Epidemiology and features of the measles course in children during the outbreak of 2018–2019 in the city of Mariupol

Keywords: infection; children; measles; clinical picture; differences.

Abstract

In 2017, Ukraine ranked in the top three among European countries in terms of measles incidence, and ranked first in measles growth in 2018. High morbidity, mortality and development of complications make the problem of knowing features of the measles clinical course, timely diagnosis and active prevention highly relevant. The purpose of the research is to study the dynamics of the incidence and clinical features of measles in children during the outbreak of 2018–2019 in the city of Mariupol, Donetsk region. A peculiarity of the measles outbreak in 2018–2019 in Mariupol is prevalence of the disease in preschool children (60.4%), inclu­ding 30.2% – those under one year of age; low vaccination rate: 52.3% of children unvaccinated; only 22.2% of children were vaccinated twice, according to the schedule. In all age groups, a moderately severe measles course prevailed (69.8%). The clinical course of measles in preschool and school age children had definitive features. Thus, Belsky–Filatov–Koplik spots were observed three times more frequently in preschool children than in schoolchildren (63.9% and 23.3%, respectively). Abdominal pain and diarrhea were only observed in children under 6 years of age (30.2%). Skin pigmentation was absent in children under one year of age and was detected in preschool and school-age children (69.8%). Skin sloughing was only observed in schoolchildren (10.4%). Severe disease course occurred in patients of all ages (29.3%), but children aged under one year and preschool children with severe disease were two times more numerous than those of the school age. Among the observed complications, the vast majority were associated with the respiratory organs: pneumonia (38.3%), subcutaneous emphysema (1.7%), bronchitis (53.2%), laryngitis (3.3%), otitis media (5%). No fatalities were observed. The city should form a commitment to immunization, restore public trust in vaccination, using all forms and means of information, and develop a program to implement the vaccination schedule into practice.

References

Antipova, A. Y., Bichurina, M. A., & Lavrentieva, I. N. (2018). K voprosu o reali­zacii programmy jeliminacii kori v stranah zapadno-tihookeanskogo regiona VOZ [Implementation of the world health organization Western-Pacific regional plan of action for measles elimination]. Infektsiya i Immunitet, 8(4), 465–472 (in Russian).

Artemova, I. V., & Kulichenko, T. V. (2017). Eepidemija kori. Real’na li ugroza? [The epidemic of measles. Is the threat real?]. Voprosy Sovremennoj Pediat­rii, 16(5), 358–361 (in Russian).

Bester, J. C. (2016). Measles and measles vaccination: A review. JAMA Pediat­rics, 170(12), 1209–1215.

Cilleruelo, M. J., García, A. F., Villaverde, S., Echevarría, J., Marín, M. A., Sanz, J. C., Lópeza, A., Royuela, F., Antoran, B. R., & Ory, F. (2017). Duration of immunity to measles, rubella and mumps during the first year of life. Vaccine, 37(30), 4164–4171.

Clemmons, N. S., Wallace, G. S., Patel, M., & Gastañaduy, P. A. (2017). Inciden­ce of measles in the United States, 2001–2015. JAMA, 318(13), 1279–1281.

Datta, S. S., O’Connor, P. M., Jankovic, D., Muscat, M., Mamou, M. C. B., Singh, S., Kaloumenos, T., Reef, S., Papania, M., & Butlera, R. (2018). Progress and challenges in measles and rubella elimination in the WHO European Region. Vaccine, 36(36), 5408–5415.

Dinh, A., Fleuret, V., & Hanslik, T. (2013). Liver involvement in adults with measles. International Journal of Infectious Diseases, 17(12), 1243–1244.

Doshi, R. H., Eckhoff, P., Cheng, A., Hoff, N. A., Mukadi, P., Shidi, C., Gerber, S., Okitolonda-Wemakoy, E., Tafum, J. J. M., Kominski, G. F., & Rimoin, F. W. (2017). Assessing the cost-effectiveness of different measles vaccination strate­gies for children in the Democratic Republic of Congo. Vaccine, 35(45), 6187–6194.

