Sunday, December 2, 2007

And you said Italy was your special place?

46 cases of measles (let's review: Paramyxoviridae, (-)ssRNA, helical, enveloped, monopartite, etc) have been linked to single outbreak in the Piemonte region on northern Italy, from September 19-November 19, 2007! The index case is reported to be an UNVACCINATED(!) 17-year old girl who had visited Cambridge (UK), London, and Norwich on a school trip (Sept 2-15, 2007) along with 54 other students....oh dear...

She developed a fever and a rash, 2 and 4 days after her return to Italy, while two other unvaccinated (again !) students on the trip also developed rashes on Sept 20 and Oct 1. Although the two siblings (who were not on the trip) of the Oct 1 rash case were vaccinated against measles on Oct 3, both developed fevers 7 days after vaccination, and rashes on Oct 11 and 12, 10 days after the onset of their sister's rash.

33 additional mealses cases were identified among adolescents and young adults living or attending schools in same city where the index case resides, while 8 cases were reported in nearby towns. Epidemiologhical studies conducted showed that the link was defined as contact with a measles case 7-18 days before the onset of rash. 96% of the cases were 12-21 years old, while 93% of the cases were unvaccinated against measles.

Given that there have been several reported cases of meales in the UK, it is likely that the index case was imported from the UK. Piemonte region health officials also reprt that the measles vaccination rates for the 1989-1992 birth cohort are low (70-85%), while a greater percentage of younger cohorts (90-92%) have been vaccinated.


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