PREVALENCE OF MEASLES IGG ANTIBODIES AMONG HEALTHCARE WORKERS IN BULGARIA

Authors

  • Stefka Krumova Assoc. Prof.
  • Ivona Andonova National Centre of Infectious and Parasitic Diseases
  • Savina Stoitsova National Centre of Infectious and Parasitic Diseases
  • Radostina Stefanova National Centre of Infectious and Parasitic Diseases
  • Nadejda Vladimirova National Centre of Infectious and Parasitic Diseases
  • Kremena Parmakova Ministry of Health
  • Anna Kurchatova National Centre of Infectious and Parasitic Diseases

DOI:

https://doi.org/10.58395/pipd.v49i2.64

Keywords:

measles, healthcare workers, measles IgG immunity, elimination

Abstract

Background: Healthcare workers are at greater risk of acquiring measles than the general population. Transmission occurs from infected patients to staff and from infected staff to patients and colleagues. In inpatient and outpatient settings, susceptible patients suffering from other conditions, especially the elderly and severely ill patients in intensive care units are at a high risk of severe disease or death if infected with measles. The most effective preventive measure against measles is vaccination with two doses of a measles-containing vaccine.

Aim: To perform a serological assessment of the presence of measles IgG antibodies among healthcare workers.

Materials and Methods: The present study involves serological testing performed on samples from persons working in hospitals and Regional Health Inspectorates in the country. Screening started in connection with a reported measles outbreak in Bulgaria in 2019, and continued into early 2020. An indirect ELISA assay for the detection of specific measles IgG antibodies in serum samples was used.

Results: The tested 152 healthcare workers were from 5 regions of the country, i.e. Sofia-capital (n=87), Burgas (n=6), Blagoevgrad (n=5), Dobrich (n=8) and Pazardzhik (n=46). Anti-measles IgG antibodies were detected in 85.5% of the participants (130/152). Negative results, indicating a possible lack of protective immunity against measles, were obtained primarily in samples from persons younger than 40 years of age.

Conclusion: Screening to identify healthcare workers who lack presumptive evidence of protective immunity against measles should be reinforced, especially among younger healthcare workers, in order to minimize the risk of measles both among healthcare workers and among patients.

References

Urbiztondo L, Borràs E, Costa J, Broner S, Campins M, et al. Prevalence of measles antibodies among health care workers in Catalonia (Spain) in the elimination era, BMC Infect Dis. 2013, 13: 391. doi: 10.1186/1471-2334-13-391

Domínguez A, Torner N, Barrabeig I, Rovira A, Rius C, et al. Large measles outbreak in a community with high vaccination coverage. Clin Infect Dis. 2008, 47: 1143-1149. 10.1086/592258.

Borràs E, Urbiztondo L, Costa J, Batalla J, Torner N, Plasencia A, et al. Measles antibodies and response to vaccination in children aged less than 14 months: implications for age of vaccination. Epidemiol Infect. 2012, 140 (9): 1599-1606. 10.1017/S0950268811002184.

Gatcheva N, Mihneva Z, Mehandjieva V, Petkova V. Elimination of measles in Bulgaria: the fever-rash illness surveillance revealed no indigenous transmission following the importations in 2005 and 2006. Probl Infect Parasit Dis., 2007, 35(2):30-33.

Kurchatova A, Krumova St, Vladimirova N, Nikolaeva-Glomb L, Stoyanova A, Kantardjiev T, Gatcheva N. Preliminary findings indicate nosocomial transmission and Roma population as most affected group in ongoing measles B3 genotype outbreak in Bulgaria, March to August 2017. Euro Surveill., 2017, 22(36):pii=30611.

Maltezou H, Poland G. Vaccination policies for healthcare workers in Europe. Vaccine. 2014, 32(38):4876-80. doi: 10.1016/j.vaccine.2013.10.046. Epub 2013 Oct 23. PMID: 24161573.

Urbiztondo L, Borràs E, Costa,J. et al. Prevalence of measles antibodies among health care workers in Catalonia (Spain) in the elimination era. BMC Infect Dis, 2013, 13, 391. https://doi.org/10.1186/1471-2334-13-391.

