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Published Date: 2012-02-19 18:07:18
Subject: PRO/EDR> Measles update 2012 (08)
Archive Number: 20120219.1046416

MEASLES UPDATE 2012 (08)
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In this update

Europe
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[1] Spain (Alicante)
[2] Russia (Belgorod)
[3] Russia (Oryol)
[4] Russia (St Petersburg)
[5] UK (Merseyside)
[6] UK (Wales)

Africa
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[7] Angola (Songo)

The Americas
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[8] USA (Indiana)

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Europe
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[1] Spain (Alicante)
Date: Thu 16 Feb 2012
Source: información.es Alica [In Spanish, machine translation, abbreviated & edited]
http://www.diarioinformacion.com/alicante/2012/02/16/sanidad-asegura-origen-epidemia-sarampion-personas-etnia-gitana/1223965.html

178 cases of measles in Alicante
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Measles continues to spread like an epidemic in the province of Alicante, although the health authorities are still referring to it as an outbreak. In the last week 50 new cases have been reported in the province. The Elda department has recorded the first two infections since the beginning of the year, while in Elche there are now 20 cases, after 14 new cases were recorded in the past week, and in the city of Alicante the figure has rises to 156 with 36 new patients. In total, 178 measles infections have been recorded since the beginning of the year across the province of Alicante.

The regional secretary for health, Nela Garcia, acknowledged yesterday in Elche an increase in measles cases in "crowded environments with few hygienic conditions." Garcia added that, specifically, an increase is taking place "among Roma community".

The disease in the past month has spread across the province, the regional secretary said that we are facing an outbreak "due to lack of vaccination." This year, he said, "we have already observed 200 cases in Valencia, a figure much higher than in previous years." Garcia added that "there is an outbreak in Alicante and consequently vaccination is being increased."

Among the measures to be taken to try to limit the contagion are advancement of the first dose of MMR vaccine (which protects against measles, rubella and mumps) from 15 to 12 months. It has also recommended that adults between 25 and 40 years of age who are not vaccinated or who have not had the disease, should be included in the vacation campaign.

Among the causes of increased disease in the past year, has been the increasing reluctance of parents to vaccinate their children for fear that the vaccine can have side effects. A trend that has its main focus in England and throughout Europe has led to an increase in cases in recent years. Measles is one of the most contagious diseases and, until last year, had been virtually eradicated.

In the province of Alicante, the Department of Health is calling all those who have had contact with a measles patient to seek vaccination, including adults who may not have had the disease. Children between 6 and 15 months are being vaccinated to protect them against disease.

However, in view of the steady increase in cases in recent weeks, other containment measures are being considered, such as advancing the second MMR dose from 5 to 2 years of age, as recommended by scientific societies.

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[Alicante is a province of eastern Spain, in the southern part of the Valencian Community. It is bordered by the provinces of Murcia on the south west, Albacete on the west, Valencia on the north, and the Mediterranean Sea on the east. The province is named after its capital, the city of Alicante. Th province of Alicante can be located by accessing the HealthMap interactive map at http://healthmap.org/r/1Ogk. - Mod.CP]

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[2] Russia (Belgorod)
Date: Mon 13 Feb 2012
Source: RuFox [In Russian, trans. & edited by Mod.CP]
http://news.rufox.ru/texts/2012/02/13/22600.htm

Measles outbreak recorded in the Belgorod region
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Nine members of staff and patients in the Chernyansky district hospital of the Belgorod oblast (region) have contracted measles. As of today [Mon 13 Feb 2012] the 9 measles cases include 3 unimmunised children under 2 years of age.

The RIA Novosti news agency reported that a 22 year old woman from Chernyanka is considered to be the source of the outbreak. According to the regional Rospotrebnadzor [health and welfare surveillance service], this woman had contracted the infection in Moscow and had returned home before symptoms developed. Her condition was not immediately diagnosed and nosocomial spread of infection occurred as a result of laxity on the part of the local medical staff. All appropriate control measures are now in place to prevent further spread of infection.

