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Measles virus genotyping an important tool in measles outbreak investigation in Norway, 2011

K Vainio1, T W Steen, T M Arnesen

  • 1Norwegian Institute of Public Health, Department of Virology, Oslo, Norway. kirsti.vainio@fhi.no

Euro Surveillance : Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin
|December 18, 2012
PubMed

Insights

Measles outbreaks in Norway in 2011 primarily affected unvaccinated children, highlighting the need for improved vaccination coverage, especially in healthcare settings. Genetic analysis confirmed multiple importations and identified various measles virus genotypes.

Area of Science:

  • Virology
  • Epidemiology
  • Public Health

Background:

  • Measles remains a public health concern globally, with ongoing efforts towards elimination in many regions.
  • Maintaining high vaccination coverage is crucial for preventing measles resurgence and outbreaks.

Purpose of the Study:

  • To describe the characteristics of measles cases in Norway in 2011.
  • To investigate the origins and genetic diversity of measles virus strains.
  • To assess transmission dynamics and identify vulnerable populations.

Main Methods:

  • Laboratory confirmation using enzyme-linked immunosorbent assay (ELISA) for antibodies and polymerase chain reaction (PCR) for viral detection.
  • Molecular characterization through sequencing and genotyping of measles virus strains.
  • Epidemiological investigation of case data, including vaccination status and exposure history.

Main Results:

  • 33 laboratory-confirmed measles cases were identified in Norway in 2011, predominantly in unvaccinated children.
  • Eight separate importations led to four outbreaks and four sporadic cases, with limited secondary spread.
  • Measles virus genotypes B3, D4, D9, and D8 were identified.
  • Twelve cases occurred in healthcare settings, including four healthcare workers (HCWs), indicating potential gaps in vaccination among staff.
  • Evidence of both primary and secondary vaccine failure was observed in two fully immunized HCWs.

Conclusions:

  • Genetic characterization of measles virus is vital for effective laboratory surveillance, particularly in countries nearing measles elimination.
  • Imported measles cases can lead to transmission among unvaccinated individuals in Norway.
  • Enhanced measles-mumps-rubella (MMR) vaccination coverage among healthcare personnel is essential to prevent nosocomial transmission.

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