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1

Callister, Lynn Clark. "Global Measles Outbreak." MCN, The American Journal of Maternal/Child Nursing 44, no. 4 (2019): 237. http://dx.doi.org/10.1097/nmc.0000000000000542.

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2

Singh, Kamaljit, and Rajesh Garg. "Outbreaks of measles in Rajasthan in 2014: a cross sectional epidemiological investigation." International Journal Of Community Medicine And Public Health 4, no. 5 (April 24, 2017): 1751. http://dx.doi.org/10.18203/2394-6040.ijcmph20171796.

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Background: In India, although the measles vaccine is available across the country up to village level, but still India is struggling with mortality and morbidity associated with Measles and its outbreaks. Investigations in measles outbreak help to know the determinants behind it and thus prevent further outbreaks. The outbreaks of measles in Rajasthan were investigated in 2014 by analyzing various socio-demographic parameters. Objective: To assess the epidemiological profile of measles outbreak in Rajasthan in 2014.Methods: The data of the measles surveillance project of Rajasthan was used for analysis. This is an analytical, cross sectional study where 10 districts of Rajasthan having confirmed measles outbreak in 2014 were included. A total of 353 laboratory plus epidemiologically linked measles cases were considered. Statistical analysis: Percentages, proportions and Chi square test were applied. Results: Out of the 23 suspected measles outbreaks subjected for confirmatory laboratory investigation, majority i.e. 14 (60.8%) were found to be of measles. Out of these 14 outbreaks, 353 cases were of measles (Laboratory confirmed + epidemiologically confirmed). Maximum numbers (around 50%) of cases were from the age group 1-4 years. Only 108 (30.6%) cases were vaccinated for measles vaccine. Girl children contributed to about 60 % of the total measles cases. Almost 2/3rd (66.9%) cases were in Muslim families. Conclusions: There was clustering of measles cases in few of the districts adjacent to each other. Measles vaccination coverage in few pockets was poor in outbreak districts. There is a need to boost up measles vaccination coverage with special attention to high risks areas like urban slums etc.
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Al-Abdullah, Nabeela Abdullah. "Measles outbreak amongst Manymar population of Jeddah City, Saudi Arabia." International Journal Of Community Medicine And Public Health 5, no. 7 (June 22, 2018): 2657. http://dx.doi.org/10.18203/2394-6040.ijcmph20182420.

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Background: Worldwide efforts for measles elimination are made possible due to the availability of a highly effective measles vaccine. In spite of a highly vaccinated population, an outbreak of measles has occurred in Jeddah province of Saudi Arabia, from January to February 2018.Methods: An outbreak investigation was conducted to describe the epidemiology of the outbreak. A performance audit of the control measures taken by the primary healthcare team was carried out in accordance with the World Health Organization (WHO) standards.Results: Of the 31 cases reported, the patient’s ages range from 1–9 years with an average age of 6 (±2) years. The index case was a 9 year old male. The performance indicator target for outbreak control measures was achieved. Ninety percent of the cases were investigated within 48 hours. Specimens such as serum blood and nasopharyngeal swabs were collected within the optimal period to test for measles IgG and IgM antibody.Conclusions: This outbreak demonstrates the increased susceptibility of unvaccinated children aged 6–11 months. To prevent possible future outbreaks, community awareness through educational campaigns, a review of children’s vaccination records, enhanced community surveillance and a measles ‘catch-up’ mass immunization campaign to interrupt chains of transmission are necessary.
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4

Taylor, Lee. "Catching a Measles Outbreak." New South Wales Public Health Bulletin 2, no. 7 (1991): 65. http://dx.doi.org/10.1071/nb91032.

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5

Arenz, Stephan, Richela Fischer, and Manfred Wildner. "MEASLES OUTBREAK IN GERMANY." Pediatric Infectious Disease Journal 28, no. 11 (November 2009): 1030–32. http://dx.doi.org/10.1097/inf.0b013e3181aa6a29.

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6

English, Peter M., Nicola Lang, Anna Raleigh, Kevin Carroll, and Margot Nicholls. "Measles outbreak in Surrey." BMJ 333, no. 7576 (November 9, 2006): 1021.3–1022. http://dx.doi.org/10.1136/bmj.39024.355822.1f.

