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Background: The Public Health Agency of Canada (PHAC) has conducted enhanced measles surveillance since 1998, the year endemic measles transmission was eliminated in Canada. The objective of this annual national measles surveillance report is to provide an epidemiologic summary of measles activity reported in Canada for 2019 in order to provide evidence to support the continued verification of Canada’s measles elimination status. Methods: Measles surveillance data are housed in the Canadian Measles and Rubella Surveillance System (CMRSS) database. Descriptive analyses of demographics and risk factors were performed. Outbreak characteristics were summarized and genotypic analyses conducted. Surveillance, laboratory and vaccine coverage data for 2019 were used to assess Canada’s status against the Pan American Health Organization (PAHO) essential criteria for the verification of measles elimination. Results: In 2019, 113 measles cases were reported in Canada (crude incidence rate of 3.0 cases per 1,000,000 population). Of these cases, 42 (37%) were imported into Canada, and of the imported cases, 12 (29%) resulted in further transmission. Infants younger than one year had the highest age-specific incidence rate at 13.1 cases per 1,000,000 population. Only 29% of cases had one or more documented doses of measles-containing vaccine. One-fifth (19%) of cases were hospitalized; no deaths were reported. Genotype information was available for 100% of outbreaks reported in 2019 and 90% of non-outbreak-related measles cases; of cases with genotype information available, 27% were B3 and 73% were D8. Conclusion: Despite meeting/partially meeting only three out of four of PAHO’s essential criteria for measles elimination status, there is no evidence that endemic measles transmission has been reestablished in Canada.

NTRODUCTION: A strong need exists for the knowledge of aetiologies of diseases as this will guide the clinicians on the strategies for their treatment and prevention. In this study, we determined the aetiologies of profound bilateral sensorineural hearing loss (pbSNHL) with a view to provide the relevant data needed for preventive and therapeutic intervention among children in Ekiti State, south western Nigeria. METHODS: medical records of children with pbSNHL seen over a ten-year period were analysed. RESULTS: in all, records of 142 children with pbSNHL were analysed. The results showed spectrum of aetiologies that were similar to those reported decades ago with the ´unknown´ assuming a recurring decimal. Of the known (acquired) cases, measles takes up the largest ´chunk´ with a prevalence of 45.8%. Twenty-eight (32.2%) of those with febrile illnesses had treated their fever with ototoxic antibiotics. Late diagnosis was characteristic of the pbSNHL. CONCLUSION: this study shows that there hasn´t been any significant shift in the common causes of pbSNHL. Of great concern is the persistence of the ´unknown´ causes which assumes a recurring decimal in this and previous studies. Also worrisome is the high prevalence of measles-induced pbSNHL despite the availability of anti-measles vaccine. We therefore suggest effective immunization against measles and other vaccine-preventable causes of pbSNHL. The need for intensive research on the unknown causes of pbSNHL is hereby stressed. Also recommended is routine hearing assessment for survivors of febrile conditions so as to detect, if any, hearing loss promptly.

Corona Virus Disease (COVID-19) is caused by severe acute respiratory coronavirus type 2 (SARS-CoV-2), which was first reported in Wuhan, China [1,2]. The transmission of the virus spread to many different countries, which compelled the World Health Organization (WHO) to declare the virus as a pandemic in March 2020 [3,4]. The first case of the Coronavirus was detected in South Sudan in the middle of March, prompting restriction of inter-states movement. The national public health laboratory performing tests, to detect Vacine-preventable Disease (VPDs) are also responsible for conducting SARS-CoV-2 tests, which is straining its capacity. In addition, disruption of the transportation of specimens to the national laboratory from the ten states of South Sudan has led to the long lead time. We used the 2019 and 2020 VPDs data sources from the South Sudan ministry of health to assess the impact COVID-19 on the measles laboratory turn-around time in South Sudan.

INTRODUCTION: measles is the leading vaccine preventable childhood disease designated for elimination by WHO. More than 20 million people are affected by measles each year, particularly in Africa and Asia. With annual outbreaks reported from Ethiopia’s Oromia region. We analyzed measles containing vaccine coverage (MCV), measles cases and measles deaths over a 10-year period (2007-2016). METHODS: we reviewed Oromia measles surveillance data and first-dose measles containing vaccine (MCV1) administrative coverage. Descriptive statistics and multivariable logistic regression were performed to assess variables associated with measles death. Additional spatial mapping was performed to visually display key areas of measles case distribution in Oromia. RESULTS: a total of 26,908 measles suspect cases were identified, of which 18,223 (68%) were confirmed. A median age of 6 years (IQ range 0.5 - 71 years) and 288 deaths were observed. Among the total cases, 29% were unvaccinated and 46% had unknown vaccination status. The highest IR was seen in Guji zone (IR=190/100,000 population) among 1-4 years, with a majority from rural areas. Risk factors associated with death include age 5 years (AOR=1.82, CI: 1.42-2.33), unvaccinated status (AOR=1.44, CI: 1.06-1.95) and inpatient treatment (AOR=2.12, CI: 1.58-2.85). Of 8,732 measles IgM negative/indeterminate specimens, 10.5% tested positive for rubella specific IgM. CONCLUSIONS: outbreaks of measles are an ongoing public health concern in the Oromia region. Children aged 1-15 years remain at high risk for contracting measles in the region. We recommend strengthening routine immunization to reach all children, especially in rural areas and that the measles-rubella (MR) vaccine be considered.

