TRANSMISSION AND MOLECULAR CHARACTERISATION OF WILD MEASLES VIRUS IN ROMANIA, 2008 TO 2012

Monday, 19th of May 2014

[source]Euro Surveillance and Outbreaks Report[|source]

Romania experienced a measles epidemic that started in December 2004 and lasted until early 2007 [11]. More than 9,000 cases were detected mostly in non-immunized patients belonging to the Roma ethnic group. The outbreak was caused by the strain MVs/Bucharest.ROM/48.04/2[D4] and variants divergent by two nucleotides or less were detected during the period 2004 to 2006. Closely related strains were detected from 2005 to 2007 in Bosnia and Herzegovina, Germany, Italy, Portugal, Serbia, Spain and Switzerland: outbreaks associated with MVs/Bucharest.ROM/48.04/2[D4] occurred in 2005 in Germany (223 cases in Hesse, MVs/Frankfurt.DEU/03.05[D4]) and from August 2006 to February 2007 in Spain (over 200 cases in Catalonia, MVs/Barcelona.SPA/41.06/1[D4]). 

 

In this report, the authors describe the genetic characterization of measles viruses detected in Romania from 2008 to 2012, focusing on the recent outbreaks that occurred in the country between 2010 and 2012 that affected mainly groups with limited access to healthcare facilities and schools. The report underlines the importance of measles genotyping during the different phases of an outbreak. More details are accessible at: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20658

 

 

ABSTRACT

Molecular characterization of measles virus is a powerful tool for tracing transmission. Genotyping may prove the absence of endemic circulation of measles virus, i.e. transmission for more than 12 months, which is one of the criteria for verifying elimination of the disease. We have genetically characterized measles viruses detected in Romania from 2008 to 2012, focusing on the recent outbreaks from 2010 to 2012 that affected mainly groups with limited access to healthcare and schools. The findings emphasize the importance of genotyping during the different phases of an outbreak. A total of 8,170 cases were notified, and 5,093 (62%) of the 7,559 possible cases were serologically confirmed. RT-PCR was performed for 104 samples: from the 101 positive samples obtained from sporadic measles cases or clusters from different counties, 73 were genotyped. Sporadic measles cases associated with D4 and D5 viruses were observed from 2008 to 2009. Genotype D4-Manchester was predominant in 2011 and 2012. In addition, the related variant D4-Maramures and MVs/Limoges.FRA/17.10[D4] and a few D4-Hamburg strains were detected. The detection of several distinct MV-D4 genotypes suggests multiple virus importations to Romania. The outbreak associated with D4 genotype is the second largest outbreak in Romania in less than 10 years.