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  1. Fulltext The mystery of plummeting cases of measles during COVID-19 pandemic in Pakistan: Hidden impact of collateral damage
    Tanveer M, Ahmed A, Siddiqui A, Gudi SK
    J Med Virol, 2021 Sep;93(9):5236-5238.
    PMID: 33942340 DOI: 10.1002/jmv.27045
    Matched MeSH terms: Measles/epidemiology*
  2. Measles in peninsular Malaysia
    Chen ST
    Med J Malaysia, 1979 Sep;34(1):18-23.
    PMID: 542144
    Matched MeSH terms: Measles/epidemiology*
  3. Measles in Malaysia: a brief report of the 1981 Anti-Measles Pilot Study
    Lo EK, AliHussein N
    Rev. Infect. Dis., 1983 5 1;5(3):405.
    PMID: 6878989
    Matched MeSH terms: Measles/epidemiology*
  4. Fulltext An Eigenspace approach for detecting multiple space-time disease clusters: Application to measles hotspots detection in Khyber-Pakhtunkhwa, Pakistan
    Ullah S, Daud H, Dass SC, Fanaee-T H, Khalil A
    PLoS One, 2018;13(6):e0199176.
    PMID: 29920540 DOI: 10.1371/journal.pone.0199176
    Identifying the abnormally high-risk regions in a spatiotemporal space that contains an unexpected disease count is helpful to conduct surveillance and implement control strategies. The EigenSpot algorithm has been recently proposed for detecting space-time disease clusters of arbitrary shapes with no restriction on the distribution and quality of the data, and has shown some promising advantages over the state-of-the-art methods. However, the main problem with the EigenSpot method is that it cannot be adapted to detect more than one spatiotemporal hotspot. This is an important limitation, since, in reality, we may have multiple hotspots, sometimes at the same level of importance. We propose an extension of the EigenSpot algorithm, called Multi-EigenSpot that is able to handle multiple hotspots by iteratively removing previously detected hotspots and re-running the algorithm until no more hotspots are found. In addition, a visualization tool (heatmap) has been linked to the proposed algorithm to visualize multiple clusters with different colors. We evaluated the proposed method using the monthly data on measles cases in Khyber-Pakhtunkhwa, Pakistan (Jan 2016- Dec 2016), and the efficiency was compared with the state-of-the-art methods: EigenSpot and Space-time scan statistic (SaTScan). The results showed the effectiveness of the proposed method for detecting multiple clusters in a spatiotemporal space.
    Matched MeSH terms: Measles/epidemiology*
  5. Fulltext Measles among US-bound refugees from Malaysia to California, Maryland, North Carolina, and Wisconsin, August–September 2011
    Clin Infect Dis, 2011 Dec;53(12):i.
    PMID: 22080131 DOI: 10.1093/cid/cir815
    Matched MeSH terms: Measles/epidemiology*
  6. Fulltext Poliomyelitis and measles serosurvey in northern Malaysia
    Saraswathy TS, Sinniah M, Lee WS, Lye MS, Choo KE, Jusoh H
    Southeast Asian J. Trop. Med. Public Health, 1994 Sep;25(3):565-8.
    PMID: 7777927
    In 1990 the Institute for Medical Research carried out a serosurvey in the state of Kelantan to study the age stratified immune prevalence rates for measles and poliomyelitis. Our findings indicate that 981 out of 1,097 (89%) of the population screened had measles antibodies and more than 90% (366 out of 400) had antibodies to all three serotypes of poliovirus. The susceptible group for measles was infants below one year of age, of whom 53.3% (8/15) did not have measles antibody. Of 400 subjects, 125 (31.3%) who were either incompletely vaccinated or had not been vaccinated against poliomyelitis, had polio neutralizing antibodies to all three poliovirus serotypes, suggesting herd immunity in the population. No high risk age group could be identified for poliomyelitis.
    Matched MeSH terms: Measles/epidemiology*
  7. Fulltext Optimum age for measles immunization in Malaysia
    Chen ST, Lam SK
    Med J Malaysia, 1985 Dec;40(4):281-8.
    PMID: 3842727
    A study was carried out at the University Hospital, Kuala Lumpur, Malaysia to determine the age-specific prevalence of measles infection by serology and the age specific - seroconversion rates following measles vaccination. The results show that the percentage of children with passively acquired measles antibodies decreased with increasing age fill three to five months of age. From 12 months of age, the percentage of positivity increased sharply due probably to natural infection. The geometric mean antibody titre was low at birth, but from six months it started to increase. These results indicate that measles infection is common in Malaysia and a small number of children began to acquire natural measles infection from six to eight months of age; however the peak age for the acquisition of measles infection was from 12 months to five years of age. Seroconversion rates following vaccination from nine months of age, ranged from 94-99%. However, the rates and the geometric mean titre were higher among those vaccinated at 11 months of age or older compared with those vaccinated at nine or ten months of age. Based on the above results, it is concluded that the optimum age for measles immunization in Malaysia should be 11 months.
    Matched MeSH terms: Measles/epidemiology
  8. An epizootic of measles in captive silvered leaf-monkeys (Presbytis cristatus) in Malaysia
    Montrey RD, Huxsoll DL, Hildebrandt PK, Booth BW, Arimbalam S
    Lab. Anim. Sci., 1980 Aug;30(4 Pt 1):694-7.
    PMID: 7421117
    An epizootic of measles occurred in a group of 31 silvered leaf-monkeys (Presbytis cristatus) that had been in captivity for 4-12 months. Twenty-four of the monkeys exhibited a maculopapular rash that persisted for 6-9 days. A serous to mucopurulent nasal discharge and conjunctivitis were seen in some animals. Eight monkeys died during the epizootic; however, their deaths could not be directly attributed to measles. Serum samples from the surviving monkeys collected 1-2 months prior to, and 5 weeks after, the epizootic were examined by the complement-fixation and hemagglutination-inhibition tests for antibodies to measles virus. The preepizootic complement-fixation titers were all less than 1:4 and hemagglutination-inhibition titers, less than 1:10. The postepizootic complement-fixation titers in 21 of 23 surviving monkeys ranged from 1:8 to 1:128, and hemagglutination-inhibition titers in 22 of 23 monkeys ranged from 1:40 to 1:80 or greater.
    Matched MeSH terms: Measles/epidemiology
  9. Natural virus infections in cynomolgus monkeys
    Suzuki M
    Jpn. J. Med. Sci. Biol., 1981 Aug;34(4):261-3.
    PMID: 7321300
    Matched MeSH terms: Measles/epidemiology
  10. Fulltext Serological assessment of the establishment of herd immunity against measles in a health district in Malaysia
    Hazlina Y, Marlindawati MA, Shamsuddin K
    BMC Infect Dis, 2016 Dec 08;16(1):740.
    PMID: 27931192
    BACKGROUND: Malaysia still faces challenges optimizing resources to effectively eliminate measles through high immunization and herd immunity, with sporadic outbreaks of measles as evidence. The objective of this study is to determine the age-specific positive measles antibodies seroprevalence used for assessing the establishment of herd immunity against measles in different age groups. This is useful for identifying vulnerable age groups requiring supplementary immunization.

