https://apps.who.int/immunization_monitoring/globalsummary/countries?countrycriteria%5Bcountry%5D%5B%5D=LUX&commit=OK
  4. World Health Organization Regional Office for Europe (WHO/Europe). Second meeting of the European Regional Verification Commission for Measles and Rubella Elimination: summary report. Copenhagen: WHO/Europe; 2014. Available from: https://apps.who.int/iris/handle/10665/136410
  5. World Health Organization Regional Office for Europe (WHO/Europe). 4th Meeting of the European Regional Verification Commission for Measles and Rubella Elimination (RVC) 2016. Copenhagen: WHO; 2016. Available from: http://www.euro.who.int/__data/assets/pdf_file/0011/304958/4th-RVC-meeting-report.pdf?ua=1
  6. European Centre for Disease Prevention and Control (ECDC). Monthly measles and rubella monitoring report - November 2019. Stockholm: ECDC; 2019. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/measles-monthly-report november-2019.pdf
  7. Brottet E, Ronnaux-Baron AS, Grangeret N, Deher M, Andrivot B, Fougere E. Measles outbreak at the Val Thorens ski station, France, 2019. Eur J Public Health. 2019;29(Supplement_4):29.
  8. World Health Organization Regional Office for Europe (WHO/Europe). Guidelines for measles and rubella outbreak investigation and response in the WHO European Region 2013. Copenhagen: WHO/Europe; 2013. Available from: https://www.euro.who.int/en/health-topics/communicable-diseases/measles-and-rubella/publications/2013/guidelines-for-measles-and-rubella-outbreak-investigation-and-response-in-the-who-european-region
  9. World Health Organization (WHO). Measles. Vaccine-Preventable Diseases Surveillance Standards. Geneva: WHO; 2018. Available from: https://www.who.int/immunization/monitoring_surveillance/burden/vpd/WHO_SurveillanceVaccinePreventable_11_Measles_R2.pdf?ua=1
  10. Bankamp B, Byrd-Leotis LA, Lopareva EN, Woo GK, Liu C, Jee Y, et al. Improving molecular tools for global surveillance of measles virus. J Clin Virol. 2013;58(1):176-82.  https://doi.org/10.1016/j.jcv.2013.05.018  PMID: 23806666 
  11. Hummel KB, Lowe L, Bellini WJ, Rota PA. Development of quantitative gene-specific real-time RT-PCR assays for the detection of measles virus in clinical specimens. J Virol Methods. 2006;132(1-2):166-73.  https://doi.org/10.1016/j.jviromet.2005.10.006  PMID: 16274752 
  12. Kremer JR, Nguyen GH, Shulga SV, Nguyen PH, Nguyen UT, Tikhonova NT, et al. Genotyping of recent measles virus strains from Russia and Vietnam by nucleotide-specific multiplex PCR. J Med Virol. 2007;79(7):987-94.  https://doi.org/10.1002/jmv.20827  PMID: 17516527 
  13. Measles virus nomenclature update: 2012. Wkly Epidemiol Rec. 2012;87(9):73-81. PMID: 22462199 
  14. The role of extended and whole genome sequencing for tracking transmission of measles and rubella viruses: report from the Global Measles and Rubella Laboratory Network meeting, 2017. Wkly Epidemiol Rec. 2018;93(6):55-9. PMID: 29424220 
  15. Kumar S, Stecher G, Tamura K. MEGA7: Molecular Evolutionary Genetics Analysis Version 7.0 for Bigger Datasets. Mol Biol Evol. 2016;33(7):1870-4.  https://doi.org/10.1093/molbev/msw054  PMID: 27004904 
  16. Rota PA, Brown K, Mankertz A, Santibanez S, Shulga S, Muller CP, et al. Global distribution of measles genotypes and measles molecular epidemiology. J Infect Dis. 2011;204(Suppl 1):S514-23.  https://doi.org/10.1093/infdis/jir118  PMID: 21666208 
  17. World Health Organization (WHO). Measles-containing vaccine. Reported estimates of MCV1 coverage. Geneva: WHO. [Accessed: 23 Dec 2019]. Available from: http://apps.who.int/immunization_monitoring/globalsummary/timeseries/tscoveragemcv1.html
