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Measles outbreaks in the Emilia-Romagna Region, Italy, during 2016

Giulia Piccirilli, Angela Chiereghin, Gabriele Turello, Roberta Zuntini, Silvia Felici, Melissa Baggieri, Loredana Nicoletti, Fabio Magurano, Gabriella Frasca, Maria Grazia Pascucci, Liliana Gabrielli, Tiziana Lazzarotto
  • Giulia Piccirilli
    Microbiology Unit, Laboratory of Virology, Department of Specialized, Experimental, and Diagnostic Medicine, St. Orsola-Malpighi Polyclinic, University of Bologna, Italy
  • Angela Chiereghin
    Microbiology Unit, Laboratory of Virology, Department of Specialized, Experimental, and Diagnostic Medicine, St. Orsola-Malpighi Polyclinic, University of Bologna, Italy
  • Gabriele Turello
    Microbiology Unit, Laboratory of Virology, Department of Specialized, Experimental, and Diagnostic Medicine, St. Orsola-Malpighi Polyclinic, University of Bologna, Italy
  • Roberta Zuntini
    Unit of Medical Genetics, Department of Medical and Surgical Sciences, University of Bologna, Italy
  • Silvia Felici
    Microbiology Unit, Laboratory of Virology, Department of Specialized, Experimental, and Diagnostic Medicine, St. Orsola-Malpighi Polyclinic, University of Bologna, Italy
  • Melissa Baggieri
    WHO National Reference Laboratory for Measles and Rubella, Network of Subnational Reference Laboratory for Measles and Rubella, MoRoNet, Istituto Superiore di Sanità, Rome, Italy
  • Loredana Nicoletti
    WHO National Reference Laboratory for Measles and Rubella, Network of Subnational Reference Laboratory for Measles and Rubella, MoRoNet, Istituto Superiore di Sanità, Rome, Italy
  • Fabio Magurano
    WHO National Reference Laboratory for Measles and Rubella, Network of Subnational Reference Laboratory for Measles and Rubella, MoRoNet, Istituto Superiore di Sanità, Rome, Italy
  • Gabriella Frasca
    Public Health Unit, Emilia-Romagna Region, Bologna, Italy
  • Maria Grazia Pascucci
    Public Health Unit, Emilia-Romagna Region, Bologna, Italy
  • Liliana Gabrielli
    Microbiology Unit, Laboratory of Virology, Department of Specialized, Experimental, and Diagnostic Medicine, St. Orsola-Malpighi Polyclinic, University of Bologna, Italy
  • Tiziana Lazzarotto
    Microbiology Unit, Laboratory of Virology, Department of Specialized, Experimental, and Diagnostic Medicine, St. Orsola-Malpighi Polyclinic, University of Bologna, Italy | tiziana.lazzarotto@unibo.it

Abstract

Background and aim. Despite the availability of a vaccine,measles continues to be endemic in Italy, where an increase of cases was reported during 2016. This study describes the measles outbreaks in Emilia-Romagna Region (ERR), one of the Italian regions mostly affected.
Materials and Methods.
A total of 101 suspected cases were reported in ERR during 2016. Laboratory diagnosis by serological and/or molecular methods was performed on 142 specimens (78 urine, 19 oral fluid and 45 sera) related to 97 suspected cases. For positive cases, measles virus (MV) strains involved were identified.
Results. Among 101 suspected cases, 72 (71.3%) were confirmed. Vaccination status was known for 61 (84.7%) cases, of which 56 (91.8%) were unvaccinated. The highest incidence was found in the age group 15-39 years. In addition, for the 34.7% (25/72) of confirmed cases, the transmission occurred in nosocomial settings, where healthcare workers were involved (60% of cases). Roma/Sinti population were also involved in 12.5% (9/72)or confirmed cases. Both groups are considered hard-to-reach for immunization. The phylogenetic analysis showed circulation of MV strains belonging to genotype B3 and D8 in 45 (80.4%) and 11 cases (19.6%), respectively. In 94.7% of cases, the measles endemic transmission was demonstrated.
Conclusions
. This data obtained through active surveillance showed the endemic transmission of MV within a population with immunity gaps including healthcare workers (20.8% of confirmed cases), among which the spread of two endemic MV strains was observed.

Keywords

Measles, molecular diagnosis, serological diagnosis, endemic MV strains

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Submitted: 2017-12-06 21:36:04
Published: 2017-12-30 00:00:00
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Copyright (c) 2018 Giulia Piccirilli, Angela Chiereghin, Gabriele Turello, Roberta Zuntini, Silvia Felici, Melissa Baggieri, Loredana Nicoletti, Fabio Magurano, Gabriella Frasca, Maria Grazia Pascucci, Liliana Gabrielli, Tiziana Lazzarotto

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