Control of a nosocomial measles outbreak among previously vaccinated adults in a population with high vaccine coverage: Korea, 2019

Song, Kyunghyun; Lee, Ju Mi; Lee, Eun Ju; Lee, Bo Ram; Choi, Ji Young; Yun, Jeong‐Ho; Lee, Se Na; Jang, Mi; Kim, Han Wool; Kim, Han-Sung; Moon, Song Mi; Kim, Yong Kyun

doi:10.1007/s10096-021-04390-4

Cited by 9 publications

(5 citation statements)

References 41 publications

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“…Interestingly, in Korea, 2019, there were 26 measles case-patients, aged 18–28 years. Twenty-five of them had previously received the MMR vaccine (12/26, 46% (two doses); 13/26, 50% (one dose)), and 16 (62%) had positive results of measles IgG prior to measles diagnosis [ 39 ]. Altogether, these are important information in the light of the previously mentioned outbreak among adults in Dubrovnik-Neretva County [ 4 ], suggesting that the lack of previous immunization, together with a decrease in seropositivity, present a risk for future epidemic outbreaks.…”

Section: Discussionmentioning

confidence: 99%

Measles Vaccination and Outbreaks in Croatia from 2001 to 2019; A Comparative Study to Other European Countries

Drenjančević-Perić

Samardžić

Stupin

et al. 2022

IJERPH

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Due to the current burden of COVID-19 on public health institutions, increased migration and seasonal touristic traveling, there is an increased risk of epidemic outbreaks of measles, mumps and rubella (MMR). The aim of the present study was to analyze the epidemiological data on MMR immunization coverage and the number of measles cases in 2001–2019 in Croatia and a number of European countries. Results revealed a decreasing trend in vaccination in 2001–2019 throughout Europe. However, Croatia and Hungary still have the highest primary and revaccination coverage, compared to other analyzed countries. The highest number of measles cases was in 2017 in Romania. There was no significant correlation between the percentage of primary vaccination and the number of measles cases (r = −0.0528, p = 0.672), but there was a significant negative correlation between the percentage of revaccination and the number of measles cases (r = −0.445, p < 0.0001). In conclusion, the results of the present study emphasize the necessity to perform a full protocol of vaccination to reach appropriate protection from potential epidemic outbreaks. Furthermore, in the light of present migrations, documenting the migrants’ flow and facilitating vaccination as needed is of utmost importance to prevent future epidemics.

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Section: Discussionmentioning

confidence: 99%

Measles Vaccination and Outbreaks in Croatia from 2001 to 2019; A Comparative Study to Other European Countries

Drenjančević-Perić

Samardžić

Stupin

et al. 2022

IJERPH

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“…In addition, it is important that isolation protocols and infection control guidelines be instituted in hospitals, to minimise nosocomial spread of infection. Good practices used in other countries, such as pre-screening over the phone [ 35 ], screening in the prodromal phase [ 45 ] or isolation in different rooms or even at home, can be adopted. Some of these practices have been successfully implemented in Spain during the COVID-19 pandemic, demonstrating that these preventive measures are feasible.…”

Section: Discussionmentioning

confidence: 99%

An interregional measles outbreak in Spain with nosocomial transmission, November 2017 to July 2018

et al. 2023

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Given sustained high vaccination coverage and enhanced surveillance for measles, Spain has been free of endemic measles transmission since 2014, achieving elimination certification from the World Health Organization in 2017. In November 2017, measles was introduced through an imported case travelling to the Valencian Community, causing an interregional outbreak. Here, we describe the outbreak using data reported to the national epidemiological surveillance network. The outbreak involved 154 cases (67 males, 87 females) notified in four regions; 148 were laboratory-confirmed and six epidemiologically linked. Most cases were adults aged 30–39 (n = 62, 40.3%) years. Sixty-two cases were hospitalised (40.3%) and 35 presented complications (22.7%). Two thirds of the cases (n = 102) were unvaccinated including 11 infants (≤ 1 year) not yet eligible for vaccination. The main route of transmission was nosocomial; at least six healthcare facilities and 41 healthcare workers and support personnel were affected. Sequencing of the viral nucleoprotein C-terminus (N450) identified genotype B3, belonging to the circulating MVs/Dublin.IRL/8.16-variant. Control measures were implemented, and the outbreak was contained in July 2018. The outbreak highlighted that raising awareness about measles and improving the vaccination coverage in under-vaccinated subgroups and personnel of healthcare facilities are key measures for prevention of future outbreaks.