  18. Toussaint T. La barre des 200.000 frontaliers dépassée au Luxembourg 2019. [The bar of 200,000 cross-border workers exceeded in Luxembourg]. Luxembourg: RTL Luxembourg; 2019. French. Available from: https://5minutes.rtl.lu/actu/luxembourg/a/1398124.html
  19. Follin P, Dotevall L, Jertborn M, Khalid Y, Liljeqvist JA, Muntz S, et al. Effective control measures limited measles outbreak after extensive nosocomial exposures in January-February 2008 in Gothenburg, Sweden. Euro Surveill. 2008;13(30):18937.  https://doi.org/10.2807/ese.13.30.18937-en  PMID: 18761910 
  20. Kantele A, Valtonen K, Davidkin I, Martelius T, Võželevskaja N, Skogberg K, et al. Travellers returning with measles from Thailand to Finland, April 2012: infection control measures. Euro Surveill. 2012;17(22):20184.  https://doi.org/10.2807/ese.17.22.20184-en  PMID: 22687913 
  21. Augusto GF, Silva A, Pereira N, Fernandes T, Leça A, Valente P, et al. Report of simultaneous measles outbreaks in two different health regions in Portugal, February to May 2017: lessons learnt and upcoming challenges. Euro Surveill. 2019;24(3).  https://doi.org/10.2807/1560-7917.ES.2019.24.3.1800026  PMID: 30670145 
  22. Botelho-Nevers E, Cassir N, Minodier P, Laporte R, Gautret P, Badiaga S, et al. Measles among healthcare workers: a potential for nosocomial outbreaks. Euro Surveill. 2011;16(2):19764.  https://doi.org/10.2807/ese.16.02.19764-en  PMID: 21251488 
  23. Cherry JD, Zahn M. Clinical Characteristics of Measles in Previously Vaccinated and Unvaccinated Patients in California. Clin Infect Dis. 2018;67(9):1315-9.  https://doi.org/10.1093/cid/ciy286  PMID: 29878209 
  24. Sundell N, Dotevall L, Sansone M, Andersson M, Lindh M, Wahlberg T, et al. Measles outbreak in Gothenburg urban area, Sweden, 2017 to 2018: low viral load in breakthrough infections. Euro Surveill. 2019;24(17).  https://doi.org/10.2807/1560-7917.ES.2019.24.17.1900114  PMID: 31039835 
  25. Augusto GF, Cruz D, Silva A, Pereira N, Aguiar B, Leça A, et al. Challenging measles case definition: three measles outbreaks in three Health Regions of Portugal, February to April 2018. Euro Surveill. 2018;23(28).  https://doi.org/10.2807/1560-7917.ES.2018.23.28.1800328  PMID: 30017024 
  26. 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).  https://doi.org/10.2807/1560-7917.ES.2018.23.20.18-00224  PMID: 29790461 
  27. Hübschen JM, Bork SM, Brown KE, Mankertz A, Santibanez S, Ben Mamou M, et al. Challenges of measles and rubella laboratory diagnostic in the era of elimination. Clin Microbiol Infect. 2017;23(8):511-5.  https://doi.org/10.1016/j.cmi.2017.04.009  PMID: 28412379 
  28. Santibanez S, Prosenc K, Lohr D, Pfaff G, Jordan Markocic O, Mankertz A. Measles virus spread initiated at international mass gatherings in Europe, 2011. Euro Surveill. 2014;19(35):20891.  https://doi.org/10.2807/1560-7917.ES2014.19.35.20891  PMID: 25210982 
  29. Harvala H, Wiman Å, Wallensten A, Zakikhany K, Englund H, Brytting M. Role of Sequencing the Measles Virus Hemagglutinin Gene and Hypervariable Region in the Measles Outbreak Investigations in Sweden During 2013-2014. J Infect Dis. 2016;213(4):592-9.  https://doi.org/10.1093/infdis/jiv434  PMID: 26347574 
  30. Penedos AR, Myers R, Hadef B, Aladin F, Brown KE. Assessment of the Utility of Whole Genome Sequencing of Measles Virus in the Characterisation of Outbreaks. PLoS One. 2015;10(11):e0143081.  https://doi.org/10.1371/journal.pone.0143081  PMID: 26569100 
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