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[The Belgorod oblast [region] was established in 1954 is part of the Central Federal District of Russia. The region is bounded by Ukraine in the south, Kursk oblast in the north, and Voronezh oblast in the east. A map and description of the Bergorod oblast can be accessed at http://map.rin.ru/cgi-bin/main_e.pl?Region=belgorod. - Mod.CP]

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[3] Russia (Oryol)
Date: Fri 17 Feb 2012
Ssurce: TRK-Istoki [In Russian, machine translation, abbreviated & edited]
http://trk-istoki.ru/news/city/16664/

Outbreak spreads to Oryol region
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There have already been more than 100 cases in our capital city St Petersburg as a consequence of the spread or measles through northern Europe due to deficiencies in vaccine coverage. Nor has our region remained unscathed. The Oryol [also transliterated as Orel. - Mod.CP] Region Office of Rospotrebnadzor [the health and welfare surveillance organisation] has received an urgent letter from Gennady Onishchenko [the head or the consumer protection agency] to the effect that the measles situation in Russia was deteriorating. One week ago this disease was reported in 13 regions, now the number has risen to 30. These include our neighboring Belgorod and Voronezh regions and spread to our region is inevitable. Indeed 2 cases have already been confirmed according to the Department of Epidemiological Surveillance of the Oryol region.

Measles can be a severe infection that is tranmitted by brief contact, and not necessarily by direct contact. According to Natalia Abashevothe virus can spread between the floors of apartments in an apartment block, even if people do not come into contact with each other. [An improbable event. - Mod.CP]. The belief that measles is a childhood disease, long ago eradicated, must be dispelled. Increasing numbers of adults are being infected, some with more severe outcomes.

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[Maps showing the locate of Oryol region can be accessed at http://russiaprofile.org/bg_places/resources_territory_districts_orel.html. - Mod.CP]

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[4] Russia (St Petersburg)
Date: Mon 13 Feb 2012
Source: Piter.TV [In Russian, trans. & edited by Mod.CP]
http://piter.tv/event/Iz_za_kori_v_obschezhitii_S/

Measles outbreak involves St Petersburg State University
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There has been an increasing incidence of measles virus infection in St Petersburg. Apart from a few dozen cases of infection admitted to the No.1 Children's Hospital, cases of measles have been recorded now in a dormitory at St Petersburg State University, which is under quarantine.

Several affected students are accommodated in a dormitory at Building 20 of the Naval University; a few are seriously ill according to media reports. The dormitory has been placed under quarantine for the period 10 Feb to 2 Mar 2012. As a consequence admission of new students to this hostel is strictly prohibited, since they might contract the infection from the resident students and staff.

It has been established that there are now several hundred cases of measles in St Petersburg. More than 80 per cent of the cases are children. In previous years there had been few cases of measles in St Petersburg, which has resulted in reduced surveillance.

The source of the present outbreak is believed to be a teenager, who came from a southern region, and who had contracted the disease from his younger sister. However, as a result of poor assessment of his condition, the youth was admitted to a hospital ward housing infants who have not yet been vaccinated against the disease. Before his condition was correctly diagnosed, he had spread the infection to others.

The federal authorities warn that there is a likelihood of further spread of measles in St Petersburg due due to the large number of persons who remain unvaccinated against the disease.

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[The interactive HealthMap of Russia at http://healthmap.org/r/1KlF can be used to locate St Petersburg. - Mod.CP]

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[5] UK (England: Merseyside)
Date: Thu 16 Feb 2012
Source: Liverpool Echo [edited]
http://www.liverpoolecho.co.uk/liverpool-news/local-news/2012/02/16/merseyside-measles-outbreak-leaves-six-in-hospital-100252-30340930/

Merseyside measles outbreak leaves 6 in hospital
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An outbreak of measles was announced by health chiefs today. There were 13 confirmed and 16 suspected cases in the region, according to the Health Protection Agency (HPA). Six people -- 4 children and 2 adults -- were being treated in hospital. This compares to just one confirmed case on Merseyside in the first 6 weeks of both 2011 and 2010.

