Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 770
Filtrar
1.
Medicina (B Aires) ; 80(2): 162-168, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32282323

RESUMO

In April 2019, UNICEF denounced that more than 20 million children worldwide had not been vaccinated and alerted on possible outbreaks of measles which, due to the high transmissibility of this virus, is the first disease preventable by vaccination to emerge. If the decline in vaccinations continues, pertussis, tetanus and other diseases, which require less coverage to achieve population protection, may also reappear. In Argentina, the current outbreak began in late August 2019. Measles virus is transmitted by air, infects multiple organs, and is associated with immunosuppression. Its genome consists of single stranded RNA. Genotyping is carried out by sequencing a 450-nucleotide fragment of the N protein, which contains the highest density of nucleotide variation. In South America, D8 is the circulating genotype and in North America, B3 accounts for 8% of the cases. Each person with measles infects, on average, another 12-18 people in a susceptible population. Vaccination confers direct and indirect protection, and induces both antibodies and cellular immunity. Newborns are protected by maternal antibodies transmitted via the placenta, up to 6 months. In Argentina, the Vaccination Calendar includes two doses of triple viral vaccine, at 12 months and 5 years, and a zero dose (6-11 months of age) in districts with disease cases. The protection conferred by the vaccine is 93% at 12 months with a dose, and with 2 doses 97% for life.


Assuntos
Sarampo/prevenção & controle , Vacinação , Argentina/epidemiologia , Pré-Escolar , Surtos de Doenças , Genótipo , História do Século XIX , Humanos , Lactente , Sarampo/epidemiologia , Sarampo/história , Sarampo/virologia , Nucleoproteínas , Proteínas Virais
2.
BMC Infect Dis ; 20(1): 244, 2020 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-32216754

RESUMO

BACKGROUND: Lebanon has experienced several measles and mumps outbreaks in the past 20 years. In this article, a case-based surveillance of both measles and mumps outbreaks in Lebanon was carried out in an attempt to outline factors contributing to the failure of elimination plans and to provide potential solutions. The relationship between the outbreaks of both diseases was described and explored. METHODS: A retrospective descriptive study of confirmed cases of measles and mumps in Lebanon between 2003 and 2018 collected from the Lebanese Ministry of Public Health Epidemiological Surveillance Unit public database was carried out. The information collected was graphically represented taking into consideration dates of reported cases, age groups affected, and vaccination status. RESULTS: The mean number of measles cases was 150.25 cases/year in the 1-4 years age group, 87 cases/year in individuals aging between 5 and 14, and 63.68 cases/year in those > 14 years old. In the latter group, only 18.05% were unvaccinated. The mean number of mumps cases was 30.4 cases/year in the < 4 year age group and 53.8 cases/year in the 10-19 years age group. During the study period, every spike in measles cases was followed by a similar spike in mumps. 9.66% of measles cases occurred in individuals who received at least 2 doses of the vaccine, 52.26% in the unvaccinated, and 38% in those whose vaccination status was undetermined. CONCLUSIONS: Measles in Lebanon is a disease of the pediatric population, but adults remain at risk. Outbreaks of mumps followed those of measles and were mainly among adolescents. Presence of a large number of Syrian refugees in the country may further complicate the situation. Vaccination activities need to be intensified.


Assuntos
Surtos de Doenças/prevenção & controle , Vacina contra Sarampo-Caxumba-Rubéola/uso terapêutico , Sarampo/epidemiologia , Sarampo/prevenção & controle , Caxumba/epidemiologia , Caxumba/prevenção & controle , Vacinação/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Líbano/epidemiologia , Masculino , Sarampo/virologia , Morbillivirus/imunologia , Morbillivirus/isolamento & purificação , Caxumba/virologia , Vírus da Caxumba/imunologia , Vírus da Caxumba/isolamento & purificação , Vigilância em Saúde Pública , Refugiados , Estudos Retrospectivos , Adulto Jovem
3.
PLoS One ; 15(3): e0230329, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32208432

