Русский
Clinical, epidemiological, and diagnostic characteristics of measles during its outbreak in a vaccined population
DOI: https://dx.doi.org/10.18565/epidem.2020.10.2.25-31
Matievskaya N.V., Samoilovich E.O., Kuznetsova E.V., Vasilyev A.V., Semeiko G.V., Miklash L.V., Ostrovskaya O.V.
1) Grodno State Medical University, Grodno, Republic of Belarus; 2) Republican Research and Practical Center for Epidemiology and Microbiology, Minsk, Republic of Belarus; 3) Grodno Regional Infectious Diseases Clinical Hospital, Grodno, Republic of Belarus; 4) Grodno Regional Center for Hygiene, Epidemiology, and Public Health, Grodno, Republic of Belarus
Materials and methods. Case histories were retrospectively analyzed in 43 patients diagnosed with measles. The diagnosis was confirmed by laboratory tests identifying anti-measles virus IgM antibodies or by detection of viral RNA in urine and/or nasopharyngeal swab. IgM was determined using enzyme-linked immunosorbent assay systems manufactured by Euroimmun (Germany) and the JSC «Vector-Best» (Russia). Viral RNA was determined by a one-step diagnostic real-time RT-PCR assay and/or a one-step RT-PCR with electrophoretic detection of reaction products. A total of 450 C-terminal nucleotides of the N-gene of 11 measles viruses were sequenced for genotyping.
Results. Among the measles cases, 83.7% were adults. Seven (16%) persons had not been vaccinated against measles. One (2%) and 28 (65%) patients received 1 and 2 doses of measles vaccine, respectively; there were no data about 7 (16%) patients. The vast majority (86.2%) of vaccinated cases had received the last dose of the vaccine 10 or more years earlier. There was no prodromal period or the latter reduced to 1–2 days in 88.4% of patients; Belsky–Filatov–Koplik spots were absent in 65.1%, and the staging of rash was in 48.8%. The unvaccinated individuals showed a higher and longer temperature response. Specific IgM antibodies were found in 36 (83.7%) patients; only molecular methods could confirm the diagnosis in 7%. 65.7% of patients formed 18 foci without subsequent disease transmission; 34.3% did 5 foci with cases of subsequent transmission. The detected measles viruses belonged to 2 genotypes: B3 and D8, the Gir Somnath genovariant.
Conclusion. The measles outbreak involved individuals vaccinated 10 or more years earlier. Mild and moderate forms of the disease prevailed in vaccinated cases. Only the combined use of serological and molecular assays makes it possible to obtain reliable measles diagnostic results in a well-vaccinated population.
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About the Autors
Information about the authors:
Nataliya V. Matsiyeuskaya – MD, Associated Professor, Head, Department of Infectious Diseases, Grodno State Medical University, Grodno, Republic of Belarus; е-mail: natamati@mail.ru; ORCID: http://orcid.org/0000-0001-8492-6377
Prof. Elena O. Samoilovich, MD, Head, Laboratory of Vaccine-Controlled Infections, Republican Research and Practical Center for Epidemiology and Microbiology, Grodno, Republic of Belarus; е-mail: esamoilovich@ gmail.com
Ekaterina V. Kuzniatsova, Infectiologist,, Grodno Regional Infectious Diseases Clinical Hospital; Grodno, Republic of Belarus; е-mail: kat.kuzniatsova@gmail.com
Aleksey V. Vasilev, Сand. Med. Sci., Associated Professor, Department of Infectious Diseases, Grodno State Medical University, Grodno, Republic of Belarus; е-mail: vasilevgrsmu@gmail.com; ORCID: http://orcid.org/0000-0002-7415-4112
Galina V. Semeiko, Сand. Biol. Sci., Leading Researcher, Laboratory of Vaccine-Controlled Infections, Republican Research and Practical Center for Epidemiology and Microbiology, Grodno, Republic of Belarus; e-mail: g-semeiko@yandex.ru
Liliya V. Miklash, Head, Department of Immunoprophylaxis, Grodno Regional Center for Hygiene, Epidemiology and Public Health, Grodno, Republic of Belarus; е-mail: ocge@mail.grodno.by
Oksana V. Ostrovskaya, Head, Diagnostic Department, Grodno Regional Infectious Diseases Clinical Hospital, Grodno, Republic of Belarus; е-mail: ostrovskaja7737@gmail.com
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