Characterisation of measles after the introduction of the combined measles-mumps-rubella (MMR) vaccine in 2004 with focus on the laboratory data, 2016 to 2019 outbreak, Romania.

Content Provider	Europe PMC
Author	Lazar, Mihaela Stănescu, Aurora Penedos, Ana Raquel Pistol, Adriana
Copyright Year	2019
Abstract	BackgroundSince January 2016, a resurgence of measles in Romania has led to the third measles epidemic in the past 12 years; 64 deaths have been confirmed so far–the highest number of measles-related deaths since the measles-mumps-rubella (MMR) vaccine was introduced in 2004.AimTo provide an overview on the characterisation on measles in Romania after the introduction of the MMR vaccine with focus on the current outbreak, laboratory and molecular analysis.MethodsWe performed an analysis of measles incidence and mortality after the introduction of MMR vaccination and a retrospective study using serological and molecular data in three consecutive outbreaks with focus on the current outbreak.ResultsIn the current outbreak, 17,533 measles cases were notified to the national surveillance system, 93% were unvaccinated. Measles virus was isolated from 429 samples and 283 were genotyped. Genotype B3 was predominant (n = 269) and sporadic measles cases associated with D8 genotype (n = 9) were also observed; genotype D4 and D8 were identified in the previous two measles outbreaks. The detection of several distinct measles virus B3 genotypes suggests multiple virus importations to Romania.ConclusionThe current outbreak is a consequence of insufficient vaccine coverage. Control measures were implemented to improve uptake of MMR vaccine, including administering the first MMR dose at a younger age (9–11 months) and offering catch-up vaccination to children that have not followed the recommended dosing schedule. More measures are needed to improve the surveillance performance and to achieve high routine MMR vaccination coverage.
ISSN	1025496X
Journal	Eurosurveillance
Volume Number	24
PubMed Central reference number	PMC6652110
Issue Number	29
PubMed reference number	31339098
e-ISSN	15607917
DOI	10.2807/1560-7917.ES.2019.24.29.1900041
Language	English
Publisher	European Centre for Disease Prevention and Control (ECDC)
Publisher Date	2019-07-01
Access Restriction	Open
Rights License	This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made. This article is copyright of the authors or their affiliated institutions, 2019.
Subject Keyword	measles outbreak Romania molecular epidemiology children MMR vaccination air-borne infections viral infections vaccine-preventable diseases measles-mumps-rubella (MMR) vaccine laboratory surveillance epidemiology laboratory molecular methods
Content Type	Text
Resource Type	Article
Subject	Virology Public Health, Environmental and Occupational Health Epidemiology