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7

Cottrell, S., and R. J. Roberts. "Measles outbreak in Europe." BMJ 342, jun15 1 (June 15, 2011): d3724. http://dx.doi.org/10.1136/bmj.d3724.

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8

Skryabina, S. V., S. A. Kovyazina, S. V. Kuzmin, A. I. Yurovskikh, O. V. Tsvirkun, A. G. Gerasimova, N. T. Tikhonova, et al. "Measles Outbreak in Sverdlovsk Region." Epidemiology and Vaccine Prevention 17, no. 2 (April 20, 2018): 50–56. http://dx.doi.org/10.31631/2073-3046-2018-17-2-50-56.

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Objective.In the Russian Federation on the background of the sporadic incidence of measles, the trend is not highly uniform distribution of morbidity on territories of the country with the formation of local outbreaks, including the result of nosocomial infection. Find out the causes of the outbreak, for example the territory, for 15 years keeping and epidemic well-being in relation to measles, high vaccination coverage in children and adults, to assess the capacity of health care organizations and epidemiology to prevent the spread of measles and the elimination of flash was the goal of this research.Material and methods. A retrospective epidemiological analysis was held: the incidence of measles for the period 2001–2016 in the Sverdlovskiy region ; 76 «Cards epidemiological case investigation suspected measles», was from October to December 2016; the analysis of the extraordinary and final reports of the measles outbreak, reports on the activities carried out in the outbreak of measles. Laboratory verification of cases suspected were examined the ELISA method in the Perm regional centre, on the basis of detection of specific IgM and/or IgG increase. Molecular genetic research of 15 clinical specimens were performed at the Scientific- methodical centre on supervision of measles and rubella (Gabrichevsky Research Institute by Epidemiology & Microbiology», Moscow).Results.During the period c from 40 to 51 week of 2016 measles ill 76 people, mostly (66 persons) residents of the city of Yekaterinburg. Prevailed among the infected children was 67% (51 persons), usually not vaccinated against this infection – 90% (46) of children had a measles vaccination. All cases were laboratory confirmed. Expected sources or place of infection was established in 90.8% of cases. Among cases and 72.4% (55 persons) amounted to unvaccinated against measles, 11.8 per cent(9 people) were vaccinated once, of 15.8% (12) had a two-fold vaccination. In 8 hospitals was 8 foci of measles, 6 of which had spread. Among the cases of measles identified in health facilities, 35 children and 19 adults, including 5 health workers and 3 medical students. The formation of foci of nosocomial infection contributed to missed cases of measles, late diagnosis, significantly reduce the effectiveness of anti-epidemic measures. The results of molecular genetic studies of 15 clinical samples of patients selected at 42–44, and 47–49 weeks possible to establish the circulating strains of measles virus genotype D8. Epidemiological investigations and the common genetic variant circulating genotypes, selected at different stages of measles spread from different foci made it possible to combine all cases in one outbreak. Analysis of clinical manifestations of measles have testified to the fact that measles is proceeded typically in 92.2% of cases. Eleven drifts infection in educational institutions of Ekaterinburg was not accompanied by the secondary spread, indicating good collective immunity.Conclusion.Thus, a retrospective epidemiological analysis of outbreaks of measles showed that in conditions of sporadic measles in doctors reduced vigilance against measles. Late diagnosis of measles and as a consequence of its failure to carry out anti- epidemic measures led to the spread of infection, as well as skid measles in other medicine organization, which consisted of nosocomial foci. The present outbreak showed that measles requires constant attention, especially during her long absence in the region. It is only possible to prevent sustained secondary transmission if measles vaccination coverage is high for the entire population.
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9

Makelele, J. P. K., S. Ade, K. C. Takarinda, M. Manzi, J. Gil Cuesta, A. Acma, M. M. Yépez, and M. Mashako. "Outcomes of cholera and measles outbreak alerts in the Democratic Republic of Congo." Public Health Action 10, no. 3 (September 21, 2020): 124–30. http://dx.doi.org/10.5588/pha.19.0074.