    METHODS: A seroprevalence study was conducted among respondents aged 6-9 years, 15-24 years and 45-54 years attending government health clinics in Seremban between September 2014 and January 2015. A total of 1541 measles IgG antibody status were determined using ELISA technique (NovaTec Immundiagnostica GMBH) and assessment of establishment of herd immunity was based on indicators developed by Plans. Data on socio-demographic background as well as medical and medication history were also gathered.

    RESULTS: Seropositive rate for all respondents were 87% (95% CI 85-89), while the rest had either indeterminate [6% (95% CI 5-7)] or negative titre [7% (95% CI 6-8)]. None of the factors analyzed except for age were significant predictors of positive measles antibodies. Seropositive rate differed by age with the highest rate seen in adults (94%; CI 92-96), followed by children (90%; 95% CI 87-94) and adolescents, and young adults (74%; 95% CI 70-78). Based on Plans' indicators, herd immunity was established in adults and children, but not in adolescents and young adults.

    CONCLUSIONS: To tackle the most susceptible group in the present study, it is advisable to give booster vaccination to secondary school students and freshmen who enter colleges and universities in Malaysia.
    Matched MeSH terms: Measles/epidemiology*
  11. Fulltext Measles--an experience in Sandakan Hospital, Sabah, 1990
    Khoo A, Ho CK, Ong TK, Khairul A
    Singapore Med J, 1994 Dec;35(6):595-8.
    PMID: 7761883
    A descriptive study of 143 cases of clinically diagnosed measles in patients under the age of 12 years admitted to the Duchess of Kent Hospital, Sandakan, Sabah, during the year 1990 was carried out. The median age of the patients was one year and 13.3% of the cases were between the ages of 6 and 9 months. The male to female ratio was 1.3:1. The majority of the cases (85.3%) were not immunised against measles while 60.0% of the cases were malnourished. Most of the cases (86.0%) had at least one complication with 32.9% of the cases having more than one complications. The main complications were pneumonia (74.1%) and diarrhea (38.5%). Other complications were convulsions, otitis media and corneal ulceration/scarring. A case of pneumonia with mediastinal emphysema and subcutaneous emphysema was noted. The case fatality rate was 1.4% while blindness was the long term morbidity in 1.4% of the cases. Measles remains an important cause of morbidity in children in Sabah.
    Matched MeSH terms: Measles/epidemiology*
  12. Fulltext Measles among U.S.-bound refugees from Malaysia--California, Maryland, North Carolina, and Wisconsin, August-September 2011
    Centers for Disease Control and Prevention (CDC)
    MMWR Morb Mortal Wkly Rep, 2011 Sep 23;60(37):1281-2.
    PMID: 21937975
    On August 26, 2011, California public health officials notified CDC of a suspected measles case in an unvaccinated male refugee aged 15 years from Burma (the index patient), who had lived in an urban area of Kuala Lumpur, Malaysia, which is experiencing ongoing measles outbreaks. Currently, approximately 92,000 such refugees are living in urban communities in Malaysia. Resettlement programs in the United States and other countries are ongoing. The health and vaccination status of urban refugees are largely unknown.
    Matched MeSH terms: Measles/epidemiology*
  13. Molecular characterization of measles viruses in Turkey (2010-2011): first report of genotype D9 involved in an outbreak in 2011
    Kalaycioglu AT, Baykal A, Guldemir D, Bakkaloglu Z, Korukluoglu G, Coskun A, et al.
    J Med Virol, 2013 Dec;85(12):2128-35.
    PMID: 23959542 DOI: 10.1002/jmv.23714
    Genetic characterization of measles viruses (MVs) combined with acquisition of epidemiologic information is essential for measles surveillance programs used in determining transmission pathways. This study describes the molecular characterization of 26 MV strains (3 from 2010, 23 from 2011) obtained from urine or throat swabs harvested from patients in Turkey. MV RNA samples (n = 26) were subjected to sequence analysis of 450 nucleotides comprising the most variable C-terminal region of the nucleoprotein (N) gene. Phylogenetic analysis revealed 20 strains from 2011 belonged to genotype D9, 3 to D4, 2 strains from 2010 to genotype D4 and 1 to genotype B3. This study represents the first report describing the involvement of MV genotype D9 in an outbreak in Turkey. The sequence of the majority of genotype D9 strains was identical to those identified in Russia, Malaysia, Japan, and the UK. Despite lack of sufficient epidemiologic information, the presence of variants observed following phylogenetic analysis suggested that exposure to genotype D9 might have occurred due to importation more than once. Phylogenetic analysis of five genotype D4 strains revealed the presence of four variants. Epidemiological information and phylogenetic analysis suggested that three genotype D4 strains and one genotype B3 strain were associated with importation. This study suggests the presence of pockets of unimmunized individuals making Turkey susceptible to outbreaks. Continuing molecular surveillance of measles strains in Turkey is essential as a means of acquiring epidemiologic information to define viral transmission patterns and determine the effectiveness of measles vaccination programs designed to eliminate this virus.
    Matched MeSH terms: Measles/epidemiology*
  14. Fulltext Impact of a measles elimination strategy on measles incidence in Malaysia