INTRODUCTION: on October 4th, 2018, a measles outbreak was declared in Madagascar. This study describes the outbreak response in terms of coordination, case management, vaccination response and epidemiological surveillance. METHODS: data were collection using a line list and vaccination tally sheet. Serum samples were collected within 30 days of rash onset for laboratory testing; confirmation was made by detection of measles immunoglobulin M antibody. RESULTS: from September 2018 to May 2019, a total of 146,277 measles cases were reported included 1394 (1%) laboratory-confirmed cases and 144,883 (99%) epidemiological link-confirmed cases. The outbreak affected equally males (72,917 cases; 49.85%) and females (73,233 cases; 50.06%). The sex was not specified for 127 (0.09%) of cases. Case fatality rate and attack rate were high among children less than 5 years. Responses interventions include effective coordination, free of charge case management, reactive vaccination, strengthened real-time surveillance, communication and community engagement and the revitalization of the routine immunization. Reactive vaccination was implemented in different phases. A total of 7,265,990 children aged from 6 months to 9 years were vaccinated. Post campaign survey coverage was 95%, 96% and 97% for phase 1, 2, 3 respectively. CONCLUSION: elimination of measles will be challenging in Madagascar because of low routine immunization coverage and the absence of a second dose of measles vaccine in the routine immunization schedule.

INTRODUCTION: On October 4th, 2018, a measles outbreak was declared in Madagascar. This study describes challenges related to resources mobilization for the outbreak response. METHODS: Data were collected using minutes of coordination committee meetings, activities reports, operational action plans and situation reports. RESULTS: The total cost of the outbreak response was estimated to US$ 11,281,381. Operational cost was the leading cost driver (42.45%) followed by vaccine cost (33.74%). Cases management, epidemiological surveillance, communication and social mobilization and routine immunization strengthening represented 23.81% of the total cost. The main funder of the outbreak response was the measles and rubella initiative. CONCLUSION: good coordination, open dialogue, good use of financial resources and accountability of government and partners have enabled to gain the confidence of national and international donors.

INTRODUCTION: Measles is vaccine-preventable viral infection of humans, primarily affecting children=5 years. During early 2019, outbreak of measles occurred in Ginnir district of Bale zone, Southeast Ethiopia. We investigated to describe the outbreak and identify risk factors. METHODS: we conducted a descriptive and 1:2 unmatched case-control study in Ginnir district from March 18 to April 29, 2019. Fifty-six cases and 112 controls were recruited. For descriptive study, we identified 1043 cases recorded on the line-list and for case-control study, cases were identified using national standard case-definition. Mothers of case-patients and controls were interviewed using structured questionnaire. We estimated vaccine efficacy (VE) from case-control study. We conducted bivariate and multivariable logistic regression. RESULTS: in four-months period, a total of 1,043 suspected measles cases epidemiologically linked to five laboratory confirmed cases reported. Of which, 555 (53.2%) were males and 714 (68.5%) were =5 years. The median age of cases was 36 months (IQR=12-60 months). The overall attack rate (AR) was 63/10,000 population with case fatality ratio of 0.5% (5 deaths/1043). Infant =9 months were the most affected age groups (AR=31/1000). Majority (79%) of measles cases were not vaccinated against measles. Last-year (2017/18) administrative measle vaccine coverage of the district was 76.7%. Being unvaccinated against measles (AOR=5.4, 95%CI=2.2-13.4), travel history (AOR=4.02, 95%CI=1.2-13.6), contact with measles case-patient (AOR=5.6, 95%CI=2.12-14.4) and mothers knowledge of measles transmission (AOR=0.36, 95%CI=0.15-0.87) were associated with measles infection. VE in children aged 9-59 months was 90% (95%CI=69-97%). CONCLUSION: this confirmed measles outbreak was caused by failure to vaccinate, as indicated by the high VE, low administrative coverage, and 79% unvaccinated cases. Strengthening routine and supplementary immunization are required.