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Setting: In 1995, a rapid response project for humanitarian and medical emergencies, including outbreak responses, named ‘Pool d’Urgence Congo’ (PUC), was implemented in the Democratic Republic of Congo by Médecins Sans Frontières.Objective: To assess the outcomes of cholera and measles outbreak alerts that were received in the PUC surveillance system between 2016 and 2018.Design: This was a retrospective cross-sectional study.Results: Overall, 459 outbreak alerts were detected, respectively 69% and 31% for cholera and measles. Of these, 32% were actively detected and 68% passively detected. Most alerts (90%) required no intervention and 10% of alerts had an intervention. There were 25% investigations that were not carried out despite thresholds being met; 17% interventions were not performed, the main reported reason being PUC operational capacity was exceeded. Confirmed cholera and measles outbreaks that met an investigation threshold comprised respectively 90% and 76% of alerts; 59% of measles investigations were followed by a delayed outbreak response of 14 days (n = 10 outbreaks).Conclusion: Some alerts for cholera and measles outbreaks that were detected in the PUC system did not lead to a response even when required; the main reported reason was limited operational capacity to respond to all of them.
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10

STEIN-ZAMIR, C., G. ZENTNER, N. ABRAMSON, H. SHOOB, Y. ABOUDY, L. SHULMAN, and E. MENDELSON. "Measles outbreaks affecting children in Jewish ultra-orthodox communities in Jerusalem." Epidemiology and Infection 136, no. 2 (April 16, 2007): 207–14. http://dx.doi.org/10.1017/s095026880700845x.

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SUMMARYIn 2003 and 2004 two measles outbreaks occurred in Jewish ultra-orthodox communities in Jerusalem. The index case of the first outbreak (March 2003) was a 2-year-old unvaccinated child from Switzerland. Within 5 months, 107 cases (mean age 8·3±7·5 years) emerged in three crowded neighbourhoods. The first cases of the second outbreak (June 2004) were in three girls aged 4–5 years in one kindergarten in another community. By November 2004, 117 cases (mean age 7·3±6·5 years) occurred. The virus genotypes were D8 and D4 respectively. Altogether, 96 households accounted for the two outbreaks, with two or more patients per family in 79% of cases. Most cases (91·5%) were unvaccinated. Immunization coverage was lower in outbreak than in non-outbreak neighbourhoods (88·3% vs. 90·3%, P=0·001). Controlling the outbreaks necessitated a culture-sensitive approach, and targeted efforts increased MMR vaccine coverage (first dose) to 95·2%. Despite high national immunization coverage (94–95%), special attention to specific sub-populations is essential.
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11

Ristanovic, Ana. "Outbreak of measles in adults." Sestrinska rec 20, no. 73 (2016): 12–13. http://dx.doi.org/10.5937/sestrec1673012r.

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12

Beattie, Greg T. "Measles outbreak in western Sydney." Medical Journal of Australia 163, no. 3 (August 1995): 165–67. http://dx.doi.org/10.5694/j.1326-5377.1995.tb127985.x.

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13

McDonnell, Louise F., Louisa R. Jorm, and Mahomed S. Patel. "Measles outbreak in western Sydney." Medical Journal of Australia 163, no. 3 (August 1995): 167. http://dx.doi.org/10.5694/j.1326-5377.1995.tb127986.x.

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14

Ibrahim, K., O. Al Gibali, M. Sakran, and K. Al Ansari. "Measles Outbreak in Qatar 2007." Qatar Medical Journal 2010, no. 2 (June 2010): 12. http://dx.doi.org/10.5339/qmj.2010.2.12.

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15

Hahné, Susan, Margreet J. M. te Wierik, Liesbeth Mollema, Eva van Velzen, Eric de Coster, Corien Swaan, Hester de Melker, and Robert van Binnendijk. "Measles Outbreak, the Netherlands, 2008." Emerging Infectious Diseases 16, no. 3 (March 2010): 567–69. http://dx.doi.org/10.3201/eid1602.090114.

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16

Wise, J. "Measles outbreak hits northeast England." BMJ 346, jan31 1 (January 31, 2013): f662. http://dx.doi.org/10.1136/bmj.f662.

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17

&NA;. "Measles outbreak - a warning bell." Inpharma Weekly &NA;, no. 806 (September 1991): 20. http://dx.doi.org/10.2165/00128413-199108060-00055.