RESUMO

Given the complicated history of Japan's National Immunization Program, a significant proportion of Japanese people including healthcare workers (HCWs) still lack adequate immunity against measles, mumps, and rubella (MMR), resulting in occasional outbreaks. In 2014, the Japanese Society of Infection Prevention and Control (JSIPC) published vaccination guidelines for HCWs. We evaluated antibody titers before and after MMR vaccination in HCWs at the Nara Medical University Hospital, the attainment rate of the target antibody titers defined by the JSIPC guidelines, and the safety of vaccines. We measured MMR antibody titers in HCWs, followed by inoculation with the respective monovalent vaccines and/or trivalent MMR (tMMR) vaccine according to the JSIPC guidelines. Among 467 HCWs evaluated, antibody titers against measles and mumps measured using the IgG-enzyme immunoassay increased from 11.0 [interquartile range (IQR): 8.0-13.6] to 13.7 (IQR: 11.3-16.9; P < 0.001) and from 2.8 (IQR: 2.1-3.5) to 4.8 (IQR: 3.7-5.7; P < 0.001), respectively. By evaluating a logarithmic value of log2(X + 1) converted from an antibody titer X, antibody titers against rubella measured using the hemagglutination assay increased from 3.2 (IQR: 0-4.1) to 6.0 (IQR: 4.6-8.0; P < 0.001). Antibody titer elevated following tMMR vaccination was lower than that following monovalent vaccination in a single dose of the measles-containing, a single dose of the mumps-containing, and two doses of rubella-containing vaccine groups (P = 0.01, 0.01, and <0.001, respectively). After vaccination, 20.0%, 61.5%, and 46.2% of HCWs attained target antibody titers specified by the JSIPC guidelines for measles, rubella, and mumps, respectively. The systemic response in female HCWs who underwent monovalent mumps vaccination was statistically higher than that in others. Although the vaccination program for HCWs according to the JSIPC guidelines caused increased MMR antibody titers, the rates of attaining the target criteria were low.


Assuntos
Anticorpos Antivirais/sangue , Surtos de Doenças/prevenção & controle , Pessoal de Saúde/estatística & dados numéricos , Vacinação em Massa/organização & administração , Vacina contra Sarampo-Caxumba-Rubéola/administração & dosagem , Adulto , Anticorpos Antivirais/imunologia , Feminino , Implementação de Plano de Saúde , Humanos , Esquemas de Imunização , Japão , Masculino , Vacinação em Massa/normas , Vacinação em Massa/estatística & dados numéricos , Sarampo/imunologia , Sarampo/prevenção & controle , Sarampo/virologia , Pessoa de Meia-Idade , Caxumba , Guias de Prática Clínica como Assunto , Rubéola (Sarampo Alemão)/imunologia , Rubéola (Sarampo Alemão)/prevenção & controle , Rubéola (Sarampo Alemão)/virologia , Vírus da Rubéola/imunologia
5.
mBio ; 10(6)2019 11 26.
Artigo em Inglês | MEDLINE | ID: mdl-31772054

RESUMO

Measles virus (MeV) is a highly contagious human pathogen that continues to be a worldwide health burden. One of the challenges for the study of MeV spread is the identification of model systems that accurately reflect how MeV behaves in humans. For our studies, we use unpassaged, well-differentiated primary cultures of airway epithelial cells from human donor lungs to examine MeV infection and spread. Here, we show that the main components of the MeV ribonucleoprotein complex (RNP), the nucleocapsid and phosphoprotein, colocalize with the apical and circumapical F-actin networks. To better understand how MeV infections spread across the airway epithelium, we generated a recombinant virus incorporating chimeric fluorescent proteins in its RNP complex. By live cell imaging, we observed rapid movement of RNPs along the circumapical F-actin rings of newly infected cells. This strikingly rapid mechanism of horizontal trafficking across epithelia is consistent with the opening of pores between columnar cells by the viral membrane fusion apparatus. Our work provides mechanistic insights into how MeV rapidly spreads through airway epithelial cells, contributing to its extremely contagious nature.IMPORTANCE The ability of viral particles to directly spread cell to cell within the airways without particle release is considered to be highly advantageous to many respiratory viruses. Our previous studies in well-differentiated, primary human airway epithelial cells suggest that measles virus (MeV) spreads cell to cell by eliciting the formation of intercellular membrane pores. Based on a newly generated ribonucleoprotein complex (RNP) "tracker" virus, we document by live-cell microscopy that MeV RNPs move along F-actin rings before entering a new cell. Thus, rather than diffusing through the cytoplasm of a newly infected columnar cell, RNPs take advantage of the cytoskeletal infrastructure to rapidly spread laterally across the human airway epithelium. This results in rapid horizontal spread through the epithelium that does not require particle release.