Fowlkes, A. L., Witte, D., Beele, J., Audet, S. A., Broadhead, R., Bellini, W. J., Cutts, F., & Helfand, R. F. (2016). Supplemental measles vaccine antibody response among HIV-infected and uninfected children in Malawi after 1- and 2-dose primary measles vaccination schedules. Vaccine, 34(12), 1459–1464.

Freidl, G. S., Tostmann, A., Curvers, M., Ruijs, W. L. M., Smits, S., Schepp, R., Dui­zer, E., Boland, G., Melker, H., Klis, F. R. M., Jeannine, L. A., Hautvast, C., & Veldhuijzen, I. K. (2018). Immunity against measles, mumps, rubella, varicella, diphtheria, tetanus, polio, hepatitis A and hepatitis B among adult asylum seekers in the Netherlands, 2016. Vaccine, 36(12), 1664–1672.

Furuse, Y., & Oshitani, H. (2017). Global transmission dynamics of measles in the measles tlimination era. Viruses, 9(4), 82.

Gastanaduy, P. A., Banerjeeb, E., DeBoltc, C., Bravo-Alcantarad, P., Samade, S. A., Pastord, D., Rotaa, P. A., Patela, M., Crowcroftf, N. S., & Durrheimg, D. N. (2018). Public health responses during measles outbreaks in elimination set­tings: Strategies and challenges. Human Vaccines and Immunotherapeutics, 14(9), 2222–2238.

Goncharov, V. O., Kotlik, L. S., Skopenko, O. V., Hruzevsky, O. A., & Grydina, T. L. (2019). Epіdemіchnі pokazniki shhodo koru v Odes’kіj oblasti [Epidemiologi­cal indicators for measles in the Odesa region]. Aktual’naja Infektologija, 7(2), 76–82 (in Ukrainian).

Hao, L., Ma, C., Wannemuehler, K. A., Su, Q., An, Z., Cairns, L., Quick, L., Rode­wald, L., Liu, Y., He, H., Xu, Q., Ma, Y., Yu, W., Zhang, N., Li, L., Wang, N., Luo, H., Wang, H., & Gregory, C. J. (2016). Risk factors for measles in children aged 8 months – 14 years in China after nationwide measles campaign: A multi-site case-control study, 2012–2013. Vaccine, 34(51), 6545–6552.

Hong, D. T., Hien, N. D., Thao, P. T. P., Anh, D. D., Mai, H. H., Huyen, D. T. T., Huong, N. L., Phuong, B. H., Iijima, M., Ito, T., & Nakayamae, T. (2019). Immunogenicity of the AIK-C measles vaccine in infants aged < 9 months in Vietnam. Vaccine, 37(32), 4576–4580.

Ishchuk, I. S., & Stetsyuk, I. O. (2018). Vakcinacіja proti koru jak efektivna profіlaktika viniknennja zahvorjuvannja [Vaccination against measles as an effective prophylaxis of the oncet of the disease]. Іnfekcіjnі Hvorobi, 93(3), 57–61 (in Ukrainian).

Jahic, R., Porobic-Jahic, H., & Zepic, D. (2017). Epidemiological and clinical chara­cteristics of children with mealsles hospitalized at the department for infectious diseases in Tuzia during the 2014–2015 measles epidemic. Central European Journal of Paediatrics, 13(1), 62–68.

Kang, H. J., Han, Y. W., Kim, S. J., Kim, Y. J., Kim, A. R., Kim, J. A., Jung, H. D., Eom, H. E., Park, O., & Kim, S. S. (2017). An increasing, potentially measles-susceptible population over time after vaccination in Korea. Vaccine, 35(23), 4126–4132.

Kharchenko, G. A., & Kimirilova, O. G. (2019). Kliniko-epidemiologicheskie oso­bennosti kori u detej Astrahanskoj oblasti [Clinical and epidemiological features of the Measles in children of the Astrakhan region]. Detskie Infektsii, 18(3), 31–36 (in Russian).

Koloskova, O. K., Ivanova, L. A., Polishchuk, M. I., Gopko, N. V., & Garas, M. N. (2019). Vrodzhenij kіr (klіnіchnij vipadok) [Congenital measles (clinical case)]. Zdorov’e Rebenka, 14, 40–43 (in Ukrainian).