Patients range in age from 9 months to 20 years. Parents are being urged to ensure their children are fully vaccinated with the MMR jab. The majority of cases have been reported in Liverpool [city] with one small family cluster in St Helens.

The 4 children were being treated in Alder Hey [hospital] and 2 adults had been admitted to the Royal Liverpool Hospital. Dr Roberto Vivancos, a consultant with the HPA, said today: "Measles is circulating in the community. We have alerted GPs and asked them to notify us of any cases they come across. We are also asking parents and GPs to do all they can to ensure that children are fully protected by the MMR vaccine."

A similar warning was issued last June in Wirral. Two confirmed cases were reported with an undisclosed number of suspected cases in both children and adults.

(byline: Liz Williams)

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[Merseyside is a metropolitan county in north west England, with a population of 1 365 900. It encompasses the metropolitan area centred on both banks of the lower reaches of the Mersey Estuary, and comprises 5 metropolitan boroughs: Knowsley, St Helens, Sefton, Wirral, and the city of Liverpool. A map showing the location of Merseyside can be accessed at http://www.pickatrail.com/jupiter/location/europe/england/merseyside.html. - Mod.CP]

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[6] UK (Wales)
Date: Fri 17 Feb 2012
Source: BBC News, North West Wales [abbreviated & edited]
http://www.bbc.co.uk/news/uk-wales-north-west-wales-17074314

Measles cases at Ysgol Eifionydd, Porthmadog
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Ten children associated with Ysgol Eifionydd secondary school in Porthmadog have been diagnosed so far. All cases had either had no MMR vaccination, or only one dose -- whereas two doses are needed.

A vaccination session for children who have not had both doses will take place at the school on Wed 22 Feb 2012. Parents [of children] at the school in Porthmadog will receive a letter on Monday about the outbreak.

Dr Chris Whiteside, consultant in communicable disease control for Public Health Wales said many of the cases under investigation had not received their scheduled MMR vaccinations. "Measles is highly contagious and spreads very easily. We would therefore expect to see more cases," he said. "As long as there are children who have not had their two MMR vaccinations, there is the potential for people to become ill with measles."

Dr Whiteside said children usually receive their first dose of the vaccine at 13 months old and the second dose at around 3 years and 4 months of age. Many people who catch measles will have a fever, cough, red eyes, and blocked nose and feel generally unwell. A blotchy rash appears a few days later, beginning on the face and spreading downwards to the rest of the body over several days. Children should not attend school or nursery for five days after the rash starts, he said. "The only way to prevent outbreaks of measles is to ensure that at least 95 per cent of children in Wales have received 2 doses of the MMR vaccine," Dr Williams added.

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[Porthmadog can be located in the HealthMap interactive map of Wales at http://healthmap.org/r/1N-I. - Mod.CP]

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Africa
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[7] Angola (Songo)
Dare: Fri 17 Fwb 2012
Source: Agola Sante [In French, machine translation, edited]
http://www.portalangop.co.ao/motix/fr_fr/noticias/saude/2012/1/7/Execution-des-mesures-preventives-pour-prevenir-epidemie-rougeole-Songo,0b910108-c33a-4764-a863-15b24ec1aa0d.html

Outbreak of measles in Songo
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SONGO: Health authorities in the municipality of Songo, in the province of Uige (north), according to a local source on Thursday, are organising campaigns for routine immunization against measles in some [surrounding] towns and villages to prevent the disease ravaged city of Uige.

On the same day the Angop news agency reported that Baya Teca Bernardo, head of the Public Health and Endemic Diseases Control in Songo, has indicated that in addition to this routine campaign, the health authorities will also carry out supplementary immunisation during the period 24 to 26 Feb 2012.