Assuntos
Actinas/metabolismo , Células Epiteliais/virologia , Vírus do Sarampo/metabolismo , Sarampo/virologia , Ribonucleoproteínas/metabolismo , Proteínas Virais/metabolismo , Diferenciação Celular , Células Epiteliais/citologia , Células Epiteliais/metabolismo , Humanos , Pulmão/citologia , Pulmão/metabolismo , Pulmão/virologia , Sarampo/metabolismo , Vírus do Sarampo/genética , Ribonucleoproteínas/genética , Proteínas Virais/genética
6.
PLoS One ; 14(10): e0224009, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31622429

RESUMO

The Republic of Serbia is a country with ongoing endemic transmission of measles. The aim of this study is to summarize the main characteristics of the measles resurgence that occurred in Serbia in 2014-2015. The national surveillance data on measles was analysed in relation to the clinical, epidemiological and laboratory data. Between November 2014 and December 2015 a measles resurgence with 420 cases was observed in Serbia. Measles virus was initially introduced by and spread among citizens of Bosnia and Herzegovina with temporary residence in Serbia, before spreading to the resident population. Of the 223 patients with available medical records, 173 (77.6%) were unvaccinated. The overall measles incidence during the outbreak was 5.8/100.000. The highest age-specific incidence rate was recorded in children aged ≤4 years (25.9/100.000), but most cases (67.9%) were ≥20 years old. Hospitalization rate was high (32.9%) and included two cases of encephalitis associated with measles. In total, 42 health-care workers and 22 related cases including hospitalized patients (n = 13) contracted measles. The overall percentage of laboratory confirmed cases was 81.7% (n = 343/420). All measles virus sequences except one (D9) belonged to genotype D8, suggesting interruption of transmission after the previous outbreak in 2010-2011 caused by genotype D4 viruses. The growing number of adult patients as compared to previous epidemics, suggests an urgent need for supplementary immunization activities targeting susceptible health care workers, unvaccinated or incompletely vaccinated adults as well as people without vaccination records. The comprehensive investigation of the 2014/2015 measles resurgence will contribute to decisions about appropriate countermeasures to stop the future measles resurgences in Serbia.


Assuntos
Vírus do Sarampo/genética , Sarampo/diagnóstico , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Genótipo , Pessoal de Saúde/estatística & dados numéricos , Hospitalização , Humanos , Imunoglobulina M/sangue , Incidência , Lactente , Masculino , Sarampo/epidemiologia , Sarampo/virologia , Vírus do Sarampo/classificação , Vírus do Sarampo/isolamento & purificação , Pessoa de Meia-Idade , Filogenia , Sérvia/epidemiologia , Vacinação/estatística & dados numéricos , Adulto Jovem
7.
Aerosp Med Hum Perform ; 90(10): 908-910, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31558201
8.
PLoS One ; 14(9): e0222428, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31553766

RESUMO

The first genotyping data on measles virus (MeV) strains in Cameroon dates from 1994, while other studies were realized in 2001 and 2011 with the establishment of MeV virological surveillance. However, the genetic data of MeV strains circulating in Cameroon remains fragmented and concentrated in certain regions, hence the need for an update. The objective of this study was to have recent data on MeV genotypes circulating in Cameroon. Ninety throat swabs collected during recent measles outbreaks were analyzed by MeV genotyping RT-PCR using the nucleoprotein gene N. The resulting sequences were analyzed on the basis of 450 nucleotides with MEGA 7 software. Overall genome analysis was performed on 40/90 sequences. The strains were from all ten regions and all belonged to cluster 1 of genotype B3. The genotype B3 has been circulating in Cameroon for long periods of time; efforts must be made in immunization for its elimination.


Assuntos
Epidemias , Vírus do Sarampo/genética , Sarampo/epidemiologia , Adolescente , Camarões/epidemiologia , Criança , Pré-Escolar , Feminino , Técnicas de Genotipagem , Humanos , Lactente , Masculino , Sarampo/virologia , Filogenia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Adulto Jovem
10.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(9): 929-933, 2019 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-31474076

RESUMO

Objective: Analyze the genetic characteristic of Hemagglutinin(H) gene of measles viruses isolated in Henan Province in 2017. Methods: Swab samples collected from 7 lab confirmed measles cases, and we got the measles virus by Vero/Slam inoculation. Fragment of H genes were amplified by reverse transcription polymerase chain reaction(RT-PCR), then the PCR products were sequenced and analyzed. Results: The age of the 7 measles confirmed cases were between 1 and 50 years old, and all of them were males. All the 7 measles viruses were identified as H1a genotype, and the average distance of the nucleotides and the amino acids was 0.005, respectively. Compared with the Shanghai-191/China-vaccine, there were some changes in isolated virus, such as 240(th), 397(th) and 381(st) sites in the amino acid sequence. Conclusion: The measles genotype which isolated in Henan Province in 2017 was H1a. There were some difference from Shanghai-191/China-vaccine in the nucleotides sequence of H gene, which suggested that it's necessary to strengthen the monitor the variation of measles virus.


Assuntos
Hemaglutininas , Vírus do Sarampo , Sarampo/virologia , Adolescente , Adulto , Criança , Pré-Escolar , China , Genótipo , Hemaglutininas/genética , Humanos , Lactente , Masculino , Vacina contra Sarampo/genética , Vírus do Sarampo/genética , Pessoa de Meia-Idade , Filogenia , Adulto Jovem
11.
PLoS One ; 14(5): e0217415, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31150445

RESUMO

INTRODUCTION AND METHODS: Hepatitis B is a vaccine preventable disease and is notifiable in South Africa. Hepatitis B vaccination was incorporated into the Expanded Programme on Immunisation in South Africa in 1995. We used a convenience sample from community-based febrile rash surveillance in 2013 to estimate hepatitis B sero-prevalence. Of samples serologically negative for acute measles infection, 450 samples spanning nine provinces of South Africa were tested for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs) and hepatitis B core antibody (anti-HBc). RESULTS: Two children (2/450; 0.4%) tested positive for HBsAg. Three hundred and three children (67.3%) had evidence of vaccine induced immunity. Vaccine induced immunity was present in 80.2% of 1-5 year olds, but only 60.3% of 10-14 year olds. Natural immunity, indicating exposure to circulating hepatitis B, was present in 13/450 (2.9%) children. CONCLUSION: Chronic hepatitis B in South African has decreased in prevalence from highly endemic levels prior to vaccine introduction to approximately 0.4% in this sample, demonstrating impact of a successful vaccination programme 18 years after introduction. Decreased vaccine-induced immunity with increasing age may reflect waning antibody titres over time.


Assuntos
Exantema/virologia , Vacinas contra Hepatite B/imunologia , Hepatite B/epidemiologia , Hepatite B/imunologia , Adolescente , Criança , Pré-Escolar , Feminino , Anticorpos Anti-Hepatite B/imunologia , Antígenos do Núcleo do Vírus da Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/imunologia , Humanos , Programas de Imunização/métodos , Lactente , Recém-Nascido , Masculino , Sarampo/virologia , Prevalência , África do Sul/epidemiologia , Vacinação/métodos
12.
BMC Public Health ; 19(1): 687, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31159788

RESUMO

BACKGROUND: To achieve the goal of measles eradication, all WHO member countries should continuously monitor the status of measles elimination. This work aims to characterize measles outbreaks in Iran from 2014 to 2016 and calculate the effective reproduction number, given that the country has recently eliminated measles. METHODS: Effective Reproduction Number (R) was estimated to achieve the goal of measles elimination using measles related outbreaks data and epidemiological data from the cases linked to imported cases. Three methods were used to estimate R includes (i) proportion of cases imported, (ii) distribution of outbreak size and (iii) distribution of outbreak generations. RESULTS: Of the 153 outbreaks occurring during the three years of the study, 29 outbreaks (19%) were unknown source, 86% of them were single cases. Estimates of R during the study period by proportion of cases imported were 0.79 (95% CI: 0.73-0.86). Corresponding values for distribution of outbreak size and distribution of outbreak generations methods were R = 0.83 (95% CI: 0.68-0.97) and R = 0.76 (95% CI: 0.54-0.90), respectively. CONCLUSIONS: Estimated values of R represent the important achievement that the outbreaks of measles originating from the indigenous genotype in Iran have been eliminated. Moreover, Iran has also achieved the goal of measles elimination by end of 2015.


