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Molecular Epidemiology of Measles in California, United States-2019

William S Probert1, Rosie Glenn-Finer2, Alex Espinosa1

  • 1Viral and Rickettsial Disease Laboratory, California Department of Public Health, Richmond, California, USA.

The Journal of Infectious Diseases
|February 2, 2021
PubMed

Insights

In 2019, California identified 26 measles importations and 72 cases, primarily from genotypes B3 and D8. Enhanced genomic sequencing improved strain tracking to maintain measles elimination in the US.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Virology

Background:

  • The United States (US) faced a significant increase in measles importations and cases in 2019, marking a critical challenge to its postelimination status.
  • California was a major entry point for imported measles cases, necessitating robust surveillance and response strategies.

Purpose of the Study:

  • To analyze measles importations, outbreaks, and cases in California during 2019.
  • To characterize detected measles genotypes (B3 and D8) and assess genotype-specific clinical outcomes.
  • To evaluate the effectiveness of whole genome sequencing (WGS) for measles strain discrimination compared to conventional methods.

Main Methods:

  • Retrospective analysis of measles surveillance data in California for 2019.
  • Detection and genotyping of measles virus strains.
  • Comparison of whole genome sequencing (WGS) with conventional N450 sequencing for epidemiological linkage.
  • Analysis of clinical data including vaccine failures, hospitalizations, and complications.

Main Results:

  • California identified 26 measles importations, 6 outbreaks, and 72 cases in 2019.
  • Only measles genotypes B3 and D8 were detected.
  • Significant differences in vaccine failures, hospitalizations, and severe complications were observed between genotypes.
  • Whole genome sequencing offered higher resolution for distinguishing between linked and sporadic measles strains.

Conclusions:

  • Maintaining high measles vaccination coverage is crucial, particularly for international travelers.
  • A robust measles surveillance system, enhanced by advanced genomic sequencing, is vital for preventing outbreaks and preserving measles elimination in the US.
Keywords:
genotypemeasles virussequencingvaccine

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