"There are cases of measles in the city of Uige. So far there have been none in Songo but to as also against other endemic diseases, it is essential to continue routine measles vaccination."

Katondi Imasa, head of the Municipal Department of Health, stated that such campaigns had been conducted in the localities of Denga, Quimussongo, common Kinvuenga.

The municipality of Songo, with an estimated population of 44 000 inhabitants, is located 40 kilometres from the city of Uige, which is the capital of the province of the same name.

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[The HealthMap interactive map of Angola can be accessed at http://healthmap.org/r/1iGj. - Mod.CP]

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The Americas
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[8] USA (Indiana)
Date: Tue 14 Feb 2012
Source: South Bend Tribune [edited]
http://articles.southbendtribune.com/2012-02-14/news/31061820_1_measles-unvaccinated-people-rubella-vaccine

13 confirmed cases of measles reported in Indiana
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Indiana health officials have reported a total of 13 confirmed cases of measles in central Indiana, involving both children and adults. All confirmed cases are residents of Boone and Hamilton counties in Indiana.

The Indiana State Department of Health continues to work with local health departments, health care providers, and all impacted organizations to identify additional cases of measles and to prevent further transmission of the disease, according to a news release.

All people who believe they may have been exposed are encouraged to check their immunization status with their health care provider.

The state Health Department has confirmed measles in a second person who traveled to Super Bowl Village on 3 Feb 2012. Both confirmed cases were together at all times and therefore the risk of exposure has not increased from initial reports.

The state Department of Health has established a hotline to help answer questions from the general public. The hotline service will be available beginning Wednesday [15 Feb]. The hotline number is 877-826-0011 (TTY/TTD 888-561-0044). State Health Department staff will be on hand from 8:15 a.m. to 4:45 p.m. Monday through Friday to answer questions.

The Health Department stresses that immunization status cannot be verified through this hotline. Those persons unsure of vaccination status are encouraged to contact their health care provider, as they have access to the Indiana Immunization Registry.

Measles is a highly contagious respiratory disease caused by a virus. It is rare in the United States because of high levels of vaccination with the measles, mumps, and rubella vaccine; however, unvaccinated visitors from other countries can transmit measles to unvaccinated people in the US, or unvaccinated US citizens traveling abroad can become infected during travel.

More than 95 per cent of people who receive a single dose of MMR will develop immunity to measles, and more than 99 per cent will be protected after receiving a second dose, according to the news release. Two doses of the vaccine are needed to be fully protected.

Measles begins with a fever, cough, runny nose, and red eyes about 7 to 10 days after exposure. The fever increases and can get as high as 105 degrees F [40.6 degrees C]. Two to four days later, a rash starts on the face and upper neck. It spreads down the back and trunk, and then extends to the arms and hands, as well as the legs and feet. After about 5 days, the rash fades the same order in which it appeared.

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Indiana

[WSJM News (http://www.wsjm.com/Berrien-County-Health-Officials-Not-Concerned-Abou/12307906) reported that: "On Fri 17 Feb 2012 Berrien County Health Officials reported that health officials and schools in the Indianapolis area are dealing with a measles outbreak after an infected person visited Super Bowl Village in Indy just a few days before the NFL championship game earlier this month. While they're battling at least a dozen cases there, health officials in Berrien County say they're not too concerned. Berrien County public health nurse Gwen Agens says measles in this part of the state has become extremely rare. Most incidents of measles come from someone going overseas and bringing the illness back with them. In the Noblesville school district north of Indianapolis, they have banned all unvaccinated teachers and students from going to class until the threat and outbreak have passed or they have received updated shots."

Further information on these cases is awaited.

A map showing the locations of the counties of Indiana can be accessed at http://www.state.in.us/isdh/24822.htm. - Mod.CP]

See Also