An ongoing measles outbreak in Bulgaria, 2009.

National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria.
Euro surveillance: bulletin europeen sur les maladies transmissibles = European communicable disease bulletin (Impact Factor: 5.49). 02/2009; 14(26).
Source: PubMed

ABSTRACT After seven years without indigenous transmission of measles in Bulgaria, an increasing number of cases have been reported since 15 April 2009. By 19 June, the total number of notifications reached 84. To date, 64 were confirmed as measles cases and 15 cases, for whom laboratory results are pending, have been classified as probable. The present measles outbreak affects mostly the Roma population living in the north-eastern part of the country. The most affected age groups are young children below 1 year of age and children 1 to 9 years of age. An immunisation campaign was started in the affected administrative regions, targeting all persons from 13 months to 30 years of age who had not received the complete two-dose MMR vaccination.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The present French and European measles outbreaks show a bimodal distribution: the two most affected populations are infants aged less than 1 year and adults older than 20 years. The purpose of this study was to determine wether there were differences in the clinical presentation and evolution of measles between adult and pediatric patients. We performed a retrospective study of adult and pediatric measles patients admitted to three tertiary-level university hospitals between January 2008 and May 2011. Data were extracted from medical charts and positive laboratory results. Collected data were age, sex, geographical origin, vaccination status, source of exposure, overseas travel before symptom onset, clinical symptoms, risk factors for complications, severity criteria on admission, type of diagnosis, biological abnormalities, complications, and treatments. A total of 305 patients (171 children and 134 adults) were included in the study. The mean age was 4.6 ± 4.4 years in children and 26.7 ± 8.1 years in adults. Children were less often hospitalized than adults (29% vs. 66%). A comparison between hospitalized pediatric (n = 49) and adult (n = 89) patients revealed that the former had a higher incidence of complications (P < 0.0001), more otorhinolaryngological complications (24% vs. 1%; P < 0.0001), and a higher incidence of severe criteria on admission (P = 0.02). Hospitalized pediatric patients differed from adults in terms of disease severity and complications.
    Japanese journal of infectious diseases. 01/2014; 67(2):71-7.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Challenges in reaching good vaccination coverage against measles emerged in several European Union/European Economic Area Member States (EU/EEA MS) leading to progressive accumulation of susceptible individuals and outbreaks. The Burden of Communicable Diseases in Europe (BCoDE) project developed a methodology for measuring the burden of communicable diseases expressed in Disability-Adjusted Life Years (DALYs) in the EU/EEA MS. The aim of this study was to compare national vaccination coverage and burden of measles across EU/EEA MS. Country-specific data on measles national vaccination coverage 2006-2011 from 29 EU/EEA MS (MCV1) were retrieved from Centralized Information System for Infectious Diseases (CISID). DALYs were calculated for each country separately using a disease progression model with a single input parameter (annual measles incidence, adjusted for under-estimation). A software application was used to compute estimated DALYs according to country-specific and year-specific population age-distributions (data retrieved from Eurostat). Log-linear mixed-effect regression modeling approach was used to investigate a linear relation between natural logarithm-transformed DALYs and coverage. The reported annual vaccination coverage ranged from 72.6% to 100%. The estimated national annual burden ranged from 0 to 30.6 DALYs/100,000. Adjusting for year, there was a significant negative relationship between coverage and burden. For a given country there was a decrease in log-transformed DALYs/100,000 of 0.025 (95% confidence interval: -0.047 to -0.003) for every percentage increase in vaccination coverage. The largest effect of calendar time on estimated burden of measles was observed for the year 2011, the smallest was for the year 2007. This study shows that the degree of success of national measles vaccination programs, when measured by the coverage obtained, is significantly associated with overall impact of measles across EU/EEA MS. In EU/EEA MS each percentage point increase in national vaccination coverage seems to lead to early significant reduction of overall burden of measles.
    Vaccine 02/2014; · 3.77 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Int J Clin Pediatr • 2013;2(1):30-33 Press Elmer This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited Abstract Background: Although immunization against rubella was intro-duced as routine practice in many European countries about 20 years ago, there are still epidemic outbreaks in some of them. This is a prerequisite for the continuous monitoring of population sus-ceptibility to rubella. The aim of this study is to determine the pro-portion of people negative for the protective antibodies (IgG) to the rubella virus in terms of discretion of susceptibility to rubella and the risk of congenital rubella syndrome (CRS). Methods: The study involved 180 subjects from two groups: children aged 1.5 -3 years and women in childbearing age. Both groups, children and women, were divided into two subgroups: Bulgarian and Roma. The serological testing was performed with the kits Euroimmun (Medizinische Labordiagnostika AG) for quan-titative determination of rubella antibodies (IgG). Results: From the Roma children17.65% (12 out of 68) was sero-negative. From the Bulgarian children the seronegative were 4.76% (2 out of 42). Of all the involved children from both groups (110 in number) in 14 children (12.73%) the results were negative. Se-ronegative women from Roma origin were 8.33% (2 out of 24), and from the Bulgarian women -13.04% (6 out of 46). The total number of women studied was 70, of them the seronegative were 8 (11.43%). Conclusions: 1). We have found still relatively high proportion of seronegative persons among the Roma children and the Bulgar-ian women of childbearing age; 2).We consider it appropriate to introduce in medical practice periodic monitoring of susceptibility to rubella virus and at risk of epidemics to carry out timely immu-nization campaigns.


Available from