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A national measles outbreak in Ireland linked to a single imported case, April to September, 2016
Peter Barrett1, Suzanne Cotter2, Fiona Ryan1
1Department of Public Health HSE South, St. Finbarr's Hospital, Cork, Ireland.
Abstract:
Endemic measles transmission was interrupted for the first time in Ireland in 2015. In May 2016, a case of measles was confirmed in an adult who had travelled from Hungary to Ireland (index case). Cases subsequently arose in five of the eight public health regions around the country. There were 40 confirmed cases in Ireland between April and September 2016. All sequenced cases were genotype B3. Vaccination status was known for 34 cases, of whom 31 were unvaccinated. Median age was 8 years (range: 3 months to 40 years). Ten cases were nosocomial, and three cases were infected on separate international flights. One linked case occurred in a resident of Slovenia. Nineteen cases were hospitalised; median duration of hospitalisation was 5 days (range: 2-8 days). The primary case was a child who travelled from Romania to Ireland via Budapest, and infected the index adult case on the same flight. This was the first reported outbreak of measles genotype B3 in Ireland. This outbreak demonstrated that Ireland remains at risk of measles outbreaks due to persistent suboptimal vaccination rates.
Insights
Ireland experienced a measles outbreak in 2016 following interrupted endemic transmission, highlighting risks from suboptimal vaccination rates. The outbreak involved genotype B3 measles and primarily affected unvaccinated children.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- Ireland achieved measles elimination in 2015.
- Measles transmission was re-established in 2016 with an imported case.
Purpose of the Study:
- To describe the epidemiology and characteristics of the 2016 measles outbreak in Ireland.
- To assess the impact of vaccination status on measles transmission.
Main Methods:
- Case-based investigation and surveillance.
- Genotyping of measles virus strains.
- Analysis of vaccination status and demographic data.
Main Results:
- 40 confirmed measles cases occurred between April and September 2016.
- All sequenced cases were genotype B3, linked to international travel.
- 31 of 34 cases with known vaccination status were unvaccinated.
Conclusions:
- The outbreak underscored Ireland's vulnerability to measles importation and resurgence.
- Suboptimal vaccination coverage remains a significant public health concern.
- Genotype B3 measles poses a continued threat, necessitating robust vaccination strategies.
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