Measles cases in Split-Dalmatia County (a Croatian tourist region), in May–July 2019: outbreak report and lessons learnt

Scientific paper - Original scientific paper

• Author: Milka Brzović
• Author: Katija Barać Juretić
• Author: Anamarija Jurčev-Savičević
• Author: Linda Mihojević
• Author: Diana Nonkovic
• Author: Pero Rizvan
• Author: Matea Vujević Petrović
• Author: Marija Tonkić
• Author: Bernard Kaić; MBZ: 235003
• Author: Andrea Babić-Erceg
• Author: Tatjana Vilibić-Čavlek
• Author: Jelena Ivančić-Jelečki
• Author's institution: University of Zagreb; School of Medicine; (Department of Medical Microbiology and Parasitology)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Medical Microbiology

Abstract (english)

Background: Measles elimination was accomplished in Croatia in 2016. Split-Dalmatia County, with population of ca. 425 000 inhabitants, is among the most important Croatian tourist areas with numerous seasonal workers coming during summer months. In both 2018 and 2019, more than 3 million tourists visited this county. In 2000-2018, there were no measles cases in this county, or their number was low (1-3 cases per year).
Methods: After measles was clinically suspected, all contacts were traced and contacted. Detection of specific IgM/IgG antibodies and real-time reverse transcription-polymerase chain reaction detection of viral RNA were used for laboratory confirmation. Sequencing and genotyping were performed for strains' molecular epidemiology analysis.
Results: Six epidemiologically unlinked measles virus occurrences happened in Split-Dalmatia County in 15 May-19 July 2019. Causative viral strains belonged to genotypes B3 and D8. Four were single imported cases. Ten patients belonged to two separate clusters within domicile population. Multiple individual and public health measures were implemented. In total, 483 contacts were identified, 64.2% within healthcare system where two persons contracted the disease.
Conclusions: Besides the importance of timely vaccination of children, the lessons learned from this outbreak point to the need of stricter implementation of other aspects of Croatian measles prevention programme, such as checking of vaccination status in early adulthood. Despite the fact that measles elimination within domicile population in this tourist region has been accomplished and maintained for years, continuous public health workers' efforts are still necessary for identification and diminishment of populational pockets of susceptibility.

• Keywords (english): Adult; Child; Croatia / epidemiology; Disease Outbreaks; Genotype; Humans; Measles virus / genetics; Measles / epidemiology; Measle s/ prevention & control
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: European Journal of Public Health
• Numbering: vol. 32, no. 6, pp. 948-954
• p-ISSN: 1101-1262
• e-ISSN: 1464-360X
• DOI: https://doi.org/10.1093/eurpub/ckac162
• URN:NBN: urn:nbn:hr:105:803170
• Publication: 2022-11-29
• Document URL: https://academic.oup.com/eurpub/article/32/6/948/6815622
• Type of resource: Text
• Access conditions: Open access
• Created on: 2023-07-13 08:13:08