INTRODUCTION: In October 4th, 2018, a measles outbreak was declared in Madagascar. This study describes the epidemiology of the outbreak and determines public health implications for measles elimination in Madagascar. METHODS: data have been collected using line list developed for the outbreak. Serum samples were collected within 30 days of rash onset for laboratory testing; confirmation was made by detection of measles immunoglobulin M (IgM) antibody. RESULTS: a total of 2,930 samples were analysed in the laboratory among which 1,086 (37%) were laboratory confirmed.Measles cases age ranged from a minimum of 1 month to a maximum of 88 years. The median and the mean were 7 years and 9 years respectively. Children between 1 to 9 years accounted for 50.6% of measles cases. Attack rate (39,014 per 1,000,000 inhabitants) and case fatality rate (1.2%) were highest among children aged 9-11 months. A total of 67.2% cases were unvaccinated. As of March 14th, 2019, all the 22 regions and 105 (92%) health districts out of 114 were affected by the measles outbreak in Madagascar. CONCLUSION: measles outbreak in Madagascar showed that the country is not on the track to achieve the goal of measles elimination by 2020.

Background: Despite the availability of a safe and effective vaccine for over 50 years, measles remains a leading cause of death among young children in developing countries. Aim: This study assessed the knowledge and home treatment of measles by caregivers of children under 5 years. Setting: Abebi community, Ibadan, Oyo State, Nigeria. Methods: A descriptive cross-sectional study of 509 caregivers of children aged 6 months to 5 years in a semi-urban community in Ibadan was conducted using a multi-stage sampling method. An interviewer administered structured questionnaire was used to collect information on socio-demographic characteristics, knowledge of aetiology, main symptoms and signs, and home treatment of measles. Chi-square test and logistic regression were used to explore associations at 5% level of significance. Results: Most of the caregivers were females (96.3%), married (86.1%) and were the biological parents of the children (90.9%). More than half had good knowledge of the cause (59.7%) and main symptoms and signs (52.8%) of measles. However, the composite knowledge was good in 57.6% of caregivers. Over half (54.4%) of the caregivers reported that their children ever had measles. Majority (91.3%) of caregivers whose children had measles gave home treatment, while 24 (8.7%) sought treatment from health facilities alone. There was a significant association between caregivers’ educational status, age, tribe and marital status and their knowledge of measles; however, tribe was the only significant predictor of knowledge after regression analysis. Caregivers from other tribes were 3.3 times more likely to have good knowledge of measles than Yoruba caregivers. Caregivers who were 35 years and older compared to those younger than 35 years (OR: 0.625; 95% CI: 0.425–0.921) and those who were not currently married compared to those married (OR: 0.455; 95% CI: 0.273–0.758) had lower odds of having good knowledge of measles, respectively. Conclusion: Home treatment by caregivers of children with measles is high. Health education on the cause, prevention and treatment of measles should be provided for caregivers.

INTRODUCTION: Despite availability of an effective vaccine, the measles epidemic continue to occur in Nigeria. In February 2015, we investigated a suspected measles outbreak in an urban slum in Rigasa, Kaduna State, Nigeria. The study was to confirm the outbreak, determine the risk factors and implement appropriate control measures. METHODS: we identified cases through active search and health record review. We conducted an unmatched case-control (1:1) study involving 75 under-5 cases who were randomly sampled, and 75 neighborhood controls. We interviewed caregivers of these children using structured questionnaire to collect information on sociodemographic characteristics and vaccination status of children. We collected 15 blood samples for measles IgM using Enzyme Linked Immunosorbent Assay. Descriptive, bivariate and logistic regression analyses were performed using Epi-info software. Confidence interval was set at 95%. RESULTS: we recorded 159 cases with two deaths {case fatality rate = 1.3%}. 50.3% (80) of the cases were male. Of the 15 serum samples, 11(73.3%) were confirmed IgM positive for measles. Compared to the controls, the cases were more likely to have had no or incomplete routine immunization (RI) [adjusted odds ratio (AOR) (95% confidence interval (CI)]: 28.3 (2.1, 392.0), contact with measles cases [AOR (95% CI)]: 7.5 (2.9, 19.7), and having a caregiver younger than 20 years [AOR (95% CI)]: 5.2 (1.2, 22.5). Measles serum IgM was positive in 11 samples. CONCLUSION: we identified low RI uptake and contact with measles cases as predictors of measles outbreak in Rigasa, Kaduna State. We recommended strengthening of RI and education of care-givers' on completing RI schedule.

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INTRODUCTION: Measles is targeted for elimination in the World Health Organization African Region by the year 2020. In 2011, Kenya was off track in attaining the 2012 pre-elimination goal. We describe the epidemiology of measles in Kenya and assess progress made towards elimination. METHODS: We reviewed national case-based measles surveillance and immunization data from January 2003 to December 2016. A case was confirmed if serum was positive for anti-measles IgM antibody, was epidemiologically linked to a laboratory-confirmed case or clinically compatible. Data on case-patient demographics, vaccination status, and clinical outcome and measles containing vaccine (MCV) coverage were analyzed. We calculated measles surveillance indicators and incidence, using population estimates for the respective years. RESULTS: The coverage of first dose MCV (MCV1) increased from 65% to 86% from 2003-2012, then declined to 75% in 2016. Coverage of second dose MCV (MCV2) remained 50% since introduction in 2013. During 2003-2016, 26,188 suspected measles cases were reported, with 9043 (35%) confirmed cases, and 165 deaths (case fatality rate, 1.8%). The non-measles febrile rash illness rate was consistently 2/100,000 population, and ?80% of the sub-national level investigated a case in 11 of the 14 years. National incidence ranged from 4-62/million in 2003-2006 and decreased to 3/million in 2016. The age specific incidence ranged from 1-364/million population and was highest among children aged 1 year. CONCLUSION: Kenya has made progress towards measles elimination. However, this progress remains at risk and the recent declines in MCV1 coverage and the low uptake in MCV2 could reverse these gains.