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18

MCBRIEN, JACQUELINE, JOHN MURPHY, DENIS GILL, MARY CRONIN, CATHERINE O’DONOVAN, and MARY T. CAFFERKEY. "Measles outbreak in Dublin, 2000." Pediatric Infectious Disease Journal 22, no. 7 (July 2003): 580–84. http://dx.doi.org/10.1097/01.inf.0000073059.57867.36.

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19

Aurpibul, Linda, Thanyawee Puthanakit, Suparat Kanjanavanit, Thira Sirisanthana, and Virat Sirisanthana. "MEASLES OUTBREAK IN AN ORPHANAGE." Pediatric Infectious Disease Journal 29, no. 2 (February 2010): 167–69. http://dx.doi.org/10.1097/inf.0b013e3181b99e15.

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20

Kumar, Sanjay. "Jarawas threatened by measles outbreak." Lancet 354, no. 9190 (November 1999): 1624. http://dx.doi.org/10.1016/s0140-6736(05)77118-x.

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Fraser, Barbara. "Measles outbreak in the Americas." Lancet 392, no. 10145 (August 2018): 373. http://dx.doi.org/10.1016/s0140-6736(18)31727-6.

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22

Csillag, Claudia. "Brazil burdened with measles outbreak." Lancet 350, no. 9077 (August 1997): 572. http://dx.doi.org/10.1016/s0140-6736(05)63159-5.

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23

Goldani, Luciano Z. "Measles outbreak in Brazil, 2018." Brazilian Journal of Infectious Diseases 22, no. 5 (September 2018): 359. http://dx.doi.org/10.1016/j.bjid.2018.11.001.

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24

Gurevich, Inge, Ricardo A. Barzarga, and Burke A. Cunha. "Measles: Lessons from an outbreak." American Journal of Infection Control 20, no. 6 (December 1992): 319–25. http://dx.doi.org/10.1016/s0196-6553(05)80237-8.

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25

Junghans, C., C. Heffernan, A. Valli, and K. Gibson. "Mass vaccination response to a measles outbreak is not always possible. Lessons from a London prison." Epidemiology and Infection 146, no. 13 (July 19, 2018): 1689–91. http://dx.doi.org/10.1017/s0950268818001991.

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AbstractIn this study, we describe a contained measles outbreak in a London prison, the second such outbreak in a custodial setting. Once vaccination commenced, just under a third of eligible prisoners were immunised due to a low uptake of the vaccine. We conducted a root-cause analysis in order to identify factors which may have prevented or altered the course of the outbreak. Our analysis revealed that many of the factors identified are those that cannot be easily changed. It is unlikely that mass vaccination at the time, even in the absence of some of the more easily rectifiable issues, could have fully avoided further cases in the event of a mass outbreak. Both measles outbreaks in a custodial setting started with a member of staff and immunisation status of the staff were largely unknown. We argue that mass vaccination following an outbreak in a prison is unlikely to fully prevent a mass outbreak, and that implementing opt-out testing, empirical vaccination and insisting on full immunisation of staff are most likely to both prevent and contain outbreaks in the future.
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Zhang, Zhengyi, Yuan Zhao, Lili Yang, Changhong Lu, Ying Meng, Xiaoli Guan, Hongjin An, et al. "Measles Outbreak among Previously Immunized Adult Healthcare Workers, China, 2015." Canadian Journal of Infectious Diseases and Medical Microbiology 2016 (2016): 1–6. http://dx.doi.org/10.1155/2016/1742530.