Kramarov, S. O., Yevtushenko, V. V., Kovalyukh, I. Y., Kaminska, T. M., & Golo­vach, O. V. (2018). Klіnіchna kartina koru v dіtej, gospіtalіzovanih pіd chas spa­lahu 2017–2018 rr. [Clinical features of measles in children hospitalized during 2017–2018 outbreak]. Aktual’naya Infektologiya, 6(5), 240–245 (in Ukrainian).

Marusik, U. I. (2017). Kіr u dіtej [Measles in children]. Aktual’naya Infektologiya, 5, 129–133 (in Ukrainian).

Molochkova, O. V., Kovalev, O. B., Shamsheva, O. V., Il’ina, N. O., Kosyreva, M. A., Brunova, O. J., Mayatski, A. A., Korsunskij, A. A., Kashchenko, O. A., & Ga­leeva, E. V. (2019). Bronholjogochnye oslozhnenija pri kori u detej (semejnyj sluchaj) [Bronchopulmonary complications of measles in children (family case)]. Detskie Infektsii, 18, 42–48 (in Russian).

Moss, W. J. (2017). Measles. Lancet, 390(10111), 2490–2502.

Muscat, M., Shefer, A., Ben Mamou, M., Spataru, R., Jankovic, D., & Deshevoy, S. (2014). The state of measles and rubella in the WHO European Region, 2013. Clinical Microbiology and Infection, 20(5), 12–18.

Nandi, A., Shet, A., Behrman, J. R., Black, M. M., Bloom, D. E., & Laxminara­yangh, R. (2019). Anthropometric, cognitive, and schooling benefits of measles vaccination: Longitudinal cohort analysis in Ethiopia, India, and Vietnam. Vaccine, 37(31), 4336–4343.

Nickovic, V., Kocic, B., Sulovic, L., Mitic, J., Jovanovic, S., & Kocic, I. (2018). Epidemiological and clinical characteristics of children with morbilli in Ser­bian enclaves in Central Kosovo. Revue d’Épidémiologie et de Santé Publi­que, 66(Suppl. 5), 284.

Ničković, V., Šulović, L., Danić-Filipović, S., Marković-Jovanović, S., Vujnović-Živković, Z., Mitić, J., Kocić, H., & Kocić, I. (2019). General, epidemiologi­cal parameters and immumization coverage of children suffering from mor­billi in central Kosovo and Metohija. Acta Medica Medianae, 58(4), 32–40.

Njie-Jobe, J., Nyamweya, S., Miles, D. J. C., vd Sande, M., Zaman, S., Touray, E., Hossin, S., Adetifa, J., Palmero, M., Burl, S., Jeffries, D., Rowland-Jones, S., Flanagan, K., Jaye, A., & Whittlea, H. (2012). Immunological impact of an additional early measles vaccine in Gambian children: Responses to a boost at 3 years. Vaccine, 30(15), 2543–2550.

Nozdracheva, A. V., Semenenko, T. A., Asatryan, M. N., Shmyr, I. C., Ershov, I. F., Solov’ev, D. V., Glinenko, V. M., & Kuzin, S. N. (2017). Immunologicheskaja vospriimchivost' naselenija megapolisa k kori na jetape ee jeliminacii [Immuno­logical susceptibility of metropolis population to measles in its elimination stage]. Epidemiologija i Vakcinoprofilaktika, 18, 18–26 (in Russian).

O'Connor, P., Jankovic, D., & Muscat., M. (2017). Measles and rubella eliminati­on in the WHO Region for Europe: Progress and challenges. Clinical Microbiology and Infection, 23(8), 504–510.

Orenstein, W. A., Cairns, L., Hinman, A., Nkowane, B., Olivé, J.-M., & Reingold, A. L. (2018). Measles and Rubella Global Strategic Plan 2012–2020 midterm review report: Background and summary. Vaccine, 36(Suppl. 1), A35–A42.

Orenstein, W. A., Hinman, A., Nkowane, B., Olive, J. M., & Reingold, A. (2018). Measles and Rubella Global Strategic Plan 2012–2020 midterm review. Vaccine, 36(Suppl. 1), A1–A34.