    Saraswathy TS, Zahrin HN, Norhashmimi H, Az-Ulhusna A, Zainah S, Rohani J
    Southeast Asian J. Trop. Med. Public Health, 2009 Jul;40(4):742-7.
    PMID: 19842408
    In Malaysia, the two dose measles - mumps - rubella (MMR) vaccine was introduced in the Expanded Program on Immunization in 2002. The Ministry of Health then initiated a measles elimination strategy which included enhanced case-based surveillance with laboratory testing of all suspected cases. The objective of our study was to analyse national measles laboratory data from 2004 to 2008 to study the impact of the nationwide strategy on measles case incidence. Blood samples collected from suspected measles cases during the acute stage of the illness were investigated for measles specific IgM. The estimated incidence of measles ranged from 22.3 cases (in 2004) to 2.27 cases (in 2006) per 100,000 population. During this time, the measles vaccination coverage was above 85%. Laboratory confirmed measles cases dropped from 42.2% in 2004, when sporadic outbreaks were reported, to 3.9% in 2007. Screening for measles IgG levels in 2008 showed that 82.8% of those > 7 years old had adequate immunity. The measles control strategy appears to have been successful in reducing the incidence of measles. Continuing high vaccination coverage rates and ongoing measles surveillance are necessary to achieve our goal of measles elimination.
    Matched MeSH terms: Measles/epidemiology
  15. Fulltext Cost analysis of measles in refugees arriving at Los Angeles International Airport from Malaysia
    Coleman MS, Burke HM, Welstead BL, Mitchell T, Taylor EM, Shapovalov D, et al.
    Hum Vaccin Immunother, 2017 05 04;13(5):1084-1090.
    PMID: 28068211 DOI: 10.1080/21645515.2016.1271518
    Background On August 24, 2011, 31 US-bound refugees from Kuala Lumpur, Malaysia (KL) arrived in Los Angeles. One of them was diagnosed with measles post-arrival. He exposed others during a flight, and persons in the community while disembarking and seeking medical care. As a result, 9 cases of measles were identified. Methods We estimated costs of response to this outbreak and conducted a comparative cost analysis examining what might have happened had all US-bound refugees been vaccinated before leaving Malaysia. Results State-by-state costs differed and variously included vaccination, hospitalization, medical visits, and contact tracing with costs ranging from $621 to $35,115. The total of domestic and IOM Malaysia reported costs for US-bound refugees were $137,505 [range: $134,531 - $142,777 from a sensitivity analysis]. Had all US-bound refugees been vaccinated while in Malaysia, it would have cost approximately $19,646 and could have prevented 8 measles cases. Conclusion A vaccination program for US-bound refugees, supporting a complete vaccination for US-bound refugees, could improve refugees' health, reduce importations of vaccine-preventable diseases in the United States, and avert measles response activities and costs.
    Matched MeSH terms: Measles/epidemiology
  16. Fulltext Measles outbreak associated with an arriving refugee - Los Angeles County, California, August-September 2011
    Centers for Disease Control and Prevention (CDC)
    MMWR Morb Mortal Wkly Rep, 2012 Jun 1;61(21):385-9.
    PMID: 22647743
    Measles is a highly communicable, acute viral illness with potential for severe complications, including death. Although endemic measles was eliminated in the United States in 2000 as a result of widespread vaccination, sporadic measles outbreaks still occur, largely associated with international travel from measles-endemic countries and pockets of unvaccinated persons. On August 26, 2011, the Los Angeles County Department of Public Health (LACDPH) was notified of suspected measles in a refugee from Burma who had arrived in Los Angeles, California, on August 24, after a flight from Kuala Lumpur, Malaysia. Passengers on the flight included 31 other refugees who then traveled to seven other states, widening the measles investigation and response activities. In California alone, 50 staff members from LACDPH and the California Department of Public Health (CDPH) interviewed and reinterviewed 298 contacts. Measles was diagnosed in three contacts of the index patient (patient A). The three contacts with measles were two passengers on the same flight as patient A and a customs worker; no secondary cases were identified. Delayed diagnosis of measles in patient A and delayed notification of health officials precluded use of measles-mumps-rubella (MMR) vaccine as an outbreak intervention. This outbreak emphasizes the importance of maintaining a high level of vaccination coverage and continued high vigilance for measles in the United States, particularly among incoming international travelers; clinicians should immediately isolate persons with suspected measles and promptly report them to health authorities.
    Matched MeSH terms: Measles/epidemiology*
  17. Fulltext A point-of-care test for measles diagnosis: detection of measles-specific IgM antibodies and viral nucleic acid
    Warrener L, Slibinskas R, Chua KB, Nigatu W, Brown KE, Sasnauskas K, et al.
    Bull World Health Organ, 2011 Sep 01;89(9):675-82.
    PMID: 21897488 DOI: 10.2471/BLT.11.088427
    OBJECTIVE: To evaluate the performance of a newly developed point-of-care test (POCT) for the detection of measles-specific IgM antibodies in serum and oral fluid specimens and to assess if measles virus nucleic acid could be recovered from used POCT strips.

