Measles epidemic in pediatric population in Greece during 2017-2018: Epidemiological, clinical characteristics and outcomes.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
18
07
2020
accepted:
01
01
2021
entrez:
20
1
2021
pubmed:
21
1
2021
medline:
10
6
2021
Statut:
epublish
Résumé
A measles outbreak occurred in Greece during 2017-2018 affecting mainly pediatric population. The aim of the study was to describe the epidemiological and clinical characteristics of the cases diagnosed in the major pediatric tertiary hospital of Athens, where 26.5% of national pediatric measles cases were diagnosed and treated. This is a retrospective study of children 0-16 years old, who presented at the emergency department and/or were hospitalized with clinical presentation compatible with measles and diagnosis was confirmed with molecular detection of the measles RNA in pharyngeal swabs. Epidemiological, clinical and laboratory characteristics were retrieved from medical records and analyzed. A total of 578 children with measles were identified during the study period. 322 (55.7%) were male with median age 36 months (range:1-193), while the largest number of documented cases (251; 43.4%) were children aged 1-5 years. Most children (429/578; 74.2%) belonged to the Roma minority and only 64 (11.1%) had Greek origin. 497 (91.5%) children were unvaccinated and 37 (6.8%) were partially vaccinated with measles vaccine. Hospitalization was required for 342 (59.2%) children, whereas one or more complications were reported in 230 (67.2%) of them. Most frequent complications were elevated transaminases (139; 40.6%), acute otitis media (72; 21%), dehydration (67; 19.6%) and pneumonia (58; 16.9%). 11 children (3.2%) required intensive care admission for altered mental status/status epilepticus (3), sepsis (2) and ARDS (6). 119/342 (34.8%) children were treated with antibiotics because of possible or confirmed bacterial coinfection. One death was reported, concerning an 11-month-old unvaccinated infant, with underlying dystrophy, who died of sepsis. Measles is not an innocent viral infection, as it is still characterized by high morbidity and complications rates. Unvaccinated or partially vaccinated populations could trigger new outbreaks, resulting in significant cost in public health. To avoid future measles outbreaks, high vaccination coverage should be achieved, as well as closing immunity gaps in the population and ensuring high-quality measles surveillance.
Sections du résumé
BACKGROUND AND AIM
A measles outbreak occurred in Greece during 2017-2018 affecting mainly pediatric population. The aim of the study was to describe the epidemiological and clinical characteristics of the cases diagnosed in the major pediatric tertiary hospital of Athens, where 26.5% of national pediatric measles cases were diagnosed and treated.
METHODS
This is a retrospective study of children 0-16 years old, who presented at the emergency department and/or were hospitalized with clinical presentation compatible with measles and diagnosis was confirmed with molecular detection of the measles RNA in pharyngeal swabs. Epidemiological, clinical and laboratory characteristics were retrieved from medical records and analyzed.
RESULTS
A total of 578 children with measles were identified during the study period. 322 (55.7%) were male with median age 36 months (range:1-193), while the largest number of documented cases (251; 43.4%) were children aged 1-5 years. Most children (429/578; 74.2%) belonged to the Roma minority and only 64 (11.1%) had Greek origin. 497 (91.5%) children were unvaccinated and 37 (6.8%) were partially vaccinated with measles vaccine. Hospitalization was required for 342 (59.2%) children, whereas one or more complications were reported in 230 (67.2%) of them. Most frequent complications were elevated transaminases (139; 40.6%), acute otitis media (72; 21%), dehydration (67; 19.6%) and pneumonia (58; 16.9%). 11 children (3.2%) required intensive care admission for altered mental status/status epilepticus (3), sepsis (2) and ARDS (6). 119/342 (34.8%) children were treated with antibiotics because of possible or confirmed bacterial coinfection. One death was reported, concerning an 11-month-old unvaccinated infant, with underlying dystrophy, who died of sepsis.
CONCLUSION
Measles is not an innocent viral infection, as it is still characterized by high morbidity and complications rates. Unvaccinated or partially vaccinated populations could trigger new outbreaks, resulting in significant cost in public health. To avoid future measles outbreaks, high vaccination coverage should be achieved, as well as closing immunity gaps in the population and ensuring high-quality measles surveillance.
Identifiants
pubmed: 33471833
doi: 10.1371/journal.pone.0245512
pii: PONE-D-20-22281
pmc: PMC7817010
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0245512Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Euro Surveill. 2010 Jul 29;15(30):
pubmed: 20684816
J Emerg Med. 2020 Apr;58(4):610-615
pubmed: 32241708
Euro Surveill. 2019 Jul;24(27):
pubmed: 31290391
Acta Microbiol Immunol Hung. 2018 Jun 1;65(2):127-134
pubmed: 29486573
Epidemiol Infect. 2007 May;135(4):570-3
pubmed: 17038204
N Engl J Med. 2019 Jul 25;381(4):349-357
pubmed: 31184814
Clin Microbiol Infect. 2019 Oct;25(10):1213-1225
pubmed: 31284031
Euro Surveill. 2017 Sep 14;22(37):
pubmed: 28933342
J Epidemiol Glob Health. 2020 Mar;10(1):46-58
pubmed: 32175710
Epidemiol Infect. 2018 Oct;146(13):1692-1698
pubmed: 30086813
PLoS One. 2013 Sep 10;8(9):e74754
pubmed: 24040337
Epidemiol Infect. 2020 Apr 29;148:e138
pubmed: 32347196
Pediatr Infect Dis J. 2019 Jun;38(6):547-552
pubmed: 31117114
Epidemiol Infect. 2016 Sep;144(12):2605-12
pubmed: 27240964
MMWR Morb Mortal Wkly Rep. 2019 May 03;68(17):396-401
pubmed: 31048675
J Prev Med Hyg. 2018 Mar 30;59(1):E8-E13
pubmed: 29938234
Euro Surveill. 2016;21(9):30152
pubmed: 26967661
Epidemiol Infect. 2020 Feb 24;148:e35
pubmed: 32089145
J Infect Dis. 2016 Dec 15;214(12):1980-1986
pubmed: 27923955
Eur J Public Health. 2019 Oct 1;29(5):966-971
pubmed: 31329846
Euro Surveill. 2017 Jan 19;22(3):
pubmed: 28128092
BMJ. 2020 Jun 16;369:m2392
pubmed: 32546575
BMC Public Health. 2007 Jul 24;7:169
pubmed: 17650298
Euro Surveill. 2017 Apr 27;22(17):
pubmed: 28488998
Hum Vaccin Immunother. 2017 Jan 2;13(1):190-197
pubmed: 27669156
Hum Vaccin Immunother. 2017 May 4;13(5):1078-1083
pubmed: 28059628
Pediatr Infect Dis J. 2017 Sep;36(9):844-848
pubmed: 28426447
PLoS One. 2018 Apr 4;13(4):e0195256
pubmed: 29617454
Euro Surveill. 2016 Aug 11;21(32):
pubmed: 27541858
Euro Surveill. 2016 Jul 7;21(27):
pubmed: 27416848
Arch Dis Child. 2020 Sep;105(9):896-899
pubmed: 30636224
Pediatr Infect Dis J. 2020 Apr;39(4):e45-e46
pubmed: 31990890
J Hosp Infect. 2018 Dec;100(4):e261-e263
pubmed: 29902487
Emerg Infect Dis. 2015 Nov;21(11):2067-9
pubmed: 26488199
BMC Public Health. 2017 Mar 14;17(1):254
pubmed: 28288596
Nature. 2020 Apr;580(7804):446-447
pubmed: 32265541
Bosn J Basic Med Sci. 2019 Aug 20;19(3):210-212
pubmed: 31064166