Keywords
outbreak
vaccination coverage
Abstract
Abstract
Introduction. Measles continues to be a major public health issue worldwide, with high morbidity and mortality rates. The disease remains endemic in 14 European countries, including Italy where, from 2013 to 2016, over 5,000 cases have been reported. In 2017, many Italian regions, including Sicily, have reported many cases of measles. In this study, we described the latest measles outbreak in the city of Messina, from 1st February to 31st August 2017.
Methods. We considered all reported measles cases that came to the “Public Health, Epidemiology and Preventive Medicine” Operative Unit of the Messina Provincial Health Agency Prevention Department, which receives all reported cases of measles in the Messina province.
Results. From 1st February to 31st August 2017, a total of 59 measles cases were reported, of which 44 were confirmed, nine were classified as possible, four were probable and two cases were discarded. Of the 57 possible, probable and confirmed cases, 31 (54%) were males and 26 (46%) were females. Moreover, 54 (95%) had not been previously vaccinated while the remaining cases had documented evidence of one (two cases) or two doses (one case). Genotype B3 was identified in 39 cases (68%) by the regional reference laboratory in Palermo.
Conclusion. Despite the development of an effective vaccination, unfortunately measles continues to threaten the lives of millions of children worldwide each year. The suboptimal immunisation level in Italy has led to an increase in the transmission of measles with detrimental effects on both public health and ongoing measles elimination efforts.
References
Amendola A, Bianchi S, Frati ER, Ciceri G, Faccini M, Senatore S , Colzani D, Lamberti A, Baggieri M, Cereda D, Gramegna M, Nicoletti L, Magurano F, Tanzi E. Ongoing large measles outbreak with nosocomial transmission in Milan, northern Italy, March–August 2017. Euro Surveill. 2017 Aug 17; 22(33). pii: 30596. doi: 10.2807/1560-7917.ES.2017.22.33.30596.
Bassetti M, Schenone E, Calzi A, Camera M, Valle L, Ansaldi F, Pagano G, Viscoli C. Measles outbreak in adults in Italy. Infez Med. 2011 Mar;19(1):16-9.
Celesia BM, Fontana R, Pinzone MR, Cuccia M, Bellissimo F, Rapisarda L, Rinnone S, Rapisarda V, Pavone P, Cacopardo B, Nunnari G. A measles outbreak in Catania, Sicily: the importance of high vaccination coverage and early notification of cases for health and economic reasons. Infez Med. 2014 Sep; 22(3):222-6
Epicentro. Morbillo, aspetti epidemiologici. Available from: http://www.epicentro.iss.it/problemi/morbillo/epidItalia.asp
European Centre for Disease Prevention and Control (ECDC). Epidemiological update: Measles - monitoring European outbreaks, 7 July 2017. Stockholm: ECDC; [Accessed 31 Aug 2017]. Available from: https://ecdc.europa.eu/en/news-events/epidemiological-update-measles-monitoring-europeanoutbreaks-7-july-2017
European Centre for Disease Prevention and Control (ECDC). Ongoing outbreak of measles in Romania, risk of spread and epidemiological situation in EU/EEA countries– 3 March 2017. Stockholm: ECDC; Mar 2017. Available from: https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/27-02-2017-RRA-Measles-Romania%2C%20European%20Union%20countries.pdf
European Centre for Disease Prevention and Control (ECDC). Measles and rubella monitoring, January 2017 – Disease surveillance data: 1 January 2016 – 31 December 2016. Stockholm: ECDC; 2017. Available from: http://ecdc.europa.eu/en/publications/Publications/measles%20-rubellamonitoring-170424.pdf
European Centre for Disease Prevention and Control (ECDC). Communicable Disease Threats Report. Week 36, 3-9 Sep 2017. Stockholm: ECDC. Available from: https://ecdc.europa.eu/sites/portal/files/documents/Communicable-disease-threats-report-09-sep-2017.pdf
European Commission. Commission Implementing Decision of 8 August 2012 amending Decision 2002/253/EC laying down case definitions for reporting communicable diseases to the Community network under Decision No 2119/98/EC of the European Parliament and of the Council. Luxembourg: Publications Office of the European Union. L262 Sep 27, 2012. Available from: http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=OJ%3AL%3A2012%3A262%3ATOC
Filia A, Amendola A, Faccini M, Del Manso M, Senatore S, Bianchi S, Borrini BM, Ciampelli A, Tanzi E, Filipponi MT, Piccirilli G, Lazzarotto T, Pascucci MG, Baggieri M, Magurano F. Outbreak of a new measles B3 variant in the Roma/Sinti population with transmission in the nosocomial setting, Italy, November 2015 to April 2016. Euro Surveill. 2016 May 19;21(20). doi: 10.2807/1560-7917.ES.2016.21.20.30235
George F, Valente J, Augusto GF, Silva AJ, Pereira N, Fernandes T, Palminha P, Aguiar BA, Martins A, Santos E, Valente P, Calé E, Leça A, Nogueira PJ. Measles outbreak after 12 years without endemic transmission, Portugal, February to May 2017. Euro Surveill. 2017 Jun; 22(23). pii: 30548. doi: 10.2807/1560-7917.ES.2017.22.23.30548.