INTRODUCTION: measles is a highly contagious viral infection with high mortality in poorly vaccinated regions. We sought to establish the trend in mortality and the factors that favoured the recent measles outbreak that occurred in Benakuma, in the North west region of Cameroon from the 21/06/2015 to 26/09/2015. METHODS: we carried out a retrospective register analysis of 223 measles cases. Time trends were established using the Mann-Kendall test while survival was assessed using the Kaplan-Meier survival analysis and log rank test for comparisons. RESULTS: we had a case fatality of 8.5% and the mortality decreased significantly (p = 0.01) after the following public health interventions were instituted: community sensitisation and education; outbreak response immunisation and the use of a clinician in controlling the outbreak. Furthermore, the number of cases (p = 0.01) and the duration from onset of illness to consultation at a health facility (p =0.01) decreased significantly after the institution of the aforementioned interventions. Also, survival during the outbreak was better in females (p = 0.02) and in those treated in health facilities (p = 0.01). CONCLUSION: the poor vaccination status in Benakuma coupled with negative cultural beliefs; poor socioeconomic and environmental factors and inadequate public health policies predisposed the region to a measles outbreak and favoured the spread of the virus. Public health policies should be revisited, modified and intensified to scale up vaccination coverage in measles endemic zones in Cameroon to help eliminate the disease and facilitate the overall attainment of the Sustainable Development Goals.

Measles is a highly contagious viral infection and still a leading cause of vaccine-preventable deaths in Africa; especially in unvaccinated populations. We reviewed the medical reports of the measles outbreak that occurred in Misaje, in the North west region of Cameroon from 11/03/2015 to 14/05/2015. Six measles cases were recorded during this period; three of them complicated by bacterial infections. Measles should be considered as a differential diagnosis for any febrile rash especially among poorly vaccinated populations. Primary preventive methods implemented by clinicians could help control outbreaks; especially with delays in public health intervention. Also, gaps in health policies in Cameroon should be addressed to scale up vaccination coverage in remote communities like Misaje to reduce the incidence of measles outbreaks.

INTRODUCTION: despite accelerated measles control efforts, a massive measles resurgence occurred in the Democratic Republic of the Congo (DRC) starting in mid-2010, prompting an investigation into likely causes. METHODS: we conducted a descriptive epidemiological analysis using measles immunization and surveillance data to understand the causes of the measles resurgence and to develop recommendations for elimination efforts in DRC. RESULTS: during 2004-2012, performance indicator targets for case-based surveillance and routine measles vaccination were not met. Estimated coverage with the routine first dose of measles-containing vaccine (MCV1) increased from 57% to 73%. Phased supplementary immunization activities (SIAs) were conducted starting in 2002, in some cases with sub-optimal coverage (d"95%). In 2010, SIAs in five of 11 provinces were not implemented as planned, resulting in a prolonged interval between SIAs, and a missed birth cohort in one province. During July 1, 2010-December 30, 2012, high measles attack rates (100 cases per 100,000 population) occurred in provinces that had estimated MCV1 coverage lower than the national estimate and did not implement planned 2010 SIAs. The majority of confirmed case-patients were aged =10 years (87%) and unvaccinated or with unknown vaccination status (75%).Surveillance detected two genotype B3 and one genotype B2 measles virus strains that were previously identified in the region. CONCLUSION: the resurgence was likely caused by an accumulation of unvaccinated, measles-susceptible children due to low MCV1 coverage and suboptimal SIA implementation. To achieve the regional goal of measles elimination by 2020, efforts are needed in DRC to improve case-based surveillance and increase two-dose measles vaccination coverage through routine services and SIAs.

Introduction: To estimate the post-campaign level of measles vaccination coverage in GuineaMethods: Interview of parents and observation of measles vaccination cards of children aged 9 to 59 months during the mass measles campaign. A nationwide cluster randomized sample under health District stratification. Results: 64.2% (95%CI = 60.9% to 67.4%) of children were vaccinated and had their measles vaccination card. With respect to card and history 90.5% (95%CI = 88.3% to 92.3%) were vaccinated. The estimation was found to be between 72.7% and 81.9%. Coverage with card increased from 55.5% to 79.30% with the level of education of parents but that was not statistically significant, (X2(trend) =3.087 P= 0.07). However coverage with card significantly increased with profession from 55.1% for farmers followed by 59.2% for other manual workers to 73.8% for sellers, ending by 74.5% for settled technicians(X2 (trend) =12.16 P= 0.0005). For unvaccinated children, lack of information accounted for the main reason(37.03%) followed by parents' occupation(23.45%), parents' sickness (8.6%), children's sickness (4.9%) and others including vaccinators absent in the post or parents' belief that it was a door to door campaign.Conclusion: The mass measles vaccination campaign achieved an approximate coverage of 75%. Although not enough for effective control of measles, it has covered an important gap left over by the routine immunization coverage 42%. Appropriate measures are needed to improve coverage in routine immunization and specific actions should be taken to target farmers and other manual workers' families but also uneducated groups for both routine immunization and mass campaigns