Park, S. H., Lee, D. H., Jin, J. Y., Shin, Y. L., Shin, M., Kim, S. S., Suh, W. S., Park, J. O., & Hong, Y. H. (2017). Measles outbreaks in the Kyeongin area of the Republic of Korea, 2013–2014: A single-center experience in a country of measles elimination. Asian Pacific Journal of Tropical Medicine, 10(1), 69–74.

Patel, M., Lee, A. D., Clemmons, N. S., Redd, S. B., Poser, S., Blog, D., Zucker, J. R., Leung, J., Link-Gelles, R., Pham, H., Arciuolo, R. J., Rausch-Phung, E., Bankamp, B., Rota, P. A., Weinbaum, C. M., & Gastañaduy, P. A. (2019). National update on measles cases and outbreaks. Morbidity and Mortality Weekly Report, 68(40), 893–896.

Pavelkina, V. F., Markosyan, N. S., Ampleeva, N. P., Alferina, E. N., & Almyasheva, R. Z. (2016). Kor’ v Respublike Mordovii: Kliniko-epidemiologicheskie aspekty [Measles in the Repablic of Mordovia: Clinical and epidemiological aspects]. Infekcionnye Bolezni: Novosti, Mnenija, Obuchenie, 3, 59–63 (in Russian).

Pham, V. H., Nguyet, D. P. H., Mai, K. N. H., Truong, K. H., Huynh, L. V., Pham, T. H. T., & Abe, K. (2014). Measles epidemic among children in Vietnam: Genomic characterization of virus responsible for measles outbreak in Ho Chi minh City, 2014. Vaccine, 1(2–3), 133–140.

Pokrovska, T. V., Hnatiuk, V. V., & Nadraha, O. B. (2015). Porіvnjal’na harakte­ristika klіnіchnogo perebіgu koru v dіtej і doroslih [Comparative analysis of clinical course of measles in children and adults]. Іnfekcіjnі Hvoroby, 1, 28–32 (in Ukrainian).

Portnoy, А., Jit, M., Helleringer, S., & Verguet, S. (2018). Impact of measles supple­mentary immunization activities on reaching children missed by routine pro­grams. Vaccine, 36(1), 170–178.

Pozdnyakov, A. A., & Chernyavskaya, O. P. (2018). Projavlenija epidemichesko­go processa kori i krasnuhi na sovremennom jetape [Manifestations of the epidemic process of measles and rubella at the present stage]. Epidemiologija i Vakcinoprofilaktika, 17(5), 45–53 (in Russian).

Savchuk, R. M., Sidneva, N. I., Djus, T. B., Pogorila, L. Y., & Stepanovich, A. M. (2017). Dіagnostika koru na Prikarpattі: Vchora, s’ogodnі, zavtra [Measles di­agnosis at the Subcarpathian region: Yesterday, today, tomorrow]. Aktual’na Infektologia, 5(6), 265–267 (in Ukrainian).

Skryabina, S. V., Kovyazina, S. A., Kuzmin, S. V., Yurovskikh, A. I., Tsvirkun, O. V., Gerasimova, A. G., Tikhonova, N. T., Malyamova, L. N., Smirnova, S. S., Kharitonov, A. N., & Rybinskova, E. A. (2018). Vspyshka kori v Sverdlovskoj oblasti v 2016 godu [Measles outbreak in Sverdlovsk Region in 2016]. Epide­miologija i Vakcinoprofilaktika, 99, 50–56 (in Russian).

Smyrnova, D. D., Usachova, O. V., & Firulina, O. M. (2019). Osoblivostі perebіgu koru v epіdsezonі 2017–2018 rr. – rozvytok asocіjovanogo z vіrusom koru ura­zhennja pechіnky [Features of epidemiological sesson 2017–2018 – develop­ment of liver lesion associated with measles virus]. Іnfekcіjnі Hvoroby, 95(1), 20–25 (in Ukrainian).

Timchenko, V. N., Chernova, T. M., Bublina, O. V., Pavlova, E. B., Nazarova, A. N., Leonicheva, O. A., & Timofeeva, E. V. (2015). Kor' u detej rannego vozrasta [Measles in infants]. Detskie Infekcii, 14, 52–58 (in Russian).

