- Dirk Werber1,2, Alexandra Hoffmann1,2,3,4, Sabine Santibanez5, Annette Mankertz5, Daniel Sagebiel1
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View Affiliations Hide AffiliationsAffiliations: 1 State Office for Health and Social Affairs, Berlin, Germany 2 These authors contributed equally to this work 3 Postgraduate Training for Applied Epidemiology (PAE), Robert Koch Institute, Berlin, Germany 4 European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden 5 National Reference Center for Measles, Mumps, Rubella, Robert Koch Institute, Berlin, GermanyDirk Werberdirk.werber lageso.berlin.de
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Citation style for this article: Werber Dirk, Hoffmann Alexandra, Santibanez Sabine, Mankertz Annette, Sagebiel Daniel. Large measles outbreak introduced by asylum seekers and spread among the insufficiently vaccinated resident population, Berlin, October 2014 to August 2015. Euro Surveill. 2017;22(34):pii=30599. https://doi.org/10.2807/1560-7917.ES.2017.22.34.30599 Received: 23 Sep 2016; Accepted: 18 Feb 2017
Large measles outbreak introduced by asylum seekers and spread among the insufficiently vaccinated resident population, Berlin, October 2014 to August 2015
Abstract
The largest measles outbreak in Berlin since 2001 occurred from October 2014 to August 2015. Overall, 1,344 cases were ascertained, 86% (with available information) unvaccinated, including 146 (12%) asylum seekers. Median age was 17 years (interquartile range: 4–29 years), 26% were hospitalised and a 1-year-old child died. Measles virus genotyping uniformly revealed the variant ‘D8-Rostov-Don’ and descendants. The virus was likely introduced by and initially spread among asylum seekers before affecting Berlin’s resident population. Among Berlin residents, the highest incidence was in children aged < 2 years, yet most cases (52%) were adults. Post-exposure vaccinations in homes for asylum seekers, not always conducted, occurred later (median: 7.5 days) than the recommended 72 hours after onset of the first case and reached only half of potential contacts. Asylum seekers should not only have non-discriminatory, equitable access to vaccination, they also need to be offered measles vaccination in a timely fashion, i.e. immediately upon arrival in the receiving country. Supplementary immunisation activities targeting the resident population, particularly adults, are urgently needed in Berlin.

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