Santibanez S, Hübschen J M, Muller C P, Freymuth F, Mosquera M M, Mamou M Ben, Mulders M N, Brown K E, Myers R, Mankertz A
WHO European Regional Reference Laboratory for Measles and Rubella, Robert Koch Institute, Seestr. 10, D-13353, Berlin, Germany,
Virus Genes. 2015 Feb;50(1):2-11. doi: 10.1007/s11262-015-1173-1. Epub 2015 Feb 7.
The World Health Organization (WHO) has adopted an elimination goal for measles and rubella, which is supposed to be met in the WHO European Region (EUR) by 2015. For verification of elimination, it is required that the genotyping data of detected measles viruses provide evidence for the interruption of endemic transmission. In order to record and assess the extent of endemic measles virus (MV) circulation in a part of the EUR, we analyzed transmission chains of the epidemiologically most relevant MV variants identified in Central and continental Western Europe (CCWE) from 2006 to 2013. Based on MV sequence data deposited in the WHO global database for molecular surveillance of measles (MeaNS), the circulation period was calculated for each MV variant at the country-level and for the entire region of CCWE. The MV variants "D5-Okinawa," "D4-Hamburg," "D4-Manchester," and "D8-Frankfurt-Main" spread widely in CCWE; they caused large and long-lasting outbreaks with secondary spread that resulted in additional outbreaks. Nation-wide outbreaks (epidemics) with thousands of measles cases occurred in four countries (Switzerland, France, Bulgaria, and Romania) and were characterized by continuous detection of the same MV variant for more than 12 months suggesting endemic transmission. In the entire region of CCWE, the circulation period of the four predominant MV variants ranged from 18 to 44 months. The long-lasting MV transmission which affected predominantly unvaccinated individuals in different hard-to-reach groups and in the general population is not consistent with the measles elimination goal. Additional efforts are necessary to meet the elimination target in the EUR.
世界卫生组织（WHO）已制定了消除麻疹和风疹的目标，欧洲区域（EUR）应在2015年实现这一目标。为核实消除情况，要求所检测到的麻疹病毒的基因分型数据能为地方性传播的中断提供证据。为记录和评估EUR部分地区地方性麻疹病毒（MV）的传播程度，我们分析了2006年至2013年在中欧和西欧大陆（CCWE）鉴定出的与流行病学最相关的MV变异株的传播链。根据存入WHO麻疹分子监测全球数据库（MeaNS）的MV序列数据，计算了每个MV变异株在国家层面以及CCWE整个区域的传播周期。MV变异株“D5-冲绳”、“D4-汉堡”、“D4-曼彻斯特”和“D8-美因河畔法兰克福”在CCWE广泛传播；它们引发了大规模且持久的疫情，并出现二代传播，导致了更多疫情。四个国家（瑞士、法国、保加利亚和罗马尼亚）发生了全国性疫情（流行病），出现了数千例麻疹病例，其特征是在超过12个月的时间里持续检测到相同的MV变异株，提示存在地方性传播。在CCWE整个区域，四种主要MV变异株的传播周期为18至44个月。这种主要影响不同难以触及群体和普通人群中未接种疫苗个体的持久MV传播与麻疹消除目标不一致。为在EUR实现消除目标，还需做出更多努力。