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Measles is caused by measles virus belonging to genusMorbillivirusof the family Paramyxoviridae. Vaccination has played a critical role in controlling measles infection worldwide. However, in the recent years, outbreaks of measles infection still occur in many developing countries. Here, we report an outbreak of measles among healthcare workers and among the 60 measles infected patients 50 were healthcare workers including doctors, nurses, staff, and medics. Fifty-one patients (85%) tested positive for IgM antibodies against the measles virus and 50 patients (83.3%) tested positive for measles virus RNA. Surprisingly, 73.3% of the infected individuals had been previously immunized against measles. Since there is no infection division in our hospital, the fever clinics are located in the Emergency Division. In addition, the fever and rash were not recognized as measles symptoms at the beginning of the outbreak. These factors result in delay in isolation and early confirmation of the suspected patients and eventually a measles outbreak in the hospital. Our report highlights the importance of following a two-dose measles vaccine program in people including the healthcare workers. In addition, vigilant attention should be paid to medical staff with clinical fever and rash symptoms to avoid a possible nosocomial transmission of measles infection.
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Fonnesbeck, Christopher J., Katriona Shea, Spencer Carran, Jose Cassio de Moraes, Christopher Gregory, James L. Goodson, and Matthew J. Ferrari. "Measles outbreak response decision-making under uncertainty: a retrospective analysis." Journal of The Royal Society Interface 15, no. 140 (March 2018): 20170575. http://dx.doi.org/10.1098/rsif.2017.0575.

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Resurgent outbreaks of vaccine-preventable diseases that have previously been controlled or eliminated have been observed in many settings. Reactive vaccination campaigns may successfully control outbreaks but must necessarily be implemented in the face of considerable uncertainty. Real-time surveillance may provide critical information about at-risk population and optimal vaccination targets, but may itself be limited by the specificity of disease confirmation. We propose an integrated modelling approach that synthesizes historical demographic and vaccination data with real-time outbreak surveillance via a dynamic transmission model and an age-specific disease confirmation model. We apply this framework to data from the 1996–1997 measles outbreak in São Paulo, Brazil. To simulate the information available to decision-makers, we truncated the surveillance data to what would have been available at 1 or 2 months prior to the realized interventions. We use the model, fitted to real-time observations, to evaluate the likelihood that candidate age-targeted interventions could control the outbreak. Using only data available prior to the interventions, we estimate that a significant excess of susceptible adults would prevent child-targeted campaigns from controlling the outbreak and that failing to account for age-specific confirmation rates would underestimate the importance of adult-targeted vaccination.
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Bisht, Anjali, Stacey Weinstein, and Daniel Uslan. "Utilizing Telemedicine During Outbreak Events to Reduce Exposure Risk." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s427—s428. http://dx.doi.org/10.1017/ice.2020.1088.

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Background: As of October 2019, the United States has seen the greatest number of annual measles cases reported since 1992, of which 2 outbreaks originated in Los Angeles County, California. Media reports and public awareness during outbreak events can result in large numbers of worried well patients or patients with outbreak mimics seeking medical attention. In densely populated cities, utilizing alternative approaches to in-person physician appointments can be beneficial to decrease both the overburden of healthcare resources as well as the spread of potential virus. During these measles outbreaks, we employed the use of telemedicine visits to facilitate triage and determination of in-person examination and testing needs. Methods: During the measles outbreak periods, patients who contacted the patient call center at our institution requesting an appointment for fever, rash, or expressing concerns for acute measles infection were instead routed for a telemedicine visit with a physician. All patients were all seen by the same physician, who was trained in internal medicine and pediatrics. During the telemedicine visit, patients were assessed for signs and symptoms consistent with acute measles based on CDC definition. If there was high enough clinical suspicion to warrant testing for measles, infection prevention coordinated logistics with clinic staff, including ensuring the use of appropriate personal protective equipment (PPE), end-of-day appointment scheduling, and appropriate diagnostic testing. Results: During this outbreak timeline, 7 patients were seen through telemedicine visits with ages ranging 13 months to 49 years. Also, 6 patients were scheduled due to a chief complaint of acute rash and 1 was due to a potential exposure to measles. Of 7 patients, 4 had received 1 dose of the MMR vaccine, and the remaining 3 were immune, unvaccinated, or had unknown immunity. The unvaccinated patient was further tested for measles but was IgM negative. Of those with chief complaint of rash, the diagnosis was determined to be some form of nonmeasles viral exanthem, allergic dermatitis/eczema, or hives. The exposed patient was deemed to be asymptomatic. Conclusions: During an outbreak, patients presenting to clinics with suspected measles symptoms can cause tremendous disruption, including concerns about exposure of staff and patients, need for contact tracing, and anxiety. Utilizing telemedicine appointments aided the management of patients during this outbreak by shifting physician evaluation outside the clinic. When evaluating suspect measles cases during an outbreak with patients who do not require further levels of care, telemedicine can prove to be useful in reducing the burden of potential exposure to others in the community and to the healthcare system.Funding: NoneDisclosures: None
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29

De Serres, Gaston, Nicole Boulianne, Sam Ratnam, and André Corriveau. "Effectiveness of Vaccination at 6 to 11 Months of Age During an Outbreak of Measles." Pediatrics 97, no. 2 (February 1, 1996): 232–35. http://dx.doi.org/10.1542/peds.97.2.232.