Assuntos
Surtos de Doenças , Sarampo/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Genótipo , Humanos , Lactente , Irã (Geográfico)/epidemiologia , Masculino , Sarampo/prevenção & controle , Sarampo/virologia , Vacina contra Sarampo , Pessoa de Meia-Idade , Morbillivirus/genética , Saúde Pública , Adulto Jovem
13.
J Infect Chemother ; 25(10): 829-831, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31253475

RESUMO

Patients with measles or rubella infections manifest acute onset fever accompanying systemic exanthema, which are clinically difficult to be distinguish. Rapid diagnosis and differentiation of such epidemic viral diseases is essential to prevent outbreaks. We developed a single-tube multiplex real-time PCR assay for these indistinguishable viruses. We used previously-reported primer settings, with a slight modification of reporter dye, and applied to multiplex Taqman real-time PCR by cobas z480 (Roche Molecular Systems, Inc.). Consequently, the assay could detect 10 copies/10 µl of measles and rubella with coefficient of variations of 11.2% and 21.8%, respectively. Strengths of our methodology include simplicity of operation, short measurement time (2 h), uses of internal control (confirming a run of PCR), and quantitative measurement with high sensitivity. Both measles and rubella currently cause social outbreaks in Japan. We hope that our single-tube multiplex assay contributes to an early diagnosis, leading to an appropriate infection control measure and prevention of epidemics.


Assuntos
Sarampo/diagnóstico , Morbillivirus/isolamento & purificação , Vírus da Rubéola/isolamento & purificação , Rubéola (Sarampo Alemão)/diagnóstico , Surtos de Doenças/prevenção & controle , Estudos de Viabilidade , Humanos , Japão/epidemiologia , Sarampo/epidemiologia , Sarampo/virologia , Morbillivirus/genética , Reação em Cadeia da Polimerase Multiplex , RNA Viral/isolamento & purificação , Reação em Cadeia da Polimerase em Tempo Real , Rubéola (Sarampo Alemão)/epidemiologia , Rubéola (Sarampo Alemão)/virologia , Vírus da Rubéola/genética , Sensibilidade e Especificidade , Fatores de Tempo
14.
PLoS One ; 14(6): e0218782, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31220172

RESUMO

Due to the Expanded Program on Immunization (EPI) and supplementary immunization activities (SIAs) in China, the incidence of measles in China has decreased extensively. The incidence reached its lowest levels in contemporary history in 2012 and 2017, with incidence rates of 4.6 and 4.3 per million population, respectively. However, more than 147,000 measles cases were reported from 2013 to 2016. Furthermore, the proportions of cases in infants < 8 months and adults have been increasing since 2013, representing a considerable challenge for measles elimination in China. A total of 14,868 measles viruses were isolated from confirmed measles cases from 2011 to 2017, of which 14,631 were identified as the predominant endemic genotype, H1; 87 were identified as genotype A viruses that were vaccine associated strains; and 150 were identified as non-H1 genotype viruses. The non-H1 genotype viruses included 62 D8 viruses, 70 D9 viruses, 3 D11 viruses, 14 B3 viruses, and 1 G3 virus, which were identified as imported or import-related viruses that caused sporadic cases or small outbreaks. Most of the transmission chains detected during the period 2011-2012 were interrupted and were followed by many new transmission chains of unknown origin that spread, causing a large measles resurgence in China during 2013-2016. After 4 years of measles resurgence and continuous implementation of the routine immunization program and SIAs, the population immunity reached a sufficiently high level to interrupt most of the transmission chains; only a few strains survived, which continued to be sporadically detected in China in 2017. In the present study, the results from the combined epidemiological and molecular virological data demonstrated the great progress towards measles elimination in China by the further analysis of circulation dynamics for the endemic H1 genotype measles virus from 2011 to 2017. And this study accumulated critical baseline data on circulating wild-type measles viruses in China and provides comprehensive information to the world. These comprehensive baseline data provide evidence to support measles elimination in the future, not only in China but also in other countries worldwide. In addition, the information will be very useful to other countries for tracing their sources of measles cases and for identifying transmission links, which can help prevent potential measles outbreaks.


