viernes, 1 de febrero de 2019

ProMED-mail

ProMED-mail

ProMED logo

« prev

ProMED logo

Published Date: 2019-01-31 22:53:01
Subject: PRO/EDR> Measles update (07): Americas, Africa, Europe
Archive Number: 20190131.6288456
MEASLES UPDATE (07): AMERICAS, AFRICA, EUROPE
*********************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:

USA
----
[1] New York (Rockland County)
[2] New York (Brooklyn)
[3] Illinois (Champaign)
[4] Georgia (Atlanta)

Africa
----
[5] Kenya (Kwale)

Europe
----
[6] Austria (Styria, Graz)
[7] Russia

******
[1] New York (Rockland County): health alert
Date: Wed 30 Jan 2019
Source: ABC7 [abridged, edited]
https://abc7ny.com/health/124-cases-of-measles-now-confirmed-in-rockland-county/5112825/


Health officials say there are now 124 confirmed cases of measles in Rockland County, with one suspected case still being investigated. These confirmed cases are the total since the outbreak began in October [2018] and are not all active cases.

Rockland County's commissioner of health, Dr. Patricia Schnabel Ruppert, announced in November [2018] that all schools in the Village of New Square were required to keep students who are unvaccinated or under-vaccinated against the disease home until 21 days have passed since the last case of measles is confirmed in the county. The same restriction applies to schools in Spring Valley and Monsey, with a measles vaccination rate of less than 70%.

The update from Rockland County comes as health officials continue to scramble to contain a measles outbreak in the U.S. Northwest that has sickened 35 people in Oregon and Washington since [1 Jan 2019], with 11 more cases suspected. Officials say one child has been hospitalized, and there have been no fatalities in any of the cases nationwide. Officials confirm that 31 of those confirmed patients had not been vaccinated against measles.

There were 17 outbreaks and about 350 cases of measles in the USA last year [2018], also with no fatalities.

[Byline: Marcus Solis]

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[HealthMap/ProMED-mail map:
Rockland County, New York, United States: http://healthmap.org/promed/p/4302]

******
[2] New York (Brooklyn)
Date: Wed 30 Jan 2019, 12:45 p.m. EST
Source: The Yeshiva World [edited]
https://www.theyeshivaworld.com/news/general/1670963/measles-in-brooklyns-orthodox-jewish-community-hits-62-cases.html


A major measles outbreak that 1st started in October [2018] has continued into the new year [2019], with 62 confirmed cases in Brooklyn. The cases all involve members of the Orthodox Jewish community, several of whom acquired the disease while traveling in Israel, health officials said.

The city Department of Health announced last week [week of Mon 21 Jan 2019] that there were 62 confirmed cases of measles as of 23 Jan [2019], 4 of which occurred just in the past 2 weeks. Most cases were found in either Borough Park, which has 36 confirmed cases, or Williamsburg, which has 24. Both those neighborhoods saw 2 new cases in the last 2 weeks.

"The initial child with measles was unvaccinated and acquired measles on a visit to Israel, where a large outbreak of the disease is occurring," the Department of Health said. "Since then, there have been additional children from Brooklyn who were unvaccinated and acquired measles while in Israel. Children who did not travel were also infected in Brooklyn or Rockland County."

The disease spread is part of a larger outbreak of measles across the country and in New York, where 124 confirmed cases were recently confirmed in Rockland County. There are also outbreaks in Oregon and Washington state, where a public health emergency was declared.

Bensonhurst and Midwood/Marine Park also each had one confirmed measles case, health officials said, though both neighborhoods haven't seen any new cases since November [2018].

When the cases 1st started popping up in October and November [2018], city health officials sent notifications to schools, providers, and hospitals with large Orthodox Jewish populations to raise awareness about vaccinations.

"If you plan to travel to Israel, protect yourself and your family against measles and get vaccinated with the measles, mumps & rubella (MMR) vaccine at least 2 weeks in advance of your trip," the department wrote in the most recent announcement.

