Epidemic Outbreak of Measles in the Region of Plovdiv, Bulgaria (March-July 2017)

Abstract

Object: To analyze the clinical, epidemiological and laboratory characteristics of the cases with measles in the Plovdiv region, Bulgaria, in the period March-July 2017. Materials and Methods: The study included 139 hospitalized patients with measles, treated in the Clinic of Infectious Diseases, University Hospital "St. George"-Plovdiv, during the observed period. Diagnosis was verified by ELISA in 133 of the patients. The following methods were used: clinical and epidemiological analysis, laboratory, microbiological and imaging tests. Results: The age distribution of the patients was: infants below 1 year were 23.8%; 1-3 years-24.5%; 4-17 years-30.9%; and over 18 years-20.8%. Ethnicity: from Roma origin were 83.5% and Bulgarians-16.5%. Most of the patients (62%) reported contact with a measles patient. Ninety eight of the patients were over 13 months of age and they should have been immunized, as the vaccine in Bulgaria is applied on the 13 month. Of these 98 patients, 49% were immunized, 28% were not, and for 23% there were not data. The most common clinical symptoms were: fever-97.1%, cough-98.6% and runny nose-82.7%. Conjunctivitis was observed in 82%, asthenia in 46%, and diarrhea in 51.1%. The rash appeared average on the 4 th day of the onset of complaints. Koplik's spots were observed in 71.9%, cervical lymphadenopathy in 56.1%, hepatomegaly-in 25.2%, and splenomegaly-in 7.9%; auscultation data for bronchitis/pneumonia-in 33.1%. Laboratory tests: leucopenia in 32.4%, leukocytosis-2.2%, normal results-in the rest 65.4%. ESR was increased in 39.1% and CRP in 76.5% of the patients. X-ray of the lung was performed under indication and was positive in 28/46. The serological test-anti-measles IgM (ELISA) was positive in 95.7% (133/139

Descriptive epidemiology of measles surveillance data, Osun state, Nigeria, 2016–2018

“…Children below the age of 15 had a national incidence of 738/100,000 in 2002 and 544/100,000 in 2003, estimated to more than 100,000 cases within the age group [6]. Despite intensive vaccination activities in the European region, cases were still reported [7].…”

“…The risk of spread and prolonged transmission of measles were associated with the presence of a susceptible population, but vaccination with at least two doses of measles vaccine was the most effective measure for the prevention and control of the disease [7]. Despite the comprehensive campaign and intervention strategies to improve the uptake of vaccination against childhood diseases in Nigeria by Nigerian government and international agencies, the confirmed cases of measles remain high and the case fatality due to the disease is yet to be alleviated [12].…”