Résumé La rougeole est une maladie très contagieuse, dont l’éradication nécessite une couverture vaccinale supérieure à 95 % à travers le monde. Malgré les mesures importantes déployées par l’OMS, ces chiffres ne sont pas atteints, et des vagues épidémiques sont et peuvent à nouveau réapparaître dans plusieurs régions du monde, et notamment en Europe. En France, 22 000 cas ont été recensés entre 2009 et 2011, touchant majoritairement les très jeunes enfants et les adultes jeunes, populations non ou insuffisamment vaccinées. Même si l’incidence a nettement baissé en 2012, la maladie reste présente sur le territoire français, notamment dans le sud de la France, obligeant tout clinicien à être alerte concernant les symptômes de la maladie et ses complications. Outre l’éruption fébrile, la rougeole est fréquemment responsable de pneumonie tant chez l’enfant que chez l’adulte, alors que l’hépatite biologique semble être une complication propre à l’adulte. Il faut savoir prêter une attention particulière à certains terrains, telle que l’immunodépression cellulaire, qui est à fort risque d’encéphalite aiguë, alors que la grossesse augmente le risque de pneumonie. Les formes frustes chez les patients préalablement vaccinés sont à risque identique de complications, mais ne sont pas contagieuses. Le diagnostic de rougeole, bien que clinique, nécessite une confirmation biologique et la sérologie reste l’examen de référence. Malgré une évolution le plus souvent spontanément favorable, la rougeole peut être mal tolérée même en l’absence de complications, et requiert un taux d’hospitalisation non négligeable. Le seul moyen de s’en protéger reste celui d’une couverture vaccinale optimale. Measles is a highly contagious infectious disease, which needs more than 95% worldwide vaccination coverage of 2 doses to be eradicated. Despite an important involvement of the WHO for massive immunization, goals have not bean reached, and outbreaks can occur at any time in many countries, including Western Europe. In France, 22,000 cases were identified between 2009 and 2011, mainly in infants and young adults, which are not or not enough vaccinated (one dose). In 2012, even though the number of cases has drastically decreased, the outbreak is still going on, especially in South of France. That is why every clinician needs to be concerned about the clinical manifestations of the disease, and its complications. Besides a febrile rash, measles is often responsible of pneumonia and biologic hepatitis in adults. Hepatitis does not seem frequent in children. Clinicians need to be aware of specific complications, like encephalitis in case of cellular immunodepression, high risk of pneumonia in pregnant women. In patients previously vaccinated, incidence of complications is the same but patients are not contagious. Even if measles diagnosis is clinical, blood confirmation by serology is recommended in France when possible. Outcome is mainly favourable, but measles is not well-tolerated with high levels of hospitalisation even without any complication. Vaccination is the only way to protect against it. [ABSTRACT FROM AUTHOR]