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“…However, waning vaccine-induced immunity over time is associated with increased measles seronegativity and susceptibility [4], and there have been reports of measles cases who received 2 doses of MMR but had negative measles IgGs [35,36] or measles outbreaks among individuals with documented receipt of prior two doses of MMR vaccine [37,38]. In addition, the rates of seronegative HCWs despite the documented receipt of prior 2-dose vaccination was up to 15% in a recent study with a relevant sample size [17,39], and the rate of measles-susceptibility was substantially high in young HCWs in the post-elimination setting [8,18,19,[40][41][42]. Therefore, we advocate for a policy of routine serologic screening, followed by one or two booster doses of the MMR vaccine for young, seronegative HCWs, especially for those that work in departments with a high risk of exposure or immunocompromised patients.…”

Section: Discussionmentioning

confidence: 99%

“…This study was conducted at Hallym University Sacred Heart Hospital, an 829-bed, a university-affiliated hospital in Anyang, Korea. At this hospital, a nosocomial measles outbreak occurred in 2019, and emergent serological testing was required for measles immunity verification for all HCWs, followed by one or two doses of the MMR vaccine for seronegative HCWs as infection control measures [19].…”

Section: Study Population and Clinical Data Collectionmentioning

confidence: 99%

Measles Virus Neutralizing Antibody Response and Durability Two Years after One or Two Doses of Measles–Mumps–Rubella Vaccine among Young Seronegative Healthcare Workers

Jang

Kim

et al. 2022

Vaccines

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Although there have been several studies regarding the immunogenicity of one or two booster doses of the measles–mumps–rubella (MMR) vaccine in measles-seronegative young adults, limited data are available about how long the immune response is sustained compared with natural infection. This study included seronegative healthcare workers (HCWs) (aged 21–38 years) who received one or two doses of the measles–mumps–rubella (MMR) vaccine and HCWs with laboratory-confirmed measles infection during an outbreak in 2019. We compared neutralizing antibody titers measured using the plaque reduction neutralization (PRN) test and measles-specific immunoglobulin G (IgG) using chemiluminescent immunoassays 2 years after vaccination or infection. Among 107 HCWs with seronegative measles IgGs, the overall seroconversion rate of measles IgGs remained 82.2% (88/107), and 45.8% (49/107) of the participants had a medium (121–900) or high (>900) PRN titer after 2 years from one or two booster doses. The measles-neutralizing antibody titers of both PRN titer (ND50) and geometric mean concentration 2 years after natural infection were significantly higher than those of one or two booster doses of the MMR vaccine (p < 0.001 and p < 0.001, respectively). Our results suggest that serologic screening followed by appropriate postexposure prophylaxis can be beneficial for young HCWs without a history of natural infection especially in a measles outbreak setting, because of possible susceptibility to measles despite booster MMR vaccination 2 years ago. Long-term data about sustainable humoral immunity after one or two booster vaccination are needed based on the exact vaccination history.

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Control of a nosocomial measles outbreak among previously vaccinated adults in a population with high vaccine coverage: Korea, 2019

Cited by 9 publications

References 41 publications

Measles Vaccination and Outbreaks in Croatia from 2001 to 2019; A Comparative Study to Other European Countries

Measles Vaccination and Outbreaks in Croatia from 2001 to 2019; A Comparative Study to Other European Countries

An interregional measles outbreak in Spain with nosocomial transmission, November 2017 to July 2018

Measles Virus Neutralizing Antibody Response and Durability Two Years after One or Two Doses of Measles–Mumps–Rubella Vaccine among Young Seronegative Healthcare Workers

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