Timchenko, V. N., Kaplina, T. A., Bunina, O. V., Leont’eva, O. A., Hakizimana, E. V., & Timofeeva, E. V. (2017). Aktual’nye problemy korevoj infekcii [Actual pro­blems of measles]. Pediatrija, 3(8), 120–129 (in Russian).

Trykhlib, V. I., Shchur, A. B., Hrushkevych, V. V., Hryshyn, O. S., Pavlovska, M. O., Musiienko, T. I., Muzyka, A. A., Ralets, N. V., Dudar, D. M., & Kozachenko, L. V. (2018). Osoblivostі klіnіchnih projavіv ta perebіgu koru [Peculiarities of measles clinical manifestations and course]. Aktual’na Infektologia, 6(3), 141–152 (in Ukrainian).

Usachova, O. V., Silina, Y. A., Pakholchuk, T. N., Konakova, O. V., Dralova, O. A., Puhir, V. P., Firyulina, O. M., & Zelenukhina, E. V. (2019). Kіr – kerovana іn­fekcіja! Dejakі epіdemіologіchnі paradigmi koru u Zaporіz'kіj oblastі [Measles – controlled infection! Some epidemiological paradigm of measles in Zaporizh­zhia region]. Sovremennaja Pediatrija, 97, 13–18 (in Ukrainian).

Utenkova, E. O. (2018). Infekcionnye jekzantemy u detej [Infectious exanthema in children]. Detskiye Infektsii, 17(3), 57–61 (in Russian).

Vemula, V. N., Li, L., Thoon, K. C., Chong, C. Y., Tee, N. W. S., Maiwald, M., & Tan, N. W. H. (2016). Risk factors and clinical profile of measles infection in children in Singapore. Infection, Disease and Health, 21(4), 192–196.

Verguet, S., Johri, M., Morris, S. K., Gauvreauf, C. L., Jha, P., & Jit, M. (2015). Controlling measles using supplemental immunization activities: A mathe­matical model to inform optimal policy. Vaccine, 33(10), 1291–1296.

Volyanska, L. A., Burbela, E. I., & Romanyuk, L. B. (2019). Nekontrol’ovanіst’ ko­ru v epohu kerovanih іnfekcіj [Uncontrolled measles in the age of controlled infections]. Zdorov’e Rebenka, 14(4), 242–249 (in Ukrainian).

Yevtushenko, V. V., Kramarov, S. О., Shadrin, V. O., Markov, A. I., Kaminsk, T. M., & Hrechukha, Y. O. (2019). Klinicheskie i epidemiologicheskie osobennosti kori u gospitalizirovannyh detej vo vremja dvuh vspyshek (2005–2006 i 2017–2018 gg.) v Ukraine [Clinical and epidemiological features of measles in child­ren hospitalized during two outbreaks (2005–2006 and 2017–2018) in Ukrai­ne]. Zaporozhskij Medicinskij Zhurnal, 21, 808–814 (in Ukrainian).

Yunasova, T. N., Gorenkov, D. V., Rukavishnikov, A. V., Movsesyants, A. A., & Merkulov, V. A. (2019). Analiz zabolevaemosti kor’ju v Rossii i problemy pro­filaktiki kori na etape eliminacii [Analysis of measles incidence in Russia and problems of measles prevention at the elimination stage]. Biopreparaty, Profi­laktika, 19, 154–160 (in Russian).

Zeng, Y., Luo, M., Chen, J., He, H., Deng, X., Xie, S., & Fang, Y. (2019). An economic evaluation of the current measles vaccination program: A case study in Zhejiang Province, east China. Vaccine, 37(23), 3071–3077.

Zhanga, R. O., Li, H. B., Li, F. Y., Han, L. H., & Xiong, Y. M. (2017). Epidemio­logical characteristics of measles from 2000 to 2014: Results of a measles catch-up vaccination campaign in Xianyang, China. Journal of Infection and Public Health, 10(5), 624–629.

Published
2020-03-01
How to Cite
Koniushevska, A. A., Parkhomenko, T. A., Sharunova, M. V., Kazantsev, A. B., & Yakovenko, D. V. (2020). Epidemiology and features of the measles course in children during the outbreak of 2018–2019 in the city of Mariupol . Regulatory Mechanisms in Biosystems, 11(1), 74-81. https://doi.org/10.15421/022010

Most read articles by the same author(s)