Evaluation of measles immunity in Turkey: is it still a threat?

Evaluation of measles immunity in Turkey: is it still a threat?

Background/aim: Measles is one of the important vaccine-preventable diseases with many complications in childhood. This studypresents cross-sectional seroepidemiological data, beginning from neonatal cord blood in infants to children under 6 years of age, aboutwaning of measles antibody and tries to suggest the proper time for measles immunization.Materials and methods: A total of 564 blood samples consisting of neonatal cord blood and samples taken from infants and children atages of 6, 9, 24–48, and 49–72 months were analyzed for measles seropositivity in a period of 6 months.Results: Measles seropositivity rate was 72.5% in 109 cord blood samples, 2.6% in 117 infants of 6 months of age, and 3.6% in 111 infantsof 9 months of age. Seropositivity was determined in 118 children at 24–48 months and in 109 children at 49–72 months and was 80.5%and 66%, respectively (P = 0.001). These children were vaccinated in the 12th month.Conclusion: Though measles immunization coverage is 97% in Turkey, population immunity is somewhat lower than expected.Increases of measles cases in Europe and the refugee problem in the country could easily lead to outbreaks. Implementing the first doseof the immunization at 9 months may be an option.

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  • 1. Waaijenborg S, Hahné SJ, Mollema L, Smits GP, Berbers GA et al. Waning of maternal antibodies against measles, mumps, rubella, and varicella in communities with contrasting vaccination coverage. Journal of Infectious Disease 2013; 208 (1): 10-16. doi: 10.1093/infdis/jit143
  • 2. Cáceres VM, Strebel PM, Sutter RW. Factors determining prevalence of maternal antibody to measles virus throughout infancy: a review. Clinical Infectious Disease 2000; 31 (1): 110- 119. doi: 10.1086/313926
  • 3. Leuridan E, Van Damme P. Passive transmission and persistence of naturally acquired or vaccine-induced maternal antibodies against measles in newborns. Vaccine 2007; 25 (34): 6296-6304. doi:10.1016/j.vaccine.2007.06.020
  • 4. Orenstein WA, Strebel PM, Papania M, Sutter RW, Bellini WJ et al. Measles eradication: is it in our future ? American Journal of Public Health 2002; 90 (10): 1521-1525. PMID:11029981
  • 5. Cutts FT, Hanson M. Seroepidemiology: an underused tool for designing and monitoring vaccination programmes in low- and middle-income countries. Tropical Medicine & International Health 2016; 21 (9): 1086-1098. doi:10.1111/tmi.12737
  • 6. Osborne K, Gay N, Hesketh L, Morgan-Capner P, Miller E. Ten years of serological surveillance in England and Wales: methods, results, implications and action. International Journal of Epidemiology 2000; 29 (2): 362-368. doi:10.1093/ije/29.2.362
  • 7. Wilson SE, Deeks SL, Hatchette TF, Crowcroft NS. The role of seroepidemiology in the comprehensive surveillance of vaccine-preventable diseases. Canadian Medical Association Journal 2011; 184 (1): E70-76. doi:10.1503/cmaj.110506
  • 8. Metcalf CJE, Farrar J, Cutts FT, Basta NE, Graham AL et al. Use of serological surveys to generate key insights into the changing global landscape of infectious disease. Lancet 2016; 388 (10045): 728-730. doi:10.1016/s0140-6736(16)30164-7
  • 9. World Health Organization. Measles Vaccines: WHO Position Paper. Geneva, Switzerland: World Health Organization; 2009.
  • 10. MacNeil A, Lee C, Dietz V. Issues and considerations in the use of serologic biomarkers for classifying vaccination history in household surveys. Vaccine 2014; 32 (39): 4893-4900. doi:10.1016/j.vaccine.2014.07.005
  • 11. Andrews N, Tischer A, Siedler A, Pebody RG, Barbara C et al. Towards elimination: measles susceptibility in Australia and 17 European countries. Bulletin of the World Health Organization 2008; 86: 197-204. PMCID: PMC2647410
  • 12. McKee A, Ferrari MJ, Shea K. The effects of maternal immunity and age structure on population immunity to measles. Theoretical Ecology 2015; 8 (2): 261-271. doi:10.1007/s12080- 014-0250-8
  • 13. Leuridan E, Hens N, Hutse V, Ieven M, Aerts M et al. Early waning of maternal measles antibodies in era of measles elimination: longitudinal study. BMJ 2010; 340 (2): c1626-c1626. doi:10.1136/bmj.c1626
  • 14. Zanetta RAC, Amaku M, Azevedo RS, Zanetta DMT, Burattini MN et al. Optimal age for vaccination against measles in the State of Sáo Paulo, Brazil, taking into account the mother’s serostatus. Vaccine 2001; 20 (1-2): 226-234. doi:10.1016/s0264
  • 15. Lu L, Cao YM, Yang QY, He Q, Dong ZQ et al. Dynamic maternal measles antibody level in infants: a longitudinal study. Zhonghua Liu Xing Bing Xue Za Zhi 2016; 37 (5): 663-667 (in Chinese). doi:10.3760/cma.j.issn.0254-6450.2016.05.015
  • 16. Kılıç A, Altınkaynak S, Ertekin V, Inandı T. The duration of maternal measles antibodies in children. Journal of Tropical Pediatrics 2003; 49 (5): 302-305. doi:10.1093/tropej/49.5.302
  • 17. Anders JF, Jacobson RM, Poland GA, Jacobsen SJ, Wollan PC. Secondary failure rates of measles vaccines: a metaanalysis of published studies. Pediatric Infectious Disease Journal 1996; 15 (1): 62-66. PMID: 8684879
  • 18. Colson KE, Zúniga-Brenes P, Ríos-Zertuche D, Conde-Glez CJ, Gagnier MC et al. A comparative estimates of crude and effective coverage of measles immunization in low-resource settings: findings from Salud Mesoamérica 2015. PLoS One 2015; 10 (7): e0130697. doi:10.1371/journal.pone.0130697
  • 19. Moss WJ, Griffin DE. Global measles elimination. Nature Reviews Microbiology 2006; 4 (12): 900-908. doi:10.1038/ nrmicro1550
  • 20. Minetti A, Kagoli M, Katsulukuta A, Huerga H, Featherstone A et al. Lessons and challenges for measles control from unexpected large outbreak, Malawi. Emerging Infectious Diseases 2013; 19 (2): 202-209. doi:10.3201/eid1902.120301
  • 21. Minetti A, Bopp C, Fermon F, François G, Grais RF et al. Measles outbreak response immunization is context-specific: insight from the recent experience of Médecins Sans Frontières. PLoS Medicine 2013; 10 (11): e1001544. doi:10.1371/journal. pmed.1001544
  • 22. The Ministry of Health of Turkey, General Directorate of Health Research. Health Statistics Yearbook 2016. Prevention of Diseases and Protection of Health. Ankara, Turkey: Ministry of Health; 2017.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK