Epidemiology of a workplace measles outbreak dominated by modified measles cases at Kansai international airport, Japan, during august-september 2016
Epidemiology of a workplace measles outbreak dominated by modified measles cases at Kansai international airport, Japan, during august-september 2016
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DOI：
10.1016/j.vaccine.2020.05.067
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发表时间：
2020-07-06
期刊：
影响因子：
5.5
通讯作者：
Oishi, Kazunori
中科院分区：
文献类型：
--
作者：
Kobayashi, Ayako;Shimada, Tomoe;Oishi, Kazunori
目的：2016年8月，关西国际机场爆发麻疹，这是自2015年3月日本被证实达到消除麻疹状态以来，首次爆发工作场所麻疹。我们调查了这次疫情，重点是评估接种疫苗的个人传播麻疹病毒(MV)的能力。方法：我们考虑了一例经实验室确认的麻疹病例，发病时间为2016年8月9日至9月29日，在关西国际机场工作人员中。通过查阅记录确认接种麻疹疫苗(MCV)的历史。结果：在确诊的30名受感染的地勤人员中，16人(53%)接种了1剂MCV，2人(7%)未接种，12人(40%)免疫状态不明。指示病例是一名接种状况不明的经典麻疹患者，推测将MV传播给了随后的所有29例病例。大多数患者(23例，77%；15例接种疫苗，8例疫苗接种状态不明)因病情较轻而被诊断为改良麻疹。改良型麻疹临床表现为卡他征(4/23，17%)，潜伏期中位数为16(11~21)天。接种疫苗的病例没有进一步传播的建议。一名有麻疹症状的境外旅客被确定为此次暴发的主要来源。结论：证实了接种疫苗的人的低MV传播能力。经疫苗接种的改良麻疹病例的接触者追踪可限于感染高危人群(例如，家庭、免疫抑制者)。为了保持消除麻疹的状态，应确保完成两剂MCV，特别是对于国际旅行者和经常接触这些旅行者的人，如机场工作人员。(C)2020年由爱思唯尔有限公司出版。
Objectives: In August 2016, a measles outbreak at Kansai International Airport was the first workplace measles outbreak since Japan was verified as having achieved measles-elimination status in March 2015. We investigated this outbreak with a focus on evaluating the ability of vaccinated individuals to transmit measles virus (MV).Methods: We considered a case of laboratory-confirmed measles with onset between August 9 and September 29, 2016, among workers of Kansai International Airport. History of vaccination status with measles-containing vaccine (MCV) was confirmed by reviewing records. The potential sources of each MV infection were assessed by interviewing each infected worker about the clinical course of their infection and their behavioral history.Results: Of 30 affected ground crews identified, 16 (53%) were vaccinated with >= 1 dose of MCV, 2 (7%) were unvaccinated, and 12 (40%) had an unknown vaccination status. The index case, a patient with classical measles with unknown vaccination status, presumably transmitted MV to all the subsequent 29 cases. The majority of patients (23, 77%; 15 vaccinated, 8 in unknown vaccination status) were diagnosed with modified measles due to mild illness. Modified measles were characterized clinically by signs of catarrh (4/23, 17%) in a few cases, with a median incubation period of 16 (range, 11-21) days. No onward transmission from vaccinated cases was suggested. An overseas traveler who visited the airport with measles symptoms was identified as the possible primary source of this outbreak.Conclusions: The low MV transmission ability of vaccinated individuals was reaffirmed. Contact tracing of vaccinated modified measles cases can be limited to a person at high risk of infection (e.g., households, person with immunosuppression). To maintain measles-elimination status, completing two doses of MCV should be ensured, especially for international travelers and for those who are frequently exposed to these travelers, such as airport workers. (C) 2020 Published by Elsevier Ltd.