Luis García Comas, María Ordobás Gavín, Juan Carlos Sanz Moreno, Inmaculada Rodero Garduño, Maria Angeles Gutiérrez Rodríguez , Maria Dolores Lasheras Carbajo , Araceli Arce Arnaez, Rafael Fernández Muñoz , Rosa Ramírez Fernández for the Epidemiological Surveillance Network of the Community of Madridz
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In February 2006, the measles elimination programme of the Epidemiological Surveillance Network of the Community of Madrid (Spain) detected a case of imported, unvaccinated measles which was the index case of a community outbreak whose epidemiological characteristics we describe.
Material and Methods:
Descriptive study of the outbreak. Clinical, epidemiological and laboratory information was collected. Measles antibodies (IgM and Ig G) were studied and the virus was isolated and genotyped.
An imported case caused an outbreak of 174 cases (93.1% confirmed). The measles virus was detected by culture in 31% of cases. The genotype was determined in 90.7% of positive samples, all of which were the B3 genotype (subgenotype B3.1), with sequencing in various genes that indicated the same viral lineage. The outbreak lasted 198 days. The age range was 2 months -37 years and 84.6% of cases were Spanish-born. A total of 9.8% of cases presented complications, 37.4% required hospital admission, and 9.2% had a documented history of immunization. Twenty-four clusters were identified in families, health workers and infant schools.
Control measures included advancing the infant MMR vaccination schedule and reinforcement vaccination in health care workers. While the measles virus still circulates, surveillance of suspected cases and maintenance of high vaccination coverages, especially in health care workers, are essential.