Résumé Introduction En France, les objectifs de couverture vaccinale anti-rougeoleuse ne sont pas atteints avec comme conséquence l’émergence d’épidémies comme celle de 2008. L’objectif de l’étude est d’identifier les différents facteurs parentaux pouvant expliquer la sous-vaccination anti-rougeoleuse de l’enfant. Méthodes Il s’agit d’une étude descriptive réalisée par le biais d’un questionnaire anonyme, auprès de parents d’enfants de moins de 15 ans. Les questionnaires ont été distribués via les médecins généralistes et les pédiatres de Metz et son agglomération. Résultats Dans la population étudiée, 94,1 % des parents déclarent avoir fait vacciner leur enfant contre la rougeole. Seulement 68,4 % des interrogés pensent avoir reçu une information sur la vaccination et 60 % des interrogés pensent qu’elle était claire. Les raisons évoquées par les parents pour justifier la non-vaccination sont pour 5,1 % la méconnaissance de ce vaccin, 1,6 % pour lesquels le vaccin n’aurait pas été proposé, 0,4 % pour lesquels le praticien a déconseillé le vaccin mais aussi l’oubli du vaccin, le refus du conjoint, la peur du vaccin. La couverture vaccinale déclarée est plus importante chez les enfants suivis par un pédiatre que par un médecin généraliste ( p < 0,01). Conclusion Dans cette étude, il n’est pas ressorti un argumentaire construit contre la vaccination anti-rougeoleuse qui évoquerait la violation de liberté individuelle, une méfiance vis-à-vis des industries pharmaceutiques ou une inefficacité des vaccins. Il est plutôt ressorti que la sous-vaccination anti-rougeoleuse dans cette population s’expliquerait par un manque d’information, soulignant le rôle majeur du praticien. Summary Introduction In France, the low vaccination coverage against measles has resulted in the emergence of epidemics since 2008. The objective of the study is to identify the different parental factors that may explain the low childhood vaccination coverage. Methods This descriptive study was conducted with an anonymous questionnaire to parents of children less than 15 years, delivered through GPs and paediatricians of Metz and its nearest towns. Results In the study population, 94.1% of parents report having their children immunized against measles. Only 68.4% of respondents believe they have received information about the vaccination and 60% of respondents believe it was clear. The reasons given by parents to justify non-vaccination are 5.1% for the unknown of this vaccine, 1.6% for the vaccine has not been proposed, 0.4% for the practitioner has advised against the vaccine; but also vaccine forget, refusal of spouse, fear of vaccine. The reported immunization coverage is higher among children followed by a paediatrician as a GP ( P < 0.01). Conclusion In our study, there is no argument about the anti-vaccine movement; this vaccine is unsafe and ineffective and measles is mild and uncommon; the mistrust of their health professionals. It is rather apparent that the anti-measles vaccination in this population can be explained by a lack of information, highlighting the key role of the practitioner. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Efforts at immunizing children against measles was intensified in Nigeria with nation-wide measles vaccination campaigns in 2005 , 2006, 2008 and 2011 targeting children between 9 and 59 months. However, there were measles outbreaks in 2010 and 2011in Abia state Nigeria. This study seeks to find out if there is any association between measles immunization coverage and measles outbreak. METHODS: This is a descriptive analysis of the 2007 to 2011 Abia state measles case-based surveillance data supplied to Abia state World Health Organization office and Abia State Ministry of Health by the disease surveillance and notification officers. RESULTS: As the proportion of cases with febrile rash who were immunized decreased from 81% in 2007 to 42% in 2011, the laboratory confirmed cases of measles increased from two in 2007 to 53 in 2011.Of the laboratory confirmed cases of measles, five (7%) occurred in children 9 months, 48 (64%) occurred in children 9 - 59 months and 22 (29%) occurred in children > 59 months old. Seventy five percent of all laboratory confirmed cases of measles occurred in rural areas. CONCLUSION: Efforts should be made to increase measles immunization in children between 9 and 59 months as most cases of measles occurred in this age group as immunization coverage dropped.

INTRODUCTION: Measles is a public health problem especially in South Asia and Africa. Nylon Health District has experienced two measles outbreaks over a period of three years. We hereby describe the epidemiology and clinical characteristics of the outbreak of February 2011. METHODS: A retrospective descriptive cross sectional study was conducted in November 2011. All suspected measles cases according to the World Health Organization case definition line listed in the district service were included. Data was analyzed using Epi Info version 3.5.3 for Windows and Microsoft Office Excel 2010. An epidemic curve was drawn and proportions per variable category were estimated and presented in frequency tables. RESULTS: The outbreak started from the 4th to the 25th epidemiological week of 2011 with a peak on the 10th week after onset. The attack and case fatality rates were 34/100000inhabitants and zero respectively. Females and infants aged 9-59 months represented 97(63.4%) and 75(49%) of cases respectively. Bonadiwoto health area alone had 81(52.9%) of cases. Of the 153 cases, only 34(22.2%) had a card-confirmed measles vaccination status. Active community surveillance permitted the identification of 42(27.5%) cases. CONCLUSION: Low measles vaccine coverage rate over the past years in the Nylon health district led to the accumulation of susceptible individuals which coupled with poor environmental conditions favoured inter-human spread of measles. Developing novel strategies to vaccinate every child, especially the Hard-to-Reach in the slums of the district will help to prevent future outbreaks.

BACKGROUND: Since adoption of the measles case-based surveillance system in Zimbabwe in 1998, data has been routinely collected at all levels of the health delivery system and sent to national level with little or no documented evidence of use to identify risky populations, monitor impact of interventions and measure progress towards achieving measles elimination. We analysed this data to determine trends in the national measles case-based surveillance system (NMCBSS). METHODS: A retrospective record review of the NMCBSS dataset for period 1999 -2008 was conducted, assessing trends in proportions of investigated cases; timeliness and nature of specimens received at laboratory; timeliness of feedback of serology results, proportion of cases confirmed as measles and national annualized rates of investigation. Comparisons with WHO performance indicators were done. The secondary data analysis was done in Excel and Epi-Info statistical software. RESULTS: Cumulatively 4994 suspected cases were reported and investigated between 1999 and 2008. Reported suspected and confirmed measles cases declined from 24, 5% and 5.9% respectively in 2000 to 3.9% and 1.0% respectively in 2008. Proportion of cases with blood specimens collected and proportion reaching laboratory timely increased from 83% and 65% respectively in 1999, to 100% and 82% respectively in 2008. Proportion of specimens arriving at laboratory in good condition improved from 65% in 2004 to 94% in 2008 while timeliness of feedback of serology results improved from 4% in 2004 to 65% in 2008. Sensitivity of the NMCBSS however has been weakening, declining from 9.04 cases investigated per 100 000 population per year in 2000 to 1.58 cases/100 000/year in 2008. CONCLUSION: The NMCBSS improved in quality, timeliness and feedback of laboratory results of specimens sent for investigation, but its sensitivity declined mainly due to reduced capacity to detect and confirm measles cases. We recommend training staff on active surveillance of cases and more support and supervisory visits to strengthen EPI surveillance.

