Molecular and phylogenetic analysis of Greek measles 2010 strains

Melidou, Angeliki; Pogka, Vasiliki; Exindari, Maria; Moutoussi, A.; Sgouras, Dionyssios N.; Papadakos, Konstantinos S.; Chatzidimitriou, Dimitrios; Karabaxoglou, D.; Mentis, Αndreas; Malisiovas, Nikolaos

doi:10.1017/s095026881100094x

Cited by 8 publications

(9 citation statements)

References 16 publications

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“…Germany (n=9) (16, 29, 32, 34, 37, 52, 56, 59, 62), Spain (n=8) (43-45, 48, 61, 63-65), Italy (n=6) (33, 36, 40, 46, 47, 58, 60) and Greece (n=5) (28, 42, 50, 51, 54, 55) were the countries that most frequently reported outbreaks involving migrants between 2000 and 2020. Two thirds (n=6) of included outbreaks in Germany affected refugee or asylum-seeking populations, mostly in temporary camps, 78% (n=7) were measles outbreaks and all but one were reported in 2010 or later.…”

Section: Resultsmentioning

confidence: 99%

“…21 reports discussing measles outbreaks were included, reporting on 24 distinct outbreaks and one report that presented all outbreak-related cases in asylum seekers in Germany from 2004 to 2014. Seven reports originated from Germany (16, 24, 29, 37, 52, 56, 59), four from Greece (50, 51, 54, 55), three from Italy (46, 47, 58), two from Spain (45, 48) and one each from Croatia (53), France (26), Ireland (49), Norway (57) and Poland (35). A large proportion of outbreaks were associated with Eastern European migrants, particularly of Roma nationality, including nine outbreaks with an Eastern European index case (16, 37, 46, 47, 51, 52, 58, 62, 67, 68).…”

Section: Resultsmentioning

confidence: 99%

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Migration and Outbreaks of Vaccine-Preventable Disease in Europe: A Systematic Review

Deal

Halliday

Crawshaw

et al. 2021

Preprint

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BackgroundMigrant populations (defined as foreign-born) are one of several under-immunised groups in the EU/EEA, yet little is known about how they are affected by outbreaks of vaccine-preventable diseases (VPDs). This information is vital to develop targeted strategies to improve the health of diverse migrant communities and to assess risk factors and correlations with major European peaks in incidence of key VPDs over time.MethodsWe did a systematic review (PROSPERO CRD42019157473; Medline, EMBASE, and Global Health January 2000 to October 2019) adhering to PRISMA guidelines, to identify studies on VPD outbreaks (measles, mumps, rubella, diphtheria, pertussis, polio, hepatitis A, N meningitidis, and H influenzae) in migrants residing in the EU/EEA and Switzerland.Results45 studies were included, reporting on 47 distinct VPD outbreaks across 13 countries (26 [55%] were reported between 2010 and 2020, including 16 [34%] since 2015). Most reported outbreaks involving migrants were of measles (n=24; 6578 total cases), followed by varicella (n=11; 596 cases), hepatitis A (n=7; 1510 cases), rubella (n=3; 487 cases) and mumps (n=2; 295 cases). 19 (40%) of outbreaks, predominantly varicella and measles, were reported in temporary camps or shelters for asylum seekers and refugees. Of 11 varicella outbreaks, 82% were associated with adult migrants. Half of measles outbreaks (n=12) were associated with migrants from Eastern European countries, often involving migrants of Roma ethnicity.ConclusionsMigrants represent one of several under-immunised groups involved in VPD outbreaks in Europe, with adult and child refugees and asylum seekers residing in shelters or temporary camps at particular risk, alongside specific nationality groups. Vulnerability varies by disease, setting, and individual demographics, highlighting the importance of tailoring strategies for implementing catch-up vaccination to specific groups, alongside the strengthening of routine data collection, in order to meet regional and global vaccination targets. Better understanding vaccine uptake and demand issues in migrant groups, and reducing the barriers they face to accessing vaccination services, is urgently needed, with direct implications for COVID-19 vaccine delivery at the current time. Strengthening vaccine delivery to migrant populations will require a greater focus on co-designing vaccine uptake strategies in close collaboration with affected communities.FunderNIHR

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Migration and Outbreaks of Vaccine-Preventable Disease in Europe: A Systematic Review

Deal

Halliday

Crawshaw

et al. 2021

Preprint

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“…In Greece, between 1990 and 2000, 12,250 measles cases were reported; since 2000, two outbreaks occurred in the country, in 2005–2006 and in 2010–2011, with 636 and 189 laboratory-confirmed cases, respectively. Phylogenetic analyses showed that the co-circulation of D4 and D6 genotypes was responsible for the 2005–2006 outbreak [ 6 ], whereas the 2010–2011 outbreak was due to the D4 genotype [ 7 ]. In both outbreaks, the social groups mainly affected were Roma–Greek children and young adults of Greek citizenship.…”

