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Measles Sequencing: Lessons Learned from a Large-Scale Outbreak.

Victoria Indenbaum1, Efrat Bucris1, Keren Friedman1

  • 1Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat Gan 52621, Israel.

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Summary
This summary is machine-generated.

Whole-genome sequencing resolved complex measles transmission during Israel's 2018-2019 outbreak. This genomic epidemiology approach is crucial for public health surveillance and maintaining measles elimination status.

Keywords:
measles virusmolecular epidemiologyoutbreakphylogeneticswhole-genome sequencing

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Area of Science:

  • Epidemiology
  • Virology
  • Genomics

Background:

  • Israel faced a significant measles outbreak (2018-2019) with over 4300 cases and 100 importations.
  • High vaccination coverage did not prevent a prolonged outbreak, threatening measles elimination status.
  • Traditional genotyping lacked resolution for distinguishing local transmission from introductions.

Purpose of the Study:

  • To investigate measles transmission dynamics using whole-genome sequencing.
  • To assess the utility of genomic epidemiology in complex outbreak scenarios.
  • To inform public health strategies for maintaining measles elimination.

Main Methods:

  • Whole-genome sequencing of 123 measles virus samples from imported and local cases.
  • Phylogenetic analysis to reconstruct transmission chains.
  • Identification of informative genetic markers, including in the MF non-coding region (MF-NCR).

Main Results:

  • Phylogenetic analysis revealed multiple distinct transmission chains.
  • Several chains were linked to specific importation events.
  • The MF non-coding region (MF-NCR) exhibited high variability and contained key phylogenetic mutations.

Conclusions:

  • Whole-genome sequencing effectively resolves complex measles transmission patterns.
  • Genomic epidemiology is vital for enhancing outbreak investigations.
  • Integrating genomic surveillance strengthens public health responses to protect measles elimination.