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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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2017-08-24
2019-02-17
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2017.22.34.30599
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Large measles outbreak introduced by asylum seekers and spread among the insufficiently vaccinated resident population, Berlin, October 2014 to August 2015
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Dirk+Werber&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Werber Dirk</a>, <a href="/search?value1=Alexandra+Hoffmann&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hoffmann Alexandra</a>, <a href="/search?value1=Sabine+Santibanez&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Santibanez Sabine</a>, <a href="/search?value1=Annette+Mankertz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mankertz Annette</a>, <a href="/search?value1=Daniel+Sagebiel&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sagebiel Daniel</a></span>. Large measles outbreak introduced by asylum seekers and spread among the insufficiently vaccinated resident population, Berlin, October 2014 to August 2015. <a href="/content/ecdc">Euro Surveill.</a> 2017;22(34):pii=30599. <a href="https://doi.org/10.2807/1560-7917.ES.2017.22.34.30599" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2017.22.34.30599</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 23 Sep 2016;&nbsp;&nbsp; <span class="generated">Accepted</span>: 18 Feb 2017 </span> </p>
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