Measles Outbreak Associated With an International Youth Sporting Event in the United States, 2007
Measles Outbreak Associated With an International Youth Sporting Event in the United States, 2007
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DOI：
10.1097/inf.0b013e3181dbaacf
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发表时间：
2010-09-01
影响因子：
3.6
通讯作者：
Ostroff, Stephen M.
中科院分区：
文献类型：
--
作者：
Chen, Tai-Ho;Kutty, Preeta;Ostroff, Stephen M.
背景：尽管美国已经消除了地方性麻疹，但与输入性麻疹相关的疫情仍在继续发生。 2007 年，多州麻疹疫情的爆发与宾夕法尼亚州举行的国际青少年体育赛事的一名参加者身上出现的输入性病例有关。方法：进行了病例发现和接触者追踪。控制措施包括隔离病人以及对没有记录的麻疹免疫力的暴露者进行暴露后预防。对疑似病例和接触者的实验室评估包括麻疹血清学检测、病毒培养、通过逆转录聚合酶链反应检测病毒RNA以及病毒基因分型。 结果：指示病例发生在一名来自日本的12岁儿童中。对 8 个州的 1250 人进行了接触者追踪，发现了 7 例麻疹病例； 5 例（71%）病例发生在没有麻疹疫苗接种记录的人群中。流行病学和实验室调查支持单一传播链，将此次疫情与日本 D5 基因型麻疹病毒的同期传播联系起来。在 471 名活动参与者中，193 人 (41%) 缺乏假定的麻疹免疫力证明，193 人中的 94 人 (49%) 是美国居民成年人，19 人 (10%) 是非美国居民成年人（年龄 > 18 岁），80 人 (41%) 是非美国居民儿童。 讨论：与输入性疾病相关的麻疹疫情可能会在美国持续下去。国际活动参与者、国际旅行者以及经常接触此类旅行者的人可能面临更大的麻疹风险。为了减少输入病例的影响，美国各地应保持麻疹、腮腺炎和风疹疫苗的高覆盖率，并应继续支持全球麻疹控制和消除。
Background: Despite elimination of endemic measles in the United States (US), outbreaks associated with imported measles continue to occur. In 2007, the initiation of a multistate measles outbreak was associated with an imported case occurring in a participant at an international youth sporting event held in Pennsylvania.Methods: Case finding and contact tracing were conducted. Control measures included isolating ill persons and administering postexposure prophylaxis to exposed persons without documented measles immunity. Laboratory evaluation of suspected cases and contacts included measles serologic testing, viral culture, detection of viral RNA by reverse-transcription polymerase chain reaction, and viral genotyping.Results: The index case occurred in a child from Japan aged 12 years. Contact tracing among 1250 persons in 8 states identified 7 measles cases; 5 (71%) cases occurred among persons without documented measles vaccination. Epidemiologic and laboratory investigation supported a single chain of transmission, linking the outbreak to contemporaneous measles virus genotype D5 transmission in Japan. Of the 471 event participants, 193 (41%) lacked documentation of presumed measles immunity, 94 (49%) of 193 were US-resident adults, 19 (10%) were non-US-resident adults (aged > 18 years), and 80 (41%) were non-US-resident children.Discussion: Measles outbreaks associated with imported disease are likely to continue in the US. Participants in international events, international travelers, and persons with routine exposure to such travelers might be at greater risk of measles. To reduce the impact of imported cases, high measles, mumps, and rubella vaccine coverage rates should be maintained throughout the US, and support should continue for global measles control and elimination.