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. 2019 Dec 4:25:9245-9254.
doi: 10.12659/MSM.920614.

Phylogenetic and Epidemiological Analysis of Measles Viruses in Shenzhen, China from January 2015 to July 2019

Min Lei  1 , Kai Wang  2 , Jing Li  3 , Yan Zhang  4 , Xuemei Wei  1 , Lifeng Qi  1 , Gaofeng Zhou  1 , Yue Wu  5
Affiliations

Phylogenetic and Epidemiological Analysis of Measles Viruses in Shenzhen, China from January 2015 to July 2019

Min Lei et al. Med Sci Monit. .

Abstract

BACKGROUND Measles morbidity and mortality were significantly reduced after the measles vaccine was introduced in China in 1965. However, measles outbreaks easily occur in densely populated areas, especially where there is no universal vaccination. The outbreak that occurred in Shenzhen, the Chinese city with the largest internal immigration, provides a lesson in measles virus mutation and measles prevention. The present study is a phylogenetic analysis of measles viruses and comparison of clinical signs between individuals with and without vaccination. MATERIAL AND METHODS We performed phylogenetic analysis of the nucleoprotein (N) genes of measles virus from 129 measles patients in Shenzhen from January 2015 to July 2019. Phylogenetic trees were constructed using the neighbor-joining method. RESULTS The phylogenetic analysis showed all viruses were classified into genotype H1. In addition, there is often a seasonal measles outbreak in July each year. The clinical data showed that patients who were unvaccinated were more likely to have coughing, chronic bronchitis, conjunctivitis, catarrh, Koplik spots, and diarrhea. Children of migrant workers and those living in mountainous and rural districts accounted for most measles cases. CONCLUSIONS Our results showed there was a seasonal measles outbreak in Shenzhen Children's Hospital. All the measles virus from 129 measles patients were H1 viruses. The clinical signs also showed a difference between unvaccinated and vaccinated patients. Moreover, most of the unvaccinated patients came from migrant worker families. We suggest there is a need for increased health promotion and vaccination programs for migrant workers and people living in remote villages.

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Conflict of interest statement

Conflicts of interest

None.

Figures

Figure 1
Figure 1
Characteristics of measles cases in Shenzhen Children Hospital, January 2015 to July 2019. (A) The age range and sex ratio in measles cases; (B) District distribution of measles cases in Shenzhen. (C). Scatter plot of age and sex in female and male measles cases.
Figure 2
Figure 2
Measles cases over time in Shenzhen Children’s Hospital, 2015 to July 2019. (A) The number of cases per month January 2015 to July 2019; (B) Monthly case count in January 2015 to July 2019.
Figure 3
Figure 3
The education level of patients’ parents in Shenzhen Children’s Hospital, January 2015 to July 2019.
Figure 4
Figure 4
Geographic distribution of patients’ household registration in Shenzhen Children’s Hospital, January 2015 to July 2019.
Figure 5
Figure 5
Phylogenetic tree based on the nucleotide protein (N) gene sequences of various strains of the measles virus. The dendrogram was created with MEGAX software and the neighbor-joining method (1000 bootstraps).
See this image and copyright information in PMC

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