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. 2010 Mar 11:10:62.
doi: 10.1186/1471-2334-10-62.

Description of two measles outbreaks in the Lazio Region, Italy (2006-2007). Importance of pockets of low vaccine coverage in sustaining the infection

Filippo Curtale  1 , Fabrizio Perrelli, Jessica Mantovani, Marta Ciofi degli Atti, Antonietta Filia, Loredana Nicoletti, Fabio Magurano, Piero Borgia, Domenico Di Lallo
Affiliations

Description of two measles outbreaks in the Lazio Region, Italy (2006-2007). Importance of pockets of low vaccine coverage in sustaining the infection

Filippo Curtale et al. BMC Infect Dis. .

Abstract

Background: Despite the launch of the national plan for measles elimination, in Italy, immunization coverage remains suboptimal and outbreaks continue to occur. Two measles outbreaks, occurred in Lazio region during 2006-2007, were investigated to identify sources of infection, transmission routes, and assess operational implications for elimination of the disease.

Methods: Data were obtained from several sources, the routine infectious diseases surveillance system, field epidemiological investigations, and molecular genotyping of virus by the national reference laboratory.

Results: Overall 449 cases were reported, sustained by two different stereotypes overlapping for few months. Serotype D4 was likely imported from Romania by a Roma/Sinti family and subsequently spread to the rest of the population. Serotype B3 was responsible for the second outbreak which started in a secondary school. Pockets of low vaccine coverage individuals (Roma/Sinti communities, high school students) facilitated the reintroduction of serotypes not endemic in Italy and facilitated the measles infection to spread.

Conclusions: Communities with low vaccine coverage represent a more serious public health threat than do sporadic susceptible individuals. The successful elimination of measles will require additional efforts to immunize low vaccine coverage population groups, including hard-to-reach individuals, adolescents, and young adults. An enhanced surveillance systems, which includes viral genotyping to document chains of transmission, is an essential tool for evaluating strategy to control and eliminate measles.

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Figures

Figure 1
Figure 1
Number of reported measles cases by month of onset of symptoms, amongst Rom/Sinti and Italian ethnic population, in the Lazio region, June 2006 - August 2007 (Total n = 449), and period of detection of different stereotypes. In the boxes the sequence of different stereotypes and clusters of common origin identified. The two cases reported among the Italian ethnic population in the first two weeks of June, and the six cases in July-August 2007, should be considered endemic cases.
Figure 2
Figure 2
Distribution of measles cases by district (LHU) of residence, in Lazio region, reported between June 2006 and August 2007 (Total n = 449). Urban Rome: LHU RM-A to RM-E. Province of Rome: RM-F to RM-H. 14 cases were diagnosed in Lazio, but resident in other regions.
Figure 3
Figure 3
Number of reported measles cases by age group, Roma/Sinti and Italian ethnic population. Lazio region, June 2006 - August 2007 (n = 449).
Figure 4
Figure 4
Measles outbreaks reported in Southern Europe in the years 2006-2007. Diffusion of the two measles genotypes affecting Lazio. Duration of the outbreaks in months and number of subjects affected in each outbreak are indicated in the boxes.
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References

    1. World Health Organization Regional Office for Europe. Strategic plan for measles and congenital rubella infection in the European region of WHO. Copenhagen: WHO Regional Office for Europe; 2003.
    1. World Health Organization Regional Office for Europe. Eliminating measles and rubella and preventing congenital rubella infection. WHO European Region strategic plan 2005-2010. Copenhagen, WHO Regional Office for Europe; 2005.
    1. World Health Organization. Progress towards elimination of measles and prevention of congenital rubella infection in the European Region, 1990-2004. Weekly Epidemiological Record. 2005;80(8):66–71. http://www.who.int/wer/2005/wer8008.pdf - PubMed
    1. Muscat M, Bang H, Wohlfahrt J, Glismann S, Mølbak K. EUVAC.NET Group. Measles in Europe, an epidemiological assessment. Lancet. 2009;373(9661):383–389. doi: 10.1016/S0140-6736(08)61849-8. - DOI - PubMed
    1. Piano Nazionale Vaccini 1999-2000: Provvedimento conferenza Stato regioni 18 Giugno 1999 (G.U. suppl. N 144 del 29 luglio 1999)

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