Assuntos
Vírus do Sarampo/genética , Sarampo/epidemiologia , Sarampo/virologia , Adolescente , Adulto , Criança , Pré-Escolar , China/epidemiologia , Surtos de Doenças , Doenças Endêmicas , Feminino , Genótipo , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Sarampo/prevenção & controle , Vírus do Sarampo/classificação , Vírus do Sarampo/imunologia , Tipagem Molecular , Filogenia , Análise de Sequência de DNA , Vacinação , Adulto Jovem
15.
Emerg Infect Dis ; 25(6): 1101-1109, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31107215

RESUMO

We estimated the economic impact of concurrent measles and rubella outbreaks in Romania during 2011-2012. We collected costs from surveys of 428 case-patients and caretakers, government records, and health staff interviews. We then estimated financial and opportunity costs. During the study period, 12,427 measles cases and 24,627 rubella cases were recorded; 27 infants had congenital rubella syndrome (CRS). The cost of the outbreaks was US $9.9 million. Cost per case was US $439 for measles, US $132 for rubella, and US $44,051 for CRS. Up to 36% of households needed to borrow money to pay for illness treatment. Approximately 17% of patients continued to work while ill to pay their treatment expenses. Our key study findings were that households incurred a high economic burden compared with their incomes, the health sector bore most costs, and CRS costs were substantial and relevant to include in rubella outbreak cost studies.


Assuntos
Coinfecção , Efeitos Psicossociais da Doença , Surtos de Doenças , Sarampo/epidemiologia , Rubéola (Sarampo Alemão)/epidemiologia , Adolescente , Criança , Pré-Escolar , Custos e Análise de Custo , Feminino , Custos de Cuidados de Saúde , História do Século XXI , Humanos , Lactente , Recém-Nascido , Masculino , Sarampo/história , Sarampo/virologia , Vigilância em Saúde Pública , Romênia/epidemiologia , Rubéola (Sarampo Alemão)/história , Rubéola (Sarampo Alemão)/virologia , Síndrome da Rubéola Congênita/epidemiologia , Síndrome da Rubéola Congênita/virologia , Fatores Socioeconômicos
16.
MMWR Morb Mortal Wkly Rep ; 68(17): 396-401, 2019 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-31048675

RESUMO

In 2010, all 53 countries* in the World Health Organization (WHO) European Region (EUR) reconfirmed their commitment to eliminating measles and rubella and congenital rubella syndrome (1); this goal was included as a priority in the European Vaccine Action Plan 2015-2020 (2). The WHO-recommended elimination strategies in EUR include 1) achieving and maintaining ≥95% coverage with 2 doses of measles-containing vaccine (MCV) through routine immunization services; 2) providing measles and rubella vaccination opportunities, including supplementary immunization activities (SIAs), to populations susceptible to measles or rubella; 3) strengthening surveillance by conducting case investigations and confirming suspected cases and outbreaks with laboratory results; and 4) improving the availability and use of evidence for the benefits and risks associated with vaccination (3). This report updates a previous report (4) and describes progress toward measles elimination in EUR during 2009-2018. During 2009-2017, estimated regional coverage with the first MCV dose (MCV1) was 93%-95%, and coverage with the second dose (MCV2) increased from 73% to 90%. In 2017, 30 (57%) countries achieved ≥95% MCV1 coverage, and 15 (28%) achieved ≥95% coverage with both doses. During 2009-2018, >16 million persons were vaccinated during SIAs in 13 (24%) countries. Measles incidence declined to 5.8 per 1 million population in 2016, but increased to 89.5 in 2018, because of large outbreaks in several EUR countries. To achieve measles elimination in EUR, measures are needed to strengthen immunization programs by ensuring ≥95% 2-dose MCV coverage in every district of each country, offering supplemental measles vaccination to susceptible adults, maintaining high-quality surveillance for rapid case detection and confirmation, and ensuring effective outbreak preparedness and response.