    METHODS: The POCT was used to test 170 serum specimens collected through measles surveillance or vaccination programmes in Ethiopia, Malaysia and the Russian Federation: 69 were positive for measles immunoglobulin M (IgM) antibodies, 74 were positive for rubella IgM antibodies and 7 were positive for both. Also tested were 282 oral fluid specimens from the measles, mumps and rubella (MMR) surveillance programme of the United Kingdom of Great Britain and Northern Ireland. The Microimmune measles IgM capture enzyme immunoassay was the gold standard for comparison. A panel of 24 oral fluids was used to investigate if measles virus haemagglutinin (H) and nucleocapsid (N) genes could be amplified by polymerase chain reaction directly from used POCT strips.

    FINDINGS: With serum POCT showed a sensitivity and specificity of 90.8% (69/76) and 93.6% (88/94), respectively; with oral fluids, sensitivity and specificity were 90.0% (63/70) and 96.2% (200/208), respectively. Both H and N genes were reliably detected in POCT strips and the N genes could be sequenced for genotyping. Measles virus genes could be recovered from POCT strips after storage for 5 weeks at 20-25 °C.

    CONCLUSION: The POCT has the sensitivity and specificity required of a field-based test for measles diagnosis. However, its role in global measles control programmes requires further evaluation.

    Matched MeSH terms: Measles/epidemiology
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