Assessment of adult measles cases followed at a military hospital during a measles epidemic: does forced migration increase infectious diseases such as measles that may affect public health?

In this study, our aim was to review the data of adult patients followed due to a measles diagnosis and the reasons for the measles cases, which has shown an increase because of the events of recent forced migration in our country. Adult patients who referred to the outpatient clinic of infectious diseases and clinical microbiology of our hospital between January and April 2013 and who were diagnosed with measles were retrospectively studied. Patients were diagnosed with measles in accordance with the presence of symptoms described by the World Health Organization (WHO) and in combination with the determination of measles IgM positivity by Enzyme Linked Immunosorbent Assay (ELISA). 16 patients did not have any information about their measles vaccination background. Only one patient reported that he received a single dose vaccination one year previously. Measles IgM positivity by ELISA was determined for all patients. When laboratory findings were assessed we found that leukopenia and thrombocytopenia developed respectively, in 4 and 4 patients. In addition, hepatitis developed in 4 patients, otitis media in 2 patients, pneumonia in 3 patients and a sinusitis complication in 2 patients. Measles is a very contagious disease with a high contagion rate but can be kept under control by maintaining vaccination rates high in the community. However, we must not forget that vaccinations may only provide 95% protection. Measles may become epidemic when sensitive individuals are present in the community at a certain ratio. Therefore, immunity rates must be accelerated in young adults in the community by vaccination campaigns (catch-up) while existing rates of childhood vaccinations are maintained. Especially when the population shows a tendency to increase, due to reasons such as migration or war, it is essential to comply with the mentioned precautions

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1. Celebi G, Piskin N, Aydemir H, Turkyilmaz R. Evaluation of 35 adult measles cases detected in a measles outbreak. Mikrobiyol Bul. 2007;41(1):79-86.

2. Piccirilli G, Lazzarotto T, Chiereghin A, Serra L, Gabrielli L, Lanari M. Spotlight on measles in Italy: why outbreaks of a vaccinepreventable infection continue in the 21st century. Expert Rev Anti Infect Ther. 2015;13(3):355-62.

3. Kuscu F, Ozturk DB, Gul S, Karagoz E, Suntur BM, Unlu B, Tomul ZD. Evaluation of Adult Measles Patients Followed up During an Epidemic. The Journal of Kırıkkale University, Faculty of Medicine. 2014;16(3):12-6

4. Orenstein W, Strebel P, Papania M, Sutter R, Bellini W, Cochi S. Measles Eradication: Is in Our Future? Am J Public Health. 2000;90(10):1521-5.

5. Gremillion DH, Crawford GE. Measles pneumonia in young adults. Am J Med 1981;71(4):539-42.

6. Mert A, Özaras R, Tabak F, Bilir M, Mürtezaoğlu A, Öztürk R, Aktuğlu Y. Genç Erişkinlerde Kızamığın Klinik ve Laboratuvar Özellikleri. Flora Dergisi. 2002;7(4):272-4.

7. Corbin V, Beytout J, Auclair C, Chambon M, Mouly D, Chamoux A, Laurichesse H. Shift of the 2009-2011 measles outbreak from children to adults: an observational review at the University Hospital of Clermont-Ferrand, France. Infection. 2013;41(6):1157-61.

8. Satoh A, Kobayashi H, Yoshida T, Tanaka A, Kawajiri T, Oki Y, Kasugai K, Tonai M, Satoh K, Nitta M. Clinicopathological study on liver dysfunction in measles. Intern Med. 1999;38(5):454-7.

9. Muscat M, Shefer A, Ben Mamou M, Spataru R, Jankovic D, Deshevoy S, Butler R, Pfeifer D. The state of measles and rubella in the WHO European Region, 2013. Clin Microbiol Infect. 2014;20(Suppl 5):12-8.

10. 12 Mart 2013 Kızamık Raporu. Halk Sağlığı Uzmanları Derneği (HASUDER) Bulaşıcı Hastalıklar Çalışma Grubu, 2014. http://hasuder.org.tr/anasayfa/jupgrade/images/hasuder_kızamık_rapo ru.pdf

11. Zencir M. Türkiye’de Kızamık, Kontrollü Artış mı? Salgın mı? İstanbul: Türk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Derneği, 2014. http://www.klimik.org.tr/wpcontent/uploads/2013/10/k%C4%B1zam%C4%B1k.pdf

12. Dilli D, Dallar Y, Önde U, Dogan F, Yağcı S. Ergenlerde Kızamık, Kızamıkçık, Kabakulak ve Suçiçeği Seroprevalansı. Çocuk Dergisi. 2008;8(3):172-8.

13. Muscat M, Shefer A, Ben Mamou M, Spataru R, Jankovic D, Deshevoy S, Butler R, Pfeifer D.The state of measles and rubella in the WHO European Region, 2013. Clin Microbiol Infect. 2014;20(5):8-12.

14. McCarthy.Measles outbreak linked to Disney theme parks reaches fiv e states and Mexico. BMJ. 2015;23:350-436.