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Hypothesis. Monovalent measles vaccine can be administered to children 6 to 11 months of age during an outbreak. Efficacy and effectiveness of this control measure still have to be assessed. Methods. During an outbreak of measles, monovalent measles vaccine was administered as part of outbreak control to children aged 6 to 11 months. Active surveillance was used to detect cases of measles occurring during the following month. Children who did not develop measles were tested for measles antibody before their revaccination at 15 months of age. Results. Of 81 children 6 to 11 months of age, 56 were vaccinated and two received immunoglobulins; the latter were excluded from the analysis. Measles occurred in 15 of the 79 children during and after the vaccination campaign, for an overall attack rate of 19%. The attack rate among unvaccinated children was 39% (9 of 23), compared with 11% (6 of 56) among those vaccinated (relative risk = 3.6, 95% confidence interval [CI] = 1.5 to 9.1). All of those who sustained measles in the vaccinated group developed the disease within 10 days after vaccination. The overall vaccine effectiveness was 73% (95% CI = 32% to 89%) when children were classified as vaccinated as soon as they were given measles vaccine. It rose to 96% (95% CI = 72% to 99%) when children were considered vaccinated 1 week postimmunization. Nineteen infants who were vaccinated and who did not develop measles during the outbreak were tested for measles antibody status at 15 months of age before revaccination. All had plaque reduction neutralizing antibody titers greater than 120. Conclusion.This study confirms that measles vaccination of infants aged 6 to 11 months is an effective intervention measure during measles outbreaks.
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Seto, Junji, Yoko Aoki, Kenichi Komabayashi, Keiko Yamada, Hitoshi Ishikawa, Tomoo Ichikawa, Tadayuki Ahiko, and Katsumi Mizuta. "Measles Outbreak Response Activity in Japan, and a Discussion for a Possible Strategy of Outbreak Response Using Cycle Threshold Values of Real-Time Reverse Transcription PCR for Measles Virus in Measles Elimination Settings." Viruses 15, no. 1 (January 6, 2023): 171. http://dx.doi.org/10.3390/v15010171.

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Measles is a highly contagious, but vaccine-preventable disease caused by the measles virus (MeV). Although the administration of two doses of measles vaccines is the most effective strategy to prevent and eliminate measles, MeV continues to spread worldwide, even in 2022. In measles-eliminated countries, preparedness and response to measles outbreaks originating from imported cases are required to maintain elimination status. Under these circumstances, real-time reverse transcription (RT) PCR for MeV could provide a diagnostic method capable of strengthening the subnational capacity for outbreak responses. Real-time RT-PCR can detect MeV RNA from patients with measles at the initial symptomatic stage, which can enable rapid public health responses aimed at detecting their contacts and common sources of infection. Furthermore, low cycle threshold (Ct) values (i.e., high viral load) of throat swabs indicate high infectiousness in patients with measles. The high basic reproduction number of measles suggests that patients with high infectiousness can easily become super-spreaders. This opinion proposes a possible strategy of rapid and intensive responses to counter measles outbreaks caused by super-spreader candidates showing low Ct values in throat swabs. Our strategy would make it possible to effectively prevent further measles transmission, thereby leading to the early termination of measles outbreaks.
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Ehresmann, Kristen R., Nroman Crouch, Paula M. Henry, John M. Hunt, Tonia L. Habedank, Robert Bowman, and Kristine A. Moore. "An Outbreak of Measles among Unvacdnated Young Adults and Measles Seroprevalence Study: Implications for Measles Outbreak Control in Adult Populations." Journal of Infectious Diseases 189, Supplement_1 (May 1, 2004): S104—S107. http://dx.doi.org/10.1086/377714.

