Measles in immunized medical residents: Case series with brief review.

Measles is a vaccine-preventable disease that continues to be a major cause of morbidity and mortality in children and young adults across the world. Immunization efforts have reduced the incidence of measles over the last 3 decades, but outbreaks are seen in high-transmission areas with susceptible populations, as is seen in hospitals and student campuses. The protection offered by prior vaccination may wean off over time making vaccinated individuals susceptible to infection. Hence, catch-up immunization drives should be undertaken for vulnerable populations such as healthcare personnel, along with routine immunization programs, with the goal to eliminate measles in the future. This case series presents measles in two of our medical residents who got infected despite being vaccinated in childhood.

A hospital-associated measles outbreak among individuals not targeted for vaccination in eastern China, 2014.

BACKGROUND: An outbreak of measles occurred in early 2014 among individuals not targeted for vaccination-adults, and infants too young to vaccinate, in Xiangshan County, Zhejiang Province, in eastern China. OBJECTIVE: We conducted an investigation to identify risk factors responsible for this outbreak and to provide evidence-based recommendations for measles elimination strategies in China. METHODS: Measles was diagnosed using national standard case definitions. In a case-control study, 20 randomly selected measles patients were matched with controls selected from the same village or community as each case in a 1:2 case-to-control ratio. Controls were matched on age, within 5 years, and gender. We compared exposure histories during the 7-21 days before rash onset of the case and the same time period for the matched controls. We also conducted a measles antibody seroprevalence survey of a convenient sample of residual serum obtained from healthy patients during routine care in a hospital. RESULTS: The outbreak consisted of 45 measles cases, with an attack rate of 8.9/100,000 total population. Among cases, 91.1% (41/45) were adults (ranged 23-51 years) who had unknown vaccination histories; the other cases were infants younger than 8 months of age. The case-control study showed major risk factors to be a visit to Hospital X (OR(MH)=7.3, 95% CI: 1.8-30.7) and treatment in an IV room in Hospital X (OR(MH)=11.0, 95% CI: 1.3-96.1). The seroprevalence survey showed that 88.8% of adults had measles IgG antibodies, and that 100% of children 2-19 years of age were seropositive. CONCLUSIONS: The outbreak was primarily among age groups not targeted for vaccination-primarily adults, but with some children too young to vaccinate. Visiting a hospital was the major risk factor for measles transmission. We conclude that in addition to maintaining high 2-dose coverage with measles vaccine, working with hospital infection control programs to implement evidence-based strategies to prevent or limit hospital transmission is an important action for eliminating measles in eastern China.

Epidemiological characteristics and impact factors of adult measles during 2009-2012 in shanghai / 上海预防医学

[Objective] To analyse the impact factors for adult measles and its epidemiological characteristics in shanghai . [ Methods] The data on adult measles incidence during 2009-2012 were analyzed using descriptive epidemiology method .And the blood antibody titers was measured by ELISA method in the adult over18 years old in Hong Kou District of Shanghai . [Results] Zero dose vaccination and vaccination failure were the key reasons for the increase of adult measles , which were closely related to our history of prevention and treatment of measles . [ Conclusion ] Adult immunization should be strengthened to improve immune barrier and to reduce the measles incidence in adults , and it is suggested that the immunization for 10-15 year-olds should be strengthened so as to improve the overall antibody levels in adults as a whole .

Analysis on CIinical Characteristics of Adult Measles Inpatients in Urumqi Municipal / 中国疫苗和免疫

Objectives To analyze the clinical and laboratory characteristics,and characteristics of population distribution as well,and to provide the scientific data for the adult measles control.Methods Using descriptive epidemiology and statistical approach to analyze the clinical information for the adult measles patients hospitalized in People's Hospital of Xinjiang Uygur Autonomous Region of Urumqi city in Xinjiang province of China between Oct.2007 and Mar.2008.Results The average age of all the patients was 25.5 years old.63 patients had fever and most of them were at 39.1～40.0℃.61(96.8%) patients had rash,and 54 (85.7%) patients had koplik spots at the moment of hospitalization.26 (41.3%) patients had the complications of acute tracheobronchitis.And the chest radiograph of 28 (44.4%) patients showed the inflammatory shadow.The proportion of the neutrophils of 11 (17.5%) patients was high level in the blood testing.The alanine aminotransferase of 18 (28.6%) patients were elevated.All the patients were recovery.Conclusion More and more adult measles patients occurred in China in recent years.The clinical characteristics among the patients was variable.It is necessary to discuss and make a decision about the issue of supplementary immunization for adult population in China.