Abstract
Purpose
This study analyzed a small outbreak of measles at a single hospital located in northern Gyeonggi-do in 2013.
Methods
We reviewed the medical records of measles patients at The Catholic University of Korea Uijeongbu St. Mary's Hospital from August to October, 2013.
Results
Fifteen children were confirmed to have measles by RT—PCR and serum IgM test; 1 neonate, 11 infants, and 3 toddlers. None of the patients had received Measles—Mumps-Rubella vaccination. All patients showed B3 type in viral genotyping. Nine children (60%) had been exposed to measles during treatment for other diseases in the pediatric ward. Incubation period was between 8 and 15 days. Fever started at a median 10 days after exposure and persisted for a median of 8 days. Rash showed at a median 13 days after exposure. Respiratory complications were observed in 40% of patients. Diarrhea developed in 53% of patients.
Conclusion
Although measles has been well—controlled due to the high rate of vaccination coverage, it is possible to have an outbreak at any given time, especially in infants. We must learn from this outbreak, and remain fully aware of the possibility of reemergence and provide proper management, including vaccination or immune globulin administration, to infants exposed to measles. Reevaluation of serum lgG titer of neonates, infants, and pregnant women may be the first step to prevent further outbreaks.
REFERENCES
1. Park Y]. Eom HS, Kim ES, Choe YI, Bae GR, Lee DH. Reemergence of measles in South Korea: implication for immunization and surveillance programs. Ipn I Infect Dis. 2013; 66:6–10.
2. Rappuoli R, Pizza M, Del Giudice G, De Gregorio E. Vaccines, new opportunities for a new society. Proc Natl Acad Sci USA. 2014; 111:12288–93.
3. Rogalska I, Karasek E, Paradowska-Stankiewicz I. Measles in Poland in 2012. Przegi Epidemiol. 2014; 68:187–90.
4. Caseris M, Houhou N, Lonquet P, Rioux C, Lepeule P, Rioux C, et al. French 2010—2011 measles outbreak in adults: report from a Parisian teaching hospital. Clin Microbiol Infect. 2014; 20:0242–4.
5. Navarro E, Mochon MM, Galicia MD, Marin I, Laquna I. Study of a measles outbreak in Granada with preventive measures applied by the courts, Spain, 2010 to 2011. Euro Surveill. 2013; 18:pii=20612.
6. Gastanaduy PA, Redd SB, Fiebelkorn AP, Rota IS, Rota PA, Bellini W], et al. Measles—United States, January 1-May 23, 2014. MMWR Morb Mortal Wkly Rep. 2014; 63:496–9.
7. Teleb N, Lebo E, Ahmed H, Hossam AR, El Sayed 61 T, Dab—bagh A, et al. Progress toward measles elimination—Eastern Mediterranean Region, 2008-2012. MMWR Morb Mortal Wkly Rep. 2014; 63:511–5.
8. Wallace AS, Masresha BG, Grant G, Goodson IL, Birhane H, Abraham M, et al. Evaluation of economic costs of a measles outbreak and outbreak response activities in Keffa Zone, Ethiopia. Vaccine. 2014; 32:4505–14.
9. Mitchell P, Turner N, Iennings L, Dong H. Previous vaccina—tion modifies both the clinical disease and immunological features in children with measles. I Prim Health Care. 2013; 52:93–8.
10. Griffine DE. Measles virus and the nervous system. Handb Clin Neur01. 2014; 123:577–90.
11. Nadaoka Y, Hayata N, Suqishita Y, Kajiwara T, Watanabe Y, Yoshida M, et al. The 2011 measles outbreak in Tokyo. An analysis of surveillance data. Nihon Koshu Eisei Zasshi. 2014; 61:136–44.
12. Maglione MA, Das L, Raaen L, Smith A, Chari R, Newberry S, et al. Safety of vaccines used for routine immunization of US. children: a systematic review. Pediatrics. 2014; 134:325–37.
13. Defay F, De Serres G, Skowornski DM, Boulianne N, Ouakki M, Landy M, et al. Measles in children vaccinated with 2 doses of MMR. Pediatrics. 2013; 132:61126–33.
15. Giddings G, Sibbald B. Imported measles outbreaks prompt call for patents to vaccinate their children. CMAI. 2014; 186:205–6.
16. Centers for Disease Control and Prevention (CDC). Two measles outbreaks after importation——Utah, March-Iune 2011. MMWR Morb Mortal Wkly Rep. 2013; 62:222–5.
17. Rosen IB, Rota IS, Hickman C], Sewers SB, Mercarder S, Rota PA, et al. Outbreak of measles among persons with prior evidence of immunity, New York City, 2011. Clin Infect Dis. 2014; 58:1205–10.
18. Tapisiz A, Polat M, Kara SS, Tezer H, Simsek H, Aktas F. Prevention of measles spread on a paediatric ward. Epidemiol Infect. 2014; 30:1–5.
19. Borrés E1. Urbiztondo L, Costa I, Batalla I, Torner N, Plasencia A, et al. Measles antibodies and response to vaccination in children aged less than 14 months: implications for age of vaccination. Epidemiol Infect. 2012; 140:1599–606.
20. Wang F], Sun X], Wang FL, Iiang LF, Xu EP, Guo IF. An out—break of adult measles by nosocomial transmission in a high vaccination coverage community. Int] Infect Dis. 2014; 26:67–70.