World Health Organization: Measles. Available online (accessed Jul 2012): http://www.who.int/mediacentre/factsheets/fs286/en/index.html

Botelho-Nevers E, Gautret P, Biellik RJ, Brouqui P. Nosocomial transmission of measles: an updated review. Vaccine. 2012, 30, 27, 3996-4001. 10.1016/j.vaccine.2012.04.023.

Baccolini V, Sindoni A, Adamo G, Rosso A, et al. Measles among healthcare workers in Italy: is it time to act?, Human Vaccines & Immunotherapeutics, 2020, 16:11, 2618-2627, DOI:10.1080/21645515.2020.1737458

https://mmr.gateway.bg/index.php

European Centre for Disease Prevention and Control. Measles and rubella surveillance. 2017. https://www.ecdc.europa.eu/sites/default/files/documents/Measles-and-Rubella-Surveillance-2017.pdf.

https://www.ecdc.europa.eu/en/publications-data/measles-notification-rate-million-population-country-eueea-1-december-2018-30-0

Holt E. 41 000 measles cases in Europe since the beginning of 2018. Lancet. 2018;392:724. doi:10.1016/S0140-6736(18)32031-2. PubMed PMID: 30191821.

Botelho-Nevers E, Cassir N, Minodier P, Laporte R, Gautret P, et al. Measles among healthcare workers: a potential for nosocomial outbreaks. Euro Surveill. 2011;16(2):pii:19764. PubMed PMID:2128492.

Haviari S, Bénet T, Saadatian-Elahi M, André P, Loulergue P, Vanhems P. Vaccination of healthcare workers: a review. Hum Vaccines Immunother. 2015, 11(11):2522–37. doi:10.1080/21645515.2015.1082014. PubMed PMID: 26291642

Chen S, Anderson S, Kutty P, Lugo F, McDonald M, Rota P, et al. Health care-associated measles outbreak in the United States after an importation: challenges and economic impact. J Infect Dis. 2011, 203(11):1517–25. doi:10.1093/infdis/jir115. PubMed PMID: 21531693.

Wilson J, Gillespie E, Stuart R, Bradford J, Leszkiewicz P. The costs of containing measles within a health care service. Health Infect. 2010, 15(2):43–46. doi:10.1071/HI10008.

Hiller U, Mankertz A, Köneke N, Wicker S. Hospital outbreak of measles - evaluation and costs of 10 occupational cases among healthcare worker in Germany, February to March 2017. Vaccine. 2019;37(14):1905–09. doi:10.1016/j.vaccine.2019.02.068. PubMed PMID: 30850241.

Karageorgou K, Katerelos P, Efstathiou A, Theodoridou M, Maltezou H. Vaccination coverage and susceptibility against vaccine-preventable diseases of healthcare students in Athens, Greece. Vaccine. 2014, 32(39):5083-6. doi: 10.1016/j.vaccine.2014.06.031. Epub 2014 Jun 30. PMID: 24992715.

Hahné S, Lochlainn L, van Burgel N, Kerkhof J, Sane J, Yap K, van Binnendijk R, Measles Outbreak Among Previously Immunized Healthcare Workers, the Netherlands, 2014, The Journal of Infectious Diseases, 214, 12, 2016, Pages 1980–1986, https://doi.org/10.1093/infdis/jiw480

Ziegler E, Roth C, Wreghitt T. Prevalence of measles susceptibility among health care workers in a UK hospital. Does the UK need to introduce a measles policy for its health care workers? Occup Med (Lond). 2003, 53(6):398-402.

Downloads

Published

2021-08-27

How to Cite

Krumova, S., Andonova, I., Stoitsova, S., Stefanova, R., Vladimirova, N. ., Parmakova, K., & Kurchatova, A. (2021). PREVALENCE OF MEASLES IGG ANTIBODIES AMONG HEALTHCARE WORKERS IN BULGARIA. PROBLEMS of Infectious and Parasitic Diseases, 49(2), 14–19. https://doi.org/10.58395/pipd.v49i2.64

Issue

Section

Articles

Most read articles by the same author(s)