Assuntos
Erradicação de Doenças , Surtos de Doenças/prevenção & controle , Sarampo/epidemiologia , Sarampo/prevenção & controle , Vigilância da População , Criança , Pré-Escolar , Europa (Continente)/epidemiologia , Genótipo , Humanos , Programas de Imunização , Esquemas de Imunização , Incidência , Lactente , Sarampo/virologia , Vacina contra Sarampo/administração & dosagem , Vírus do Sarampo/genética , Cobertura Vacinal/estatística & dados numéricos
18.
Am J Dermatopathol ; 41(12): 914-923, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31021834

RESUMO

Despite available vaccination, measles is one of the leading causes of death among young children in developing countries. In clinical practice, the spectrum of differential diagnoses of morbilliform exanthemas associated with fever is wide, and it can be hard to differentiate from other infectious eruptions, especially in adults or in atypical courses in immunocompromised patients. The goal of our study was to identify characteristic histomorphological and immunohistochemical patterns of measles exanthema through the study of 13 skin biopsy specimens obtained from 13 patients with this disease and a review of cases in the literature. Histopathological features of measles exanthema are quite distinctive and characterized by a combination of multinucleated keratinocytes, and individual and clustered necrotic keratinocytes in the epidermis with pronounced folliculosebaceous as well as acrosyringeal involvement. Immunohistochemical staining of skin biopsies with anti-measles virus (MeV) nucleoprotein and anti-MeV phosphoprotein can be of great value in confirming the diagnosis of measles. Both methods can serve as quick additional diagnostic tools for prompt implementation of quarantine measures and for providing medical assistance, even in patients in whom the clinician did not consider measles as a differential diagnosis of the rash due to the rarity of the disease in a putatively vaccinated community.


Assuntos
Exantema/diagnóstico , Imuno-Histoquímica , Vírus do Sarampo/patogenicidade , Sarampo/diagnóstico , Sarampo/patologia , Nucleoproteínas/análise , Fosfoproteínas/análise , Dermatopatias Virais/diagnóstico , Pele , Proteínas Virais/análise , Adolescente , Adulto , Biópsia , Diagnóstico Diferencial , Exantema/metabolismo , Exantema/patologia , Exantema/virologia , Feminino , Humanos , Masculino , Sarampo/metabolismo , Sarampo/virologia , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Pele/química , Pele/patologia , Pele/virologia , Dermatopatias Virais/metabolismo , Dermatopatias Virais/patologia , Dermatopatias Virais/virologia , Adulto Jovem
19.
Mem Inst Oswaldo Cruz ; 114: e180545, 2019 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-30892375

RESUMO

Measles is a human infectious disease of global concern that is caused by the measles virus. In this study, we report the complete genome sequencing of one measles virus isolate, genotype D8, that was obtained directly from a urine sample in Boa Vista city, the capital of Roraima state in Brazil. Phylogenetic reconstruction grouped the genome described in this study with that of samples from Australia, South Korea, and Italy. To our knowledge, this is the first complete genome sequence of a wild-type measles virus reported from Latin America. Therefore, the present data strengthen the current knowledge on the molecular epidemiology of measles worldwide.


Assuntos
Vírus do Sarampo/genética , Sarampo/virologia , RNA Viral/genética , Brasil/epidemiologia , Surtos de Doenças , Genótipo , Humanos , Sarampo/epidemiologia , Filogenia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Análise de Sequência de RNA
20.
Braz J Infect Dis ; 23(1): 66-69, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30876879

RESUMO

Here we reported the outbreak of measles cases caused by the genotype D8 measles virus for the first time in Jiangsu province in China, which was possibly imported by a foreign student from Laos. Throat swab specimens were collected, and used to isolate virus. 634-bp fragment of the N gene and 1854-bp fragment of H gene were amplified by reverse transcription-PCR and sequenced, respectively. Phylogenetic results indicated that they belonged to genotype D8 measles virus. Further epidemiology investigation showed that the adults with D8 measles virus infection did not receive measles vaccine before having measles. In China, almost all D8 genotype MeV only infected those population without receiving measles vaccine immunization. Therefore, it is still necessary to implement the supplement activity of measles immunization target adult with immunity gap.


Assuntos
Doenças Transmissíveis Importadas/epidemiologia , Doenças Transmissíveis Importadas/virologia , Surtos de Doenças , Vírus do Sarampo/genética , Sarampo/epidemiologia , Sarampo/virologia , Adulto , China/epidemiologia , Feminino , Genótipo , Humanos , Vírus do Sarampo/isolamento & purificação , Filogenia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA