Protecting infants against measles in England and Wales: a review

Manikkavasagan, Gayatri; Ramsay, Mary

doi:10.1136/adc.2008.149880

Cited by 23 publications

(17 citation statements)

References 44 publications

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“…Therefore, it is possible that some of these infants, particularly those over the age of 6 months, may be susceptible. 27 Further modelling could estimate the effect of including these infants, in addition to expanding analysis to account for age-sex and geospatial mixing patterns. 16 Although immunisation data held by CHIS are more up to date and timely than COVER data, there may be delays in the reporting of information from GP practices to CHIS; however, this is unlikely to be significant to impact on WHO susceptibility thresholds for this analysis.…”

Section: Strengths and Weaknessesmentioning

confidence: 99%

Measles outbreaks in the UK, is it when and where, rather than if? A database cohort study of childhood population susceptibility in Liverpool, UK

et al. 2017

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ObjectivesThere was a large outbreak of measles in Liverpool, UK, in 2012–2013, despite measles, mumps and rubella (MMR) immunisation uptake rates that were higher than the national average. We estimated measles susceptibility of a cohort of children born in Liverpool between 1995 and 2012 to understand whether there was a change in susceptibility before and after the outbreak and to inform vaccination strategy.DesignRetrospective cohort study.SettingThe city of Liverpool, North West UK.ParticipantsAll children born in Liverpool (72 101) between 1995 and 2012 inclusive who were identified using the Child Health Information System (CHIS) and were still resident within Liverpool in 2014.Primary and secondary outcome measuresWe estimated cohort age-disaggregated and neighbourhood-disaggregated measles susceptibility according to WHO thresholds before and after the outbreak for children aged 1–17 years.ResultsSusceptibility to measles was above WHO elimination thresholds before and after the measles outbreak in the 10+ age group. The proportion of children susceptible before and after outbreak, respectively: age 1–4 years 15.0% before and 14.9% after; age 5–9 years 9.9% before and 7.7% after; age 10+ years 8.6% before and 8.5% after. Despite an intensive MMR immunisation catch-up campaign after the 2012–2013 measles outbreak, the overall proportion of children with no MMR remains high at 6.1% (4390/72 351). Across all age groups and before and after the outbreak, measles susceptibility was clustered by neighbourhood, with deprived areas having the greatest proportion of susceptible children.ConclusionsThe risk of sustained measles outbreaks remains, especially as large pools of susceptible older children will start leaving secondary education and continue to aggregate in higher education, employment and other community settings and institutions resulting in the potential for a propagated measles outbreak.

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Section: Strengths and Weaknessesmentioning

confidence: 99%

Measles outbreaks in the UK, is it when and where, rather than if? A database cohort study of childhood population susceptibility in Liverpool, UK

et al. 2017

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“…The waning of maternally derived protection under current vaccination system may explain an increasing proportion of infants being susceptible to measles before the age of measles vaccination. 26,27 Accordingly, our serological data of <1 y normal infants clearly suggested that 55.9% were found to be seropositive. The rate was lower than that of in 2011 when our previous survey was carried out.…”

Section: Discussionmentioning

confidence: 90%

The epidemiological and serological characteristics of measles in Dongguan, China, 2005–2014

Han

Chen

Tang

et al. 2016

Human Vaccines & Immunotherapeutics

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This study examined the epidemiological and serological characteristics of measles in Dongguan, China. From 2005 to 2014, a total of 8,224 measles cases were reported in Dongguan, 33.5% of which were aged <1 y and 30.6% >14 y. From 2005 to 2014, the proportion of the <1 y measles cases increased year by year from 24.3% to 47.9%. Of the cases aged 8 months (n D 6,768 cases), only 11.6% had been immunized with at least one dose of measles vaccine. Of the 2,213 cases who had never been immunized with measles vaccine, immigrants accounted for 82.4%. 52.4% of the measles cases were diagnosed with pneumonia, and 12 cases died from respiratory failure. Seroprevalence rate in women and their newborns was 86.0% and 82.5%, respectively. Measurement of serum measles antibody levels for infants aged less than 8 months indicated that seroprevalence rate dramatically declined from 97.3% at birth to 9.3% and 13.2% at 6-and 7-month old. The existence of a sufficient pool of unvaccinated people (especially immigrants) and decreased level of passively transferred measles antibodies in infants from vaccinated mothers contributed to the sustained transmission observed in Dongguan. In addition to high routine vaccination coverage, new strategies and innovations for measles vaccination are needed to eliminate measles.

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“…At intervals, outbreaks do occur, facilitated by a primary and secondary vaccine failure as well as limited coverage of vaccination [2,7,18,28] and waning of antibodies in adolescents and young adults, often even in individuals vaccinated with 2 doses [6]. For the moment, however, the clinical consequence of this susceptibility gap in population under 1 year old seems to be limited: most outbreaks do not involve infants below the age of 12 months.…”

Section: Discussionmentioning

confidence: 96%