Measles outbreaks in France between January 2008 and April 2009. Results of a survey of DDASS and CIRE offices.

In response to the resurgence of measles cases that began in the spring of 2008 and continued into 2009, a retrospective questionnaire-based survey was conducted among all Departmental Directorates of Health and Social Affairs (DDASS) and Interregional Epidemiology Units (CIRE) regarding outbreaks occurring in community settings (excluding healthcare settings) between January 2008 and April 2009. The objective was to assess the number and scale of the outbreaks, describe their characteristics, identify epidemiological links between outbreaks, and report on the difficulties encountered by various field personnel in managing and investigating these outbreaks. In total, 88 outbreaks were reported across 33 departments, with the onset dates of the index case’s rash ranging from May 3, 2008, to March 7, 2009. These outbreaks accounted for a total of 731 measles cases, of which 426 (59%) were identified through active surveillance, 373 (51%) were identified through case-based reporting, and 170 (23%) were biologically confirmed. The number of hospitalizations was 31, and the number of severe complications was 6, including one case of encephalitis followed by death. Vaccination status data available for 555 cases showed that 90% were unvaccinated. Median vaccination coverage rates in the population were 56% and 51% for the first and second doses, respectively. Epidemiological links between outbreaks were reported for 70% of them. In 58% of the outbreaks, the Ddass and Cire encountered difficulties in investigating and implementing control measures around the cases, due mainly to late reporting, reluctance on the part of families, and even some physicians, particularly regarding the implementation of post-exposure vaccination measures. This survey highlights underreporting of measles in France. It demonstrates the difficulty in containing the spread of a measles outbreak in a community as long as the affected population remains insufficiently vaccinated. A proposal for catch-up mass vaccinations within schools or other communities when a case is reported could be an option to consider to halt the current spread of the virus. (R.A.)

Author(s): Stoll J, Dennetiere G, Collioud Marichallot L, Langely L, Escourolle D, Parent du Chatelet I

Publishing year: 2009

Pages: 419-23

Weekly Epidemiological Bulletin, 2009, n° 39-40, p. 419-23

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