684. Epidemiological Features of Reemerging Measles in Auvergne (France)
Session: Abstracts: Virology
Friday, October 22, 2010
Background:

After several years without any case, measles reappeared in Auvergne in summer 2008. It has been persisting since then. Epidemiological determinants of this re-emerging disease in our province were investigated.

Methods:

Notified cases in Auvergne province were collected and reviewed for their clinical and epidemiological  features. Sampling was done to determine the viral strains involved. Vaccination coverage was known and we tried to determined the community in which the epidemic developed more likely and the susceptibility of the population.

Results:

Since October 2008 to April 2010, the number of notified cases was 211 (incidence=11.3/100 000), rather homogenous along the year. All the age group were concerned with increasing involvement of adults. 33% patients were hospitalized (16%), mostly infants and adults with respiratory conditions; 3 patients were admitted in intensive care. No death occurred. Most of the patients had never been vacinated; 12% had previously received one dose. Two strains were succesively detected: genotype D5 circulated from October 2008 to May 2009. genotype D4 was disclosed in patients since June 2010 and is still persisting. They affected separately two communities refusing vaccination for religious reasons; the second were gypsies (infected with D4 strain) who use to participate in periodical meeting, opportunity for viral spreading. Secondary cases affected were frequent among adolescents and young adults ; hospital occupational infections affected 5 persons. The children vaccination coverage in the region in 2008 was 86% with one dose and 71% with two. Lack of immunization was obvious among older adolescents and young adults.        

Conclusion:

Determinants of the development of two successive epidemics in Auvergne were: 1) the occurrence of measles in 2 communities refusing vaccination for religious reasons; half nomadic behavior and meetings in gypsies participating to the persistence of the last epidemic;3) insufficient vaccination coverage of the population espe=cially in adolecents and young adults.


Subject Category: V. Virology including clinical and basic studies of viral infections, including hepatitis

Speakers:
Jean Beytout, MDPhD , Infectious diseases, CHU de Clermont-Ferrand, Clermont-Ferrand, France
Olivier Lesens , Maladies infectieuses, CHU de Clermont-Ferrand, Clermont-Ferrand, France
Marie-Françoise Stachowski , Cellule Interrégionale d'Epidémiologie de l'Auvergne, Clermont-Ferrand, France
Henri Laurichesse , Maladies Infectieuses, CHU de Clermont-Ferrand, Clermont-Ferrand, France
Damien Mouly , Cellule Interrégionale d'Epidémiologie de l'Auvergne, Clermont-Ferrand, France
Isabelle Parent du Chatelet , Institut de Veille Sanitaire, Saint-Maurice, France
François Freymuth , Centre de référence de la rougeole., CHU de Caen, Caen, France

Disclosures:

J. Beytout, Yes
Sanofi Pasteur MSD; Glaxo Smith Kline: Investigator, I participated in investigating vaccines produced by these 2 companies. I received a grant for travel and stay to be able to present the result of independent epidemiological investigations at the IDSA meeting. and Research support

O. Lesens, None

M. F. Stachowski, None

H. Laurichesse, Yes
Sanofi Pasteur MSD: Investigator,

D. Mouly, None

I. Parent du Chatelet, None

F. Freymuth, None

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