Section: Introductionmentioning

confidence: 99%

Spatiotemporal Distribution and Genetic Characterization of Measles Strains Circulating in Greece during the 2017–2018 Outbreak

Pogka

Horefti

Evangelidou

et al. 2020

Viruses

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Between May 2017 and November 2018, Greece has experienced a severe measles outbreak with a total of 3258 cases reported, after reaching its goal of eliminating measles since 2014–2015. In this study, we aimed to investigate the origin and the dispersal patterns of the measles strains that circulated in Greece during this outbreak and to identify possible transmission patterns of measles virus (MeV) in the country. Of the 832 measles suspect cases referred to the National Measles and Rubella Reference Laboratory for MeV RNA detection, 131 randomly selected positive samples, representative of the temporal and spatial distribution of the laboratory-confirmed measles cases in Greece, were processed for genotypic identification by an RT-PCR amplification of a 598 bp fragment containing the 450 bp hypervariable region of the measles virus N gene. Phylogenetic analysis was carried out by the approximate maximum likelihood method (ML) under the generalized time-reversible (GTR + cat) model. All samples analyzed were found to belong to genotype B3. Comparative analysis with other European and reference measles strains revealed three separate major clusters and other multiple viruses circulating simultaneously in Greece. They were all isolated from three main community groups, Greek-Roma children, non-minority Greek nationals and immigrants/refugees, a finding that is in accordance with what was also observed in the last two measles outbreaks in 2005–2006 and 2010–2011. Notably, for one of the three clusters, no similarity was detected with previously reported prototype strains. Our results indicate the need for a more intensive vaccination program against measles amongst minority populations and in refugee hot-spots as well as the importance of molecular surveillance as a tool for monitoring measles outbreaks.

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“…21 There had been no reported cases of measles G3 in Europe since 2006 until by the end of 2010 it reappeared in several different countries in Europe. 22 Unlike other outbreaks, 11,12,23 six different genotypes have been isolated in Catalonia during the study period, showing several importations as a result of the high incidence in other neighboring territories.…”

Section: Resultsmentioning

confidence: 84%

Epidemiology of two large measles virus outbreaks in Catalonia

Torner

Antón

Barrabeig³

et al. 2013

Human Vaccines & Immunotherapeutics

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Measles cases in the European Region have been increasing in the last decade; this illustrates the challenge of what we are now encountering in the form of pediatric preventable diseases. In Catalonia, autochthonous measles was declared eliminated in the year 2000 as the result of high measles-mumps-rubella vaccine (MMR) coverage for first and second dose (15 mo and 4 y) since the mid-1990s. From then on, sporadic imported cases and small outbreaks appeared, until in 2006-2007 a large measles outbreak affecting mostly unvaccinated toddlers hit the Barcelona Health Region. Consequently, in January 2008, first dose administration of MMR was lowered from 15 to 12 mo of age. A new honeymoon period went by until the end of 2010, when several importations of cases triggered new sustained transmission of different wild measles virus genotypes, but this time striking young adults. The aim of this study is to show the effect of a change in MMR vaccination schedule policy, and the difference in age incidence and hospitalization rates of affected individuals between both outbreaks. Epidemiologic data were obtained by case interviews and review of medical records. Samples for virological confirmation and genotyping of cases were collected as established in the Measles Elimination plan guidelines. Incidence rate (IR), rate ratio (RR) and their 95% CI and hospitalization rate (HR) by age group were determined. Statistic z was used for comparing proportions. Total number of confirmed cases was 305 in the 2010 outbreak and 381 in the 2006-2007 outbreak; mean age 20 y (SD 14.8 y; 3 mo to 51 y) vs. 15 mo (SD 13.1 y; 1 mo to 50 y). Highest proportion of cases was set in ≥ 25 y (47%) vs. 24.2% in 2006 (p < 0.001). Differences in IR for ≤ 15 mo (49/100,000 vs. 278.2/100,000; RR: 3,9; 95%CI 2,9-5.4) and in overall HR 29.8% vs. 15.7% were all statistically significant (p < 0.001). The change of the month of age for the administration of the first MMR dose proved successful to protect infants. Yet, given the current epidemiological situation, continued awareness and efforts to reach young adult population, especially those at high risk of infection and transmission such as healthcare workers and travelers, are needed to stop the spread of the virus when importations occur.

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Molecular and phylogenetic analysis of Greek measles 2010 strains

Cited by 8 publications

References 16 publications

Migration and Outbreaks of Vaccine-Preventable Disease in Europe: A Systematic Review

Migration and Outbreaks of Vaccine-Preventable Disease in Europe: A Systematic Review

Spatiotemporal Distribution and Genetic Characterization of Measles Strains Circulating in Greece during the 2017–2018 Outbreak

Epidemiology of two large measles virus outbreaks in Catalonia

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