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32

Wong Chi, Hong, Chuang Shuk Kwan, Wing Hang Lam, Ho Yeung Lam, Tsz Sum Lam, Raymond Ho Lei Ming, Hong Leung Yi, and Chau Kuen Yonnie Lam. "Investigation and control of a measles outbreak at the Hong Kong International Airport, 2019." Western Pacific Surveillance and Response Journal 11, no. 2 (June 30, 2020): 1–4. http://dx.doi.org/10.5365/wpsar.2019.10.2.007.

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Introduction: Hong Kong SAR (China) achieved measles elimination status in 2016, and the incidence of measles infection had been low over the past few years. However, the Centre for Health Protection (CHP) at the Department of Health was notified on 22 March 2019 of an outbreak of three cases of measles infection among workers at the Hong Kong International Airport (HKIA). Methods: We reviewed notifications of measles received by CHP from 1 January to 17 May 2019. We defined a confirmed case of measles as having laboratory evidence of measles infection. All confirmed cases among airport workers or those with epidemiological information suggesting they had been infected by contact with airport workers were included in the review. We described the epidemiological features and reviewed the control measures against the outbreak. Results: We identified 33 cases, 29 of which were among airport workers. They comprised 22 men and 11 women, aged 20–49 years (median 25 years). The majority of people with confirmed measles presented with fever and rash. All required hospitalization. None developed complications. Control measures, including enhanced environmental hygiene and improved ventilation at HKIA and vaccinations for the airport community, were implemented. Vaccinations were provided to 8501 eligible airport workers, and the outbreak was declared over on 17 May 2019. Discussion: Early recognition of the outbreak and prompt control measures, especially targeted vaccination of the exposed population, effectively controlled the outbreak in just two weeks.
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33

Torner, N., J. Ferràs, L. Curto, J. Rebull, J. Sol, J. Costa, M. M. Mosquera, C. Izquierdo, A. Martínez, and M. Jané. "Measles outbreak related to healthcare transmission." Vacunas (English Edition) 22, no. 1 (January 2021): 20–27. http://dx.doi.org/10.1016/j.vacune.2021.01.003.

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34

Pike, Jamison, Alan Melnick, Paul A. Gastañaduy, Meagan Kay, Jeff Harbison, Andrew J. Leidner, Samantha Rice, Kennly Asato, Linda Schwartz, and Chas DeBolt. "Societal Costs of a Measles Outbreak." Pediatrics 147, no. 4 (March 12, 2021): e2020027037. http://dx.doi.org/10.1542/peds.2020-027037.

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35

Hall, Victoria, Emily Banerjee, Cynthia Kenyon, Anna Strain, Jayne Griffith, Kathryn Como-Sabetti, Jennifer Heath, et al. "Measles Outbreak — Minnesota April–May 2017." MMWR. Morbidity and Mortality Weekly Report 66, no. 27 (July 14, 2017): 713–17. http://dx.doi.org/10.15585/mmwr.mm6627a1.

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36

Robo, Alma, Elona Kureta, Alma Pura, Iria Preza, Erida Nelaj, Artan Simaku, Eugena Tomini, and Silvia Bino. "INVESTIGATION OF AN IMPORTED MEASLES OUTBREAK." International Journal of Ecosystems and Ecology Science (IJEES) 8, no. 4 (October 1, 2018): 809–12. http://dx.doi.org/10.31407/ijees8423.

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37

Welfare, W., and R. McCann. "Measles outbreak in Qassim, Saudi Arabia." Journal of Public Health 31, no. 2 (March 12, 2009): 306–7. http://dx.doi.org/10.1093/pubmed/fdp016.

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38

Mankazana, E. M. "Measles outbreak in a day nursery." Public Health 99, no. 3 (May 1985): 165–68. http://dx.doi.org/10.1016/s0033-3506(85)80106-2.

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39

ZOLER, MITCHEL L. "Vaccine Refusal Triggered 2005 Measles Outbreak." Family Practice News 36, no. 17 (September 2006): 26. http://dx.doi.org/10.1016/s0300-7073(06)73762-8.