Grammens T, Schirvel C, Leenen S, Shodu N, Hutse V, Mendes da Costa E, Sabbe M. Ongoing measles outbreak in Wallonia, Belgium, December 2016 to March 2017: characteristics and challenges. Euro Surveill. 2017 Apr 27;22(17). pii:30524. doi:10.2807/1560-7917.ES.2017.22.17.30524
Magurano F, Marella GL, Marchi A, Filia A, Marsella LT, Potenza S, Massa R, Bucci P, Baggieri M, Nicoletti L. A case of fulminant subacute sclerosing panencephalitis presenting with acute myoclonic-astatic epilepsy. Ann Ist Super Sanita. 2017 Apr-Jun; 53(2): 167-169. doi: 10.4415/ANN_17_02_15
Ministry of Health, Italy. Lettera circolare del 20 aprile 2007. Piano nazionale di eliminazione del morbillo e della rosolia congenita: istituzione di un sistema di sorveglianza speciale per morbillo. Available from: http://www.epicentro.iss.it/focus/morbillo/pdf/sorveglianza-speciale_morbillo.pdf (Last access: Sep 2017).
Ministry of Health, Italy. Piano nazionale per l'eliminazione del morbillo e della rosolia congenita (PNEMoRc) 2010-2015 (PNEMoRc). 2011. Available from: http://www.salute.gov.it/imgs/C_17_pubblicazioni_1519_allegato.pdf
Ministry of Health, Italy. 2016. Vaccination coverage in childhood and in adolescents. (Accessed: Sep 2017). Italy. Available from: http://www.salute.gov.it/imgs/C_17_tavole_20_allegati_iitemAllegati_0_fileAllegati_itemFile_5_file.pdf and http://www.salute.gov.it/imgs/C_17_tavole_20_allegati_iitemAllegati_3_fileAllegati_itemFile_5_file.pdf
National Integrated Measles Rubella Surveillance System. Measles in Italy: weekly bulletin. Week: 4-10 september 2017) Update as of 12 September 2017. Rome: Istituto Superiore di Sanità. (Accessed: Sep 2017). Available from: http://www.epicentro.iss.it/problemi/morbillo/bollettino/Measles_WeeklyReport_N25.pdf
Nic Lochlainn L, Mandal S, de Sousa R, Paranthaman K, van Binnendijk R, Ramsay M, Hahné S, Brown KE. A unique measles B3 cluster in the United Kingdom and the Netherlands linked to air travel and transit at a large international airport, February to April 2014. Euro Surveill. 2016; 21(13). doi: 10.2807/1560-7917.ES.2016.21.13.30177
Porretta A, Quattrone F, Aquino F, Pieve G, Bruni B, Gemignani G, Vatteroni ML, Pistello M, Privitera GP, Lopalco PL. A nosocomial measles outbreak in Italy, February-April 2017. Euro Surveill. 2017 Aug 17;22(33). pii: 30597. doi: 10.2807/1560-7917.ES.2017.22.33.30597
Veneto Region. Italy. ULSS20 Verona. Indagine sui determinanti del rifiuto dell’offerta vaccinale nella Regione Veneto. [Final report. Survey to identify determinants of vaccine refusal in the Veneto region, Italy]. Verona: Veneto Region Department of Health; June 2011. [Accessed Sep 2017]. Available from: https://prevenzione.ulss20.verona.it/docs/RicercheScelteVaccinali/Indagine-Determinanti-Scelta-Vaccinale-Report.pdf
WHO. World Health Organization. Eliminating Measles and rubella - Framework for the verification process in the WHO European Region 2014. Copenhagen: WHO; 2014. Available from: http://www.euro.who.int/__data/assets/pdf_file/0009/247356/Eliminating-measles-and-rubella- Framework-for-the-verification-process-in-the-WHO-European-Region.pdf
WHO. Regional Office for Europe, 64th session, Copenhagen, Denmark, September 2014, European Vaccine Action Plan 2015–2020 Available from: http://www.euro.who.int/__data/assets/pdf_file/0020/253730/64wd15e_EVAP_140459.pdf
WHO. World Health Organization. Measles Nucleotide Surveillance (MeaNS) Database. Geneva 2017. Available from: http://www.hpa-bioinformatics.org.uk/Measles/Public/Web_Front/main.php
WHO. World Health Organization. (Updated July 2017) Available from: http://www.who.int/mediacentre/factsheets/fs286/en/