Five out of 6 WHO regions have set time-limited goals to move from regional measles mortality reduction to the regional elimination of indigenous transmission. Despite the abundance of research, there are a number of unanswered questions as we move towards a goal of measles elimination, many of which will be critical to achieving the elimination goal. We present here a list of research priorities from a programmatic and operational perspective

Abstract: Measles is one of the most contagious diseases implicated in an outbreak in Western Europe for a few years. In France, the outbreak began in 2008, especially in the southern regions. Most of the cases are mild but deleterious effects can occur in infants, during the pregnancy, or in immunosuppressive patients. Pneumonia and encephalitis are the major complications in these patients. Measles illness during pregnancy results in a higher risk of premature labor, spontaneous abortion, and low-birthweight infants. Death from measles was reported in approximately 0.3% of cases. The National Reference Center for measles and paramyxoviridae is implicated in biological confirmation of cases and epidemiologic surveillance. Virologic diagnosis consists in a direct detection of viral RNA (real time PCR), or indirect detection of the immune response (IgM and IgG) in saliva samples. The measles genotype is determined by sequencing a 450 nucleotids fragment of the N gene, as the World Health Organization (WHO) recommendation. This molecular analysis helps determine the geographic origin of the virus and the viral strains circulating in the country. In 2011, 3105 specimens were received. PCR was positive for 1990 patients (64%), with a large majority of children younger than 2 years of age and young adults. The most important cause of measles resurgence is low vaccination coverage. The role of pediatricians is important in order to achieve the goal of 95% of vaccination coverage established by the WHO. [Copyright &y& Elsevier]

Summary: Objective: To assess the levels of primary care physicians’ adherence to the 2010 French vaccination schedule against pertussis, measles-mumps-rubella (MMR), and pneumococcal infections in northern France. Methods: Two hundred forty-nine primary care physicians were questioned over the phone from February 15th to May 27th 2010. Results: The total response rate was 61% (n =152) : 43 pediatricians and 109 general practitioners (GPs). The conjugated pneumococcal vaccination was routinely proposed by 93% of the physicians (100% of the pediatricians and 90% of the GPs, P =0.02), and the recommended immunization schedule was correctly stated by 98% of the pediatricians and 70% of the GPs, P <0.001. While the pertussis vaccination was proposed by all the physicians, the recommended immunization schedule was correctly followed in only 46% of the cases (there was no significant difference between the 2 groups of physicians). As for the MMR vaccination, 1 physician did not propose it; 27% had correct knowledge about the MMR vaccination schedule (44% of the pediatricians and 20% of the GPs, P <0.01); 39% initiated an early MMR vaccination schedule for children in day care centers. The main source of their information was medical representatives of pharmaceutical companies, medical journals, and to a lesser degree, weekly epidemiological bulletins and continuing medical education meetings. Conclusion: The level of physicians’ knowledge about the vaccination schedule in children was insufficient in northern France, especially for pertussis and measles. This can decrease vaccination coverage levels as well as its beneficial effects for children. [Copyright &y& Elsevier]

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Abstract: Objective: A recent measles epidemic in France incited us to report and describe measles cases requiring hospitalization, to raise the awareness of health professionals on under-diagnosis and frequent complications of this viral disease. Design: We carried out a retrospective and epidemiologic study of measles cases recorded in the Nantes Teaching Hospital between August 2008 and September 2009. All these cases where confirmed by biological diagnosis and recorded by the Teaching Hospital virological laboratory. Results: Thirteen cases of measles (11 adults and two children) were recorded during the study period. Adults were young (mean age 21.4 years); the oldest was 35 years old. We noted two severe cases with viral pneumonia and hypoxemia and one case with bacterial pneumonia. Two female patients were pregnant; one delivered prematurely, in the acute phase of measles, with no complication for the newborn. Two cases occurred in the nursing staff by documented nosocomial transmission. Sixty-nine percent of the patients were not vaccinated whereas the vaccinal status was not documented for 31%. Conclusions: These cases underline the potential severity of this infection and the difficulty to diagnose measles at the early phase because of lack of awareness of medical staff. It will be necessary to reinforce prevention messages and promote measles vaccination in children as well as in young people and health workers. [Copyright &y& Elsevier]

