Titel: Molecular epidemiology of measles virus in respect to the elimination goal: Fair or fail?
ID: 18/MSV
Art: Abstractautor
Session: Workshop 04
Molecular Epidemiology of Infectious Diseases (StAG RK, FG MS)

Referent: Annette Mankertz (Berlin)

Abstract - Text

Measles virus is a highly contagious paramyxovirus transmitted by droplet infection. Contraction of measles virus results in maculo-papular rash, high fever and malaise. Approximately one of 1,000 infections will lead to death. An attenuated life vaccines against measles was developed in the 1960s by John F. Enders. Descendants of this vaccine are still in use and have led to a dramatic decrease of the global incidence and the number of fatal measles cases. Since measles vaccine evokes a robust immune response which is supposed to last life-long and measles virus infects only human beings, measles is one of the few viral pathogens that have been targeted by WHO for global elimination.

As Germany and other European countries are nearing elimination, a high-quality surveillance and the verification of the elimination process become more and more important. Surveillance is based on two principles: firstly the notification of the disease by clinicians and of laboratory results indicative of an infection to the local health authority and secondly the molecular surveillance enabling us to study transmission of single virus variants. The elimination process is considered to be successful, when the incidence has dropped to a value 1 measles per inhabitant (corresponding to only 80 annual measles cases in Germany!). This can be accomplished only, when the vaccination rates are further improved and stabilized on a high level. As a second criterion, transmission chains of one certain virus type must not circulate longer than a 12 months period in the country. Molecular classification according to the WHO protocol uses a 450 nt fragment from the N-gene region of the measles virus genome. Analyzing this data set, measles virus circulation has demonstrated during the last years, that variants were detected for more than 12 months in Germany. Thus, virus circulation is still considered to be endemic. On a happier note, the situation looks differently, when a second, larger sequence window is used. Using this data set, the situation in Germany may be not as bad as we thought.

To further improve the situation for Germany, all patients should be checked for missing vaccinations according to the STIKO recommendations and throat swabs and/or urine samples from suspected measles cases should be sent to the National Reference Center Measles, Mumps, Rubella in Berlin.