Large measles outbreak introduced by asylum seekers and spread among the insufficiently vaccinated resident population, Berlin, October 2014 to August 2015.

Publisher: European Centre for Disease Prevention and Control (ECDC) Country of Publication: Sweden NLM ID: 100887452 Publication Model: Print Cited Medium: Internet ISSN: 1560-7917 (Electronic) Linking ISSN: 1025496X NLM ISO Abbreviation: Euro Surveill Subsets: MEDLINE

Publication: Stockholm, Sweden : European Centre for Disease Prevention and Control (ECDC)
Original Publication: Saint-Maurice : Hôpital national de Saint-Maurice

Communicable Disease Control*; Disease Outbreaks/*prevention & control ; Measles virus/*genetics ; Refugees/*statistics & numerical data ; Vaccination/*statistics & numerical data; Adolescent ; Adult ; Berlin/epidemiology ; Child ; Child, Preschool ; Disease Outbreaks/statistics & numerical data ; Emigration and Immigration/statistics & numerical data ; Female ; Genotype ; Humans ; Incidence ; Male ; Mandatory Testing/statistics & numerical data ; Measles/epidemiology ; Measles virus/classification ; Measles virus/isolation & purification ; Young Adult

The largest measles outbreak in Berlin since 2001 occurred from October 2014 to August 2015. Overall, 1,344 cases were ascertained, 86% (with available information) unvaccinated, including 146 (12%) asylum seekers. Median age was 17 years (interquartile range: 4-29 years), 26% were hospitalised and a 1-year-old child died. Measles virus genotyping uniformly revealed the variant 'D8-Rostov-Don' and descendants. The virus was likely introduced by and initially spread among asylum seekers before affecting Berlin's resident population. Among Berlin residents, the highest incidence was in children aged < 2 years, yet most cases (52%) were adults. Post-exposure vaccinations in homes for asylum seekers, not always conducted, occurred later (median: 7.5 days) than the recommended 72 hours after onset of the first case and reached only half of potential contacts. Asylum seekers should not only have non-discriminatory, equitable access to vaccination, they also need to be offered measles vaccination in a timely fashion, i.e. immediately upon arrival in the receiving country. Supplementary immunisation activities targeting the resident population, particularly adults, are urgently needed in Berlin.
(This article is copyright of The Authors, 2017.)

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Keywords: asylum seeker; disease outbreaks; measles; post-exposure prophylaxis; surveillance; vaccine-preventable diseases

Date Created: 20170901 Date Completed: 20180306 Latest Revision: 20220408

20240829

PMC5753442

10.2807/1560-7917.ES.2017.22.34.30599

28857043