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40

Champredon, David, Affan Shoukat, Burton H. Singer, Alison P. Galvani, and Seyed M. Moghadas. "Curbing the 2019 Samoa measles outbreak." Lancet Infectious Diseases 20, no. 3 (March 2020): 287–88. http://dx.doi.org/10.1016/s1473-3099(20)30044-x.

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41

Stewart, Oliver A., Joseph Kingsbery, and Shannon Chang. "Outbreak in New York! Measles Hepatitis." American Journal of Gastroenterology 115, no. 4 (April 2020): 502. http://dx.doi.org/10.14309/ajg.0000000000000325.

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42

Goodson, James L., Robert T. Perry, Ondrej Mach, David Manyanga, Elizabeth T. Luman, Mary Kitambi, Mary Kibona, Eric Wiesen, and K. Lisa Cairns. "Measles outbreak in Tanzania, 2006–2007." Vaccine 28, no. 37 (August 2010): 5979–85. http://dx.doi.org/10.1016/j.vaccine.2010.06.110.

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43

Narain, J. P., J. B. Farrell, J. P. Lofgren, and R. A. Gunn. "Imported measles outbreak in a university." American Journal of Public Health 75, no. 4 (April 1985): 397–98. http://dx.doi.org/10.2105/ajph.75.4.397.

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44

Kim, Yong Chan, and Young Hwa Choi. "Current and Prospect on Measles Outbreak." Korean Journal of Medicine 94, no. 3 (June 1, 2019): 237–45. http://dx.doi.org/10.3904/kjm.2019.94.3.237.

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45

Coronado, F. "Retrospective Measles Outbreak Investigation: Sudan, 2004." Journal of Tropical Pediatrics 52, no. 5 (January 9, 2006): 329–34. http://dx.doi.org/10.1093/tropej/fml026.

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46

Ratho, R. K., Baijayantimala Mishra, Tarundeep Singh, Pooja Rao, and Rajesh Kumar. "Measles outbreak in a migrant population." Indian Journal of Pediatrics 72, no. 10 (October 2005): 893–94. http://dx.doi.org/10.1007/bf02731127.

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47

Baggieri, Melissa, Anna Morea, Antonella Marchi, Paola Bucci, Daniela Loconsole, Maria Chironna, and Fabio Magurano. "Measles outbreak in Apulia, southern Italy." Journal of Medical Virology 92, no. 12 (July 27, 2020): 2897–99. http://dx.doi.org/10.1002/jmv.26313.

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48

Lindegren, M. L. "Measles vaccination in pediatric emergency departments during a measles outbreak." JAMA: The Journal of the American Medical Association 270, no. 18 (November 10, 1993): 2185–89. http://dx.doi.org/10.1001/jama.270.18.2185.

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49

Lindegren, Mary Lou. "Measles Vaccination in Pediatric Emergency Departments During a Measles Outbreak." JAMA: The Journal of the American Medical Association 270, no. 18 (November 10, 1993): 2185. http://dx.doi.org/10.1001/jama.1993.03510180055033.

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50

Yagci Sokat, Kezban, and Benjamin Armbruster. "Modeling and Controlling Epidemic Outbreaks: The Role of Population Size, Model Heterogeneity and Fast Response in the Case of Measles." Mathematics 8, no. 11 (October 31, 2020): 1892. http://dx.doi.org/10.3390/math8111892.

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Abstract:
Modelers typically use detailed simulation models and vary the fraction vaccinated to study outbreak control. However, there is currently no guidance for modelers on how much detail (i.e., heterogeneity) is necessary and how large a population to simulate. We provide theoretical and numerical guidance for those decisions and also analyze the benefit of a faster public health response through a stochastic simulation model in the case of measles in the United States. Theoretically, we prove that the outbreak size converges as the simulation population increases and that the outbreaks are slightly larger with a heterogeneous community structure. We find that the simulated outbreak size is not sensitive to the size of the simulated population beyond a certain size. We also observe that in case of an outbreak, a faster public health response provides benefits similar to increased vaccination. Insights from this study can inform the control and elimination measures of the ongoing coronavirus disease (COVID-19) as measles has shown to have a similar structure to COVID-19.
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