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bulletin de la Société de Pathologie Exotique is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Objective: An outbreak of measles occurred from 2005 to 2006 in Mayotte, a French territory in the Indian Ocean. The aim of this study was to describe the outbreak, to analyze epidemiologic and sociodemographic characteristic of cases, and to suggest recommendations for measles surveillance and preventive measures in Mayotte. Design: An outbreak investigation was conducted and an enhanced passive surveillance system of incident cases was implemented. Results: During the outbreak, 1269 clinical cases, including 156 (12.3%) biologically confirmed cases, were reported. The attack rate was 0.71% and no death due to measles was recorded. The median age of cases was 12 years and the M/F sex-ratio 1.1. Teenagers and young adults (10–19 years) were the most frequently affected (44.4%) and infants less than one year of age accounted for 21.6% of the cases. In the 1269 clinical cases, 27.3% of patients had received at least one dose of measles vaccine before the outbreak. The immunization coverage in school children reached 59.1% at the end of the vaccination campaign. Conclusion: In the future, this vaccinal coverage should be improved to prevent other outbreaks, especially in vulnerable groups like immigrants. A surveillance system with systematical report of the biologically confirmed cases is needed in Mayotte. [Copyright &y& Elsevier]

Abstract: Measles incidence in France has decreased since 1987, but immunization uptake remains suboptimal in young children, while adolescents and young adults are insufficiently protected. The plan for elimination of measles and congenital rubella prepared in 2005 should solve these problems. It consists in giving the two doses of vaccine nearer during the second year of life, and to implement a catch-up programme for all unprotected persons born since 1980. These measures are completed by the reinscription of measles as a reportable disease, the encouragement to verify the clinical diagnosis by biology, and to promote all these activities. [Copyright &y& Elsevier]

Abstract: Purpose: Ever since vaccination was introduced, a minority has been opposed to this practice. Recently however, fear of adverse events and a general questioning of the usefulness of certain vaccines have led to wariness on the part of the broader public. In France, this phenomenon is particularly striking since the hepatitis B vaccination campaign. We wished to analyse the situation by drawing on the results of surveys conducted by the French Institute of Prevention and Health Education (Institut national de prévention et d''éducation pour la santé, INPES) which sought to gain a better understanding of health care professionals'' and the general public''s attitudes towards immunization. Main points: Although the majority of French men and women are convinced of the overall benefit of vaccination in the past, they increasingly question vaccine safety and usefulness today. Perspectives: In order to prevent further deterioration of the situation, efforts must be made to enhance public and professional awareness as to the stakes involved in the control of vaccine preventable diseases. [Copyright &y& Elsevier]

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Abstract: Private practice physicians play a central role in the detection and control of outbreaks. In Geneva, a local alert and response network completes the federal surveillance system, based on the mandatory reporting of infectious diseases. The common objective of these two mechanisms is to help health authorities in detecting, assessing, and controlling infectious diseases treats. Private practice physicians are one of the most effective and timely sources of information. As network members, they receive brief reports and information and are involved in the implementation of control and prevention measures. Their key-role was confirmed during a measles epidemic which occurred in Geneva in the spring of 2003. [Copyright &y& Elsevier]

Les vaccins figurent parmi les armes présentant le meilleur rapport coût/efficacité dans l’arsenal de la médecine moderne. Les politiques volontaristes et les stratégies rationnelles de vaccination ont un fort impact en santé publique. Grâce aux vaccins, l’éradication de la variole a été obtenue, la poliomyélite a disparu de la plus grande partie du monde et un net recul d’un certain nombre d’infections de l’enfant, telles que rougeole, diphtérie, tétanos et coqueluche, a été obtenu. En France, comme dans la plupart des pays, on dispose de comités d’experts dépendant du Ministère de la Santé (Conseil Supérieur d’Hygiène Publique de France et Comité Technique des Vaccinations) qui sont chargés de proposer des modifications du calendrier vaccinal ou l’intégration de nouveaux vaccins dans le programme national de vaccination. Les décisions sont publiées annuellement dans le Bulletin Epidémiologique Hebdomadaire.Mots clés : vaccins, calendrier vaccinal, maladies infectieuses @SUMMARY HD2 = Abstract Vaccines are among the most cost-effective preventive measures against infectious diseases in the armamentarium of modern medicine. When used aggressively with a rational epidemiological strategy, vaccines achieve great success. Vaccines have eradicated smallpox globally, eliminated poliomyelitis from the Western hemisphere, and have drastically diminished the incidence of a number of childhood infections, such as measles, diphtheria, tetanus and pertussis. As is the situation in most countries, in France the Ministry of Health (Conseil Supérieur d’Hygiène Publique de France and Comité Technique des Vaccinations) has appointed committees of experts, with a mandate to assess proposals for the modification or inclusion of new vaccines into the national immunisation programme. The decisions are published annually in the Bulletin Epidémiologique Hebdomadaire.Keywords: vaccine, immunisation programme, infectious diseases [ABSTRACT FROM AUTHOR]