Measles and rubella immunity in the population of Bhutan, 2017

Details

• Journal Article:
  Vaccine
• Personal Author:
  Wangchuk, Sonam ; Nogareda, Francisco ; Tshering, Namgay ; Khandu, Lekey ; Pelden, Sonam ; Wannemuehler, Kathleen ; Wangdi, Sonam ; Wangchuk, Ugyen ; Mulders, Mick ; Tamang, Tshewang ; Patel, Minal K.
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• Description:
  Background: ; In 2017, measles elimination was verified in Bhutan, and the country appears to have sufficiently high vaccination coverage to achieve rubella elimination. However, a measles and rubella serosurvey was conducted to find if any hidden immunity gaps existed that could threaten Bhutan’s elimination status. ; Methods: ; A nationwide, three-stage, cluster seroprevalence survey was conducted among individuals aged 1–4, 5–17, and >20 years in 2017. Demographic information and children’s vaccination history were collected, and a blood specimen was drawn. Serum was tested for measles and rubella immunoglobulin G (IgG). Frequencies, weighted proportions, and prevalence ratios for measles and rubella seropositivity were calculated by demographic and vaccination history, taking into account the study design. ; Results: ; Of the 1325 individuals tested, 1045 (81%, 95% CI 78%–85%) were measles IgG seropositive, and 1290 (97%, 95% CI 95%–99%) were rubella IgG seropositive. Rubella IgG seropositivity was high in all three age strata, but only 47% of those aged 5–17 years were measles IgG seropositive. Additionally, only 41% of those aged 5–17 years who had documented receipt of two doses of measles– or measles-rubella–containing vaccine were seropositive for measles IgG, but almost all these children were rubella IgG seropositive. ; Conclusions: ; An unexpected measles immunity gap was identified among children 5–17 years of age. It is unclear why this immunity gap exists; however, it could have led to a large outbreak and threatened sustaining of measles elimination in Bhutan. Based on this finding, a mass vaccination campaign was conducted to close the immunity gap.
• Keywords:
  • Measles
  • Rubella
  • Seroprevalence
  • Bhutan
  • Adolescent
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Disease Eradication
  • Female
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• Source:
  Vaccine. 37(43):6463-6469
• DOI:
  http://dx.doi.org/10.1016/j.vaccine.2019.08.085
• Pubmed ID:
  31500970
• Pubmed Central ID:
  PMC7034396
• Document Type:
  Text ; Journal Article
• Funding:
  001/WHO_/World Health OrganizationInternational/ ; CC999999/Intramural CDC HHSUnited States/
• Genre:
  Journal Article
• Volume:
  37
• Issue:
  43
• Download URL:
  https://stacks.cdc.gov/view/cdc/85262/cdc_85262_DS1.pdf
• File Type:
  [PDF - 643.71 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:380894933a92692808ecb6c8ece02e0b6d1ee1d89cd2dd8b35399859390e2881bbda760d20c6a2f40839aa93a0858b11bbdee41ef61e965e7f1631985e964d6a