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[HealthMap/ProMED-mail map:
Brooklyn, New York, United States: http://healthmap.org/promed/p/745]

******
[3] Illinois (Champaign)
Date: Wed 30 Jan 2019
Source: The News-Gazette [edited]
http://www.news-gazette.com/news/local/2019-01-30/tests-find-six-suspected-cases-arent-measles-no-others-pending.html


Test results for 6 more people with suspected measles have come back negative, according to Champaign-Urbana Public Health district administrator Julie Pryde.

All 6 people tested had some form of contact with the one person diagnosed with measles last week [week of Mon 21 Jan 2019] and had symptoms, Pryde said. The public health district doesn't have any further measles tests pending in connection with the one confirmed case, she added.

If no more measles cases develop, Pryde said, the local outbreak will be considered over [Sat 9 Feb 2019].

Since the one confirmed case, the Carle health system has established a measles hotline number for its own patients to call ahead before coming to a clinic location with measles symptoms. The hotline is being staffed by a nurse 7 days a week, according to Carle spokeswoman Jamie Mullin.

[Byline: Debra Pressey]

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[It would be good to know the etiology of the 6 cases that came back negative for measles. Did they have a rash? Measles begins with non-specific symptoms, such as high fever, cough, runny nose (coryza), and red, watery eyes (conjunctivitis), which could all be attributed to a number of viral infections, but progresses to a distinctive rash.

[HealthMap/ProMED-mail map:
Champaign, Illinois, United States: http://healthmap.org/promed/p/43078
- Mod.LK]

******
[4] Georgia (Atlanta)
Date: Wed 30 Jan 2019
Source: WJBF [edited]
https://www.wjbf.com/news/georgia-news/measles-outbreak-now-in-georgia/1739098227


Three people have been diagnosed with measles in the Atlanta area. The Georgia Department of Public Health said Tuesday [29 Jan 2019] that all 3 people are part of the same family. News outlets reported 2 cases were confirmed on [Sun 13 Jan 2019], and the 3rd case was confirmed on [Sat 26 Jan 2019].

The names and ages have not been released. Health officials did not say where the family lived. Officials say no other cases have been found outside the family. The department did say none of those affected had been vaccinated.

Spokeswoman Nancy Nydam said in an email that the measles, mumps & rubella [MMR] vaccine is one of the most effective vaccines, and while the disease is highly contagious, it is preventable through vaccination.

There have been 6 measles cases in Georgia in the last 14 years.

[Byline: Brandi Heath]

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[HealthMap/ProMED-mail map:
Atlanta, Georgia, United States: http://healthmap.org/promed/p/3625]

******
[5] Kenya (Kwale)
Date: Wed 30 Jan 2019
Source: Nation [abridged, edited]
https://www.nation.co.ke/counties/kwale/Measles-scare-in-Kwale-as-five-are-taken-ill/3444918-4958682-nk14do/index.html


Anxiety has gripped Kwale residents after a measles outbreak was reported in Msulwa village. So far, 5 people, who exhibited symptoms of the disease, were treated at Msulwa Dispensary.

"So far, 5 cases have been confirmed, and samples have been taken to Nairobi. The county health department is trying to contain the situation," a doctor who wished not to be named since he is not authorised to speak to the media told the Nation.

The medic said that the health department was struggling to contain the situation. County health executive Francis Gwama promised to issue a statement later.

"I have just received the report on the measles (outbreak). I will give a statement later," Mr Gwama told the Nation.

[Byline: Winnie Atieno]

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[HealthMap/ProMED-mail map:
Kwale, Kenya: http://healthmap.org/promed/p/44852]

******
[6] Austria (Styria, Graz)
Date: Wed 30 Jan 2019
Source: Steiermark [in German, trans., edited]
https://steiermark.orf.at/news/stories/2961629/


On [Fri 11 Jan 2019], a 15-year-old boy was waiting in the emergency ward of the Children's Hospital of Graz, presumably infecting a boy who, on his part, infected pupils of his primary school. As a consequence, all children without sufficient titre or sufficient measles vaccination, respectively, must not attend public buildings.

So far, 14 cases of measles have been reported to the Landessanitatsdirektion. At Graz Children's Hospital, physicians face challenges. Since [Fri 11 Jan 2019], 50 patients have been treated for measles or suspicion of measles.

About 3 weeks ago, the 1st measles case this year [2019] became known. Meanwhile, over a dozen cases have been reported and largely confirmed, and more are expected, it was said on Tuesday [29 Jan 2019].

According to Graz Children's Hospital board member Ernst Eber, around 50 patients had been treated for measles or suspicion [of measles] since [Fri 11 Jan 2019]. Five new suspected cases were ordered to the LKH on Wednesday [30 Jan 2019].

On [Mon 21 Jan 2019], a boy suffering from measles had visited the elementary school Anger in the district of Weiz; he is regarded as the contact person to the 15-year-old who spent 3 hours with measles in the waiting area of the Graz Children's Hospital on [Fri 11 Jan 2019]. Now 26 unvaccinated children were forbidden to attend school; "that is, the children have been informed by us that they are not allowed to attend school until the end of the incubation period on [Sun 10 Feb 2019]," said district captain Rudiger Taus.

In these cases, a vaccine is too late: it works only 72 hours after the infection, according to official Ulrike Hammerl. She recognizes the risk that unvaccinated students may already be ill. "Accoding to current trends, we know that 1-2 hours of contact in the same room will suffice to infect [unimmunized individuals]. I expect that I will see secondary cases."

How many cases could still occur is difficult to extrapolate, according to Eber, because it is a matter of chance. In order to be able to largely rule out further infections, an immunity of 95% is necessary, but this [is not the situation] in Styria. "It would be great luck if that were the [result], but we do not expect it," Eber said. According to Werner Zenz, an expert on infectious diseases in pediatrics, the vaccination coverage for the 1st vaccine in Styria is currently 89%; for the 2nd vaccine, it is 79%.

The unvaccinated students are also not allowed to visit any childcare or healthcare facilities such as a family doctor or a hospital, sports facilities such as football fields and swimming pools, or other public events and facilities, according to the district council's decision.

An additional 15 children from the elementary school in Anger did not receive all of the partial vaccinations. These children can either get a vaccination or prove through a blood test that they are adequately protected.

District captain Taus is an advocate of vaccination prophylaxis "so that exactly such problems are avoided." According to Taus, no teachers or other staff of the school were banned, because all were vaccinated or could prove their immune status. The measure was "unusual" but necessary, in view of the high risk of infection.

Clinic board member Eber also considers the action to be meaningful: "The child has, with very high probability, infected all other unvaccinated classmates." That a lot of contacts should be checked, underscore a number: A single patient with measles, who is treated at the LKH, already has 51 contacts. It is enough if they were in the same room. Of these 51, 10 were not even one year old. Of these, 5 were ordered as new cases to the Children's Hospital to be treated with immunoglobulins. This "passive vaccine" protects up to 83% against the measles. The classic double vaccine, however, helps up to 99%.

Marianne Wassermann-Neuhold from the Styrian state health department described in the APA interview on Wednesday [30 Jan 2019] that she had 14 cases of measles reported. Of these, 12 have now been confirmed. In 2 -- a case had only become known on Tuesday-Wednesday [29-30 Jan 2019] afternoon, the results of the investigations were still outstanding.

Among the confirmed cases, there are 3 babies born in 2018 who were previously unable to get vaccinated. The other measles infections are children who should have already been vaccinated. In addition, a 34-year-old mother has been infected.

Ombudsman Gunther Krauter had just recently demanded "finally, effective public health measures": "For years, the Ombudsman's office has called for a consistent health policy against the highly contagious and dangerous measles. Victims especially include toddlers, who cannot be vaccinated yet."

Statistically, a measles sufferer infects about 18 people. A measles vaccination obligation must be included in the mother-child passport, which the minister of health has, so far, rejected to the Ombudsman.

"I do not understand [this rejection of mandatory vaccination]. This opportunity must be seized, because education campaigns and appeals have proven to be ultimately ineffective," Krauter said.

Meanwhile, health minister Beate Hartinger-Klein (FPO) again spoke out against compulsory vaccination on Wednesday [30 Jan 2019]: "Self-determination" and education by health workers indicate that vaccinations are meaningful," she said on the sidelines of the Council of Ministers.

--
Communicated by:
Dr. Christian Lenart
Krankenhaus Wien-Hietzing, Abteilung fur Notfallmedizin.
1130 Vienna, Wolkersbergenstrabe 1
Austria
<christian.lenart@wienkav.at>

[ProMED thanks Dr. Lenart for submitting this report on measles in Austria. Vaccination is a problem that needs to be addressed as the rate of immunization decreases and outbreaks are occurring regularly everywhere: the developed world as well as the underdeveloped. The debate between those who would like to implement compulsory vaccination (with exemptions for medical and religious reasons) and those who feel vaccination should not be made mandatory goes on. The group against compulsory vaccination for children entering school prefer education primarily and possibly incentives, and they feel these options need to be explored 1st before turning to compulsion. Examples for incentives include payments for immunization, lower (health) insurance premiums, or even tax exemptions. Those supporting mandates argue the benefits of vaccination outweigh any individual and societal risks accrued by remaining unvaccinated. This is very simply stated, but the argument is really much more complex regarding the rights of individuals vs the good of society.

HealthMap/ProMED-mail map:
Graz, Styria, Austria: http://healthmap.org/promed/p/22092
- Mod.LK]

******
[7] Russia
Date: Wed 30 Jan 2019
Source: Tass [edited]
http://tass.com/society/1042474


The measles morbidity rate in Russia's regions stood at 1.73 cases per 100 000 inhabitants in 2018, which is more than 3 times higher than in 2017, the press service of the Russian Health Ministry told reporters on Wednesday [30 Jan 2019].

"In 2018, the morbidity rate was 1.73 cases per 100 000 people (compared to 0.5 in 2017). A total of 2538 measles cases were registered in 66 regions across the country (54 regions in 2017). There were no fatal measles cases," the press service noted.

According to the Health Ministry, "Most cases are related to infections brought into Russia from abroad, which is confirmed by in-depth molecular genetic studies."

The press service noted that the lowest measles morbidity rates were registered in Russia from 2007-2011, thanks to high immunization rates. "The WHO's criterion on the measles morbidity rate in the elimination period, that is, less than one case per 1 million inhabitants, was met," it stressed.

Vaccination rates
-------------
According to the Russian Health Ministry, those who have not been immunized account for the largest number of people diagnosed with measles. "The people who have not been vaccinated or have no information about vaccination (over 90%) account for the largest proportion of those diagnosed with measles. The proportion of children (55.4%) remains high; 90% of them are children who have not been vaccinated against measles," the ministry said.

Children under one year of age are also at risk. This is because, according to the immunization schedule, the 1st inoculation against measles is carried out when a child is one year old, while the 2nd booster shot is given at the age of 6.

According to allergist/immunologist Alexei Bessmertny, children are infected with the measles most often because, as a rule, grownups are immunized, and many elderly people had this viral infection when they were kids. "Those children who have not been vaccinated due to medical reasons or because of parents' reluctance are at risk. The children who have not been fully vaccinated are less susceptible. They are protected more than 90%, but they can fall ill as well. This disease is most dangerous for those who have not been inoculated at all," he explained.

--
Communicated by:
Steven Simpson
MNR LandCare
<info@stevensimpsonbooks.com>

[ProMED-mail thanks Steven Simpson for submitting this report from Russia. The immunization rate apparently has dropped in Russia, as it has elsewhere in the world, largely as a result of the anti-vax movement. - Mod.LK

HealthMap/ProMED-mail map:
Russia: http://healthmap.org/promed/p/98]

See Also

Measles update (06): Americas, Europe 20190125.6278243
Measles update (05): vaccine hesitancy, WHO, Asia, Americas, Pacific 20190120.6268510
Measles update (04): Asia, Africa, Europe, Pacific, Americas 20190119.6266885
Measles update (03): Europe, Americas, Asia, Africa, vaccine 20190112.6254875
Measles update (02): Pacific, Europe, Americas, Middle East, comment 20190108.6248575
Measles update (01): Americas, Africa, Southeast Asia 20190102.6240858
2018
----
Measles update (81): Europe, Americas, Africa 20181231.6236997
Measles update (80): Europe, Pacific, Asia, Americas, Middle East 20181228.6226574
Measles update (79): Middle East, Americas, Europe, Pacific 20181223.6221389
Measles update (78): Europe, Americas, Africa 20181220.6216069
Measles update (77): Americas, Europe, Pacific 20181213.6207900
Measles update (76): Southeast Asia, Europe, Americas 20181209.6200560
Measles update (75): S America, SE Asia, vaccine 20181206.6183455
Measles update (74): WHO, PAHO, South America, USA, Southeast Asia 20181202.6176861
Measles update (73): WHO, Europe, Pacific, Middle East, USA, South America 20181201.6174755
Measles update (72): Middle East, Africa, Southeast Asia 20181128.6168366
Measles update (71): Europe, Americas, Southeast Asia, Pacific 20181125.6163324
Measles update (70): Europe, Pacific, Americas 20181115.6146626
Measles update (69): South East Asia, Pacific, Middle East, Americas, Europe 20181112.6140598
Measles update (68): USA, South America, Middle East, Pacific 20181106.6130335
Measles update (67): Middle East, USA, Europe, South America 20181106.6128235
Measles update (66): Europe, Americas, Southeast Asia 20181102.6124542
Measles update (65): Africa, USA 20181025.6112636
Measles update (64): Americas, Canada, Europe, Africa, Asia, Pacific 20181023.6107919
Measles update (63): Americas, Europe, Africa 20181019.6101105
Measles update (62): Middle East, Europe, Pacific 20181017.6095283
Measles update (61): Middle East ex Ukraine, Europe, USA 20181015.6090960
Measles update (60): Europe, Middle East, Africa 20181004.6069532
Measles update (59): PAHO 20180923.6046073
Measles update (58): Southeast Asia, Europe, USA 20180908.6015965
Measles update (57): Africa, Americas, Europe, Pacific 20180906.6009763
Measles update (56): Americas, Europe 20180831.6000907
Measles update (55): Americas, PAHO 20180830.5996307
Measles update (54): Americas 20180824.5985569
Measles update (53): Europe, WHO, worldwide 20180821.5978356
Measles update (52): Americas, Pacific 20180819.5975478
Measles update (51): Americas, Europe 20180816.5970434
Measles update (50): Americas, Europe 20180812.5961680
Measles update (49): Americas, Europe, Asia 20180807.5950837
Measles update (48): Americas, Europe 20180802.5943952
Measles update (47): Americas, Europe 20180729.5935207
Measles update (46): Americas, Asia, Indian Ocean, Europe 20180724.5924938
Measles update (45): Europe, Americas, Africa 20180720.5917479
Measles update (44): Americas, Europe, Asia 20180716.5908969
Measles update (43): Libya 20180715.5906212
Measles update (42): Somoa, MMR vaccine recall 20180712.5901735
Measles update (41): Americas, Europe, Pacific 20180709.5895186
Measles update (40): Middle East, Europe, Americas 20180704.5888315
Measles update (39): Americas, Europe, Pacific 20180626.5876101
Measles update (38): Americas, Europe, Pacific 20180624.5872709
Measles update (37): Americas, Europe, Africa, Asia 20180621.5866860
Measles update (36): Europe, South America, Africa 20180615.5858483
Measles update (35): Europe, Americas, Asia 20180610.5848499
Measles update (34): Europe, Asia, Pacific 20180606.5841052
Measles update (33): Asia, Africa, Europe, USA 20180526.5820018
Measles update (32): Europe, Pacific, Asia 20180524.5815287
Measles update (31): Asia, Africa, Europe, Americas 20180514.5796699
Measles update (30): Americas, Asia, Africa, Europe 20180510.5791951
.................................................sb/lk/tw/jh

ProMED logo
Publicado por en

No hay comentarios:

Publicar un comentario

Suscribirse a: Enviar comentarios (Atom)