title: Spread of measles virus D4-Hamburg, Europe, 2008-2011.
abstract: A new strain of measles virus, D4-Hamburg, was imported from London to Hamburg in December 2008 and subsequently spread to Bulgaria, where an outbreak of >24,300 cases was observed. We analyzed spread of the virus to demonstrate the importance of addressing hard-to-reach communities within the World Health Organization European Region regarding access to medical care and vaccination campaigns. The D4-Hamburg strain appeared during 2009-2011 in Poland, Ireland, Northern Ireland, Austria, Greece, Romania, Turkey, Macedonia, Serbia, Switzerland, and Belgium and was repeatedly reimported to Germany. The strain was present in Europe for >27 months and led to >25,000 cases in 12 countries. Spread of the virus was prevalently but not exclusively associated with travel by persons in the Roma ethnic group; because this travel extends beyond the borders of any European country, measures to prevent the spread of measles should be implemented by the region as a whole.
authors.affiliation: Robert Koch Institute, Berlin, Germany. mankertza@rki.de
authors.forename: Annette
authors.initials: A
authors.lastname: Mankertz
authors.forename: Zefira
authors.initials: Z
authors.lastname: Mihneva
authors.forename: Hermann
authors.initials: H
authors.lastname: Gold
authors.forename: Sigrid
authors.initials: S
authors.lastname: Baumgarte
authors.forename: Armin
authors.initials: A
authors.lastname: Baillot
authors.forename: Rudolph
authors.initials: R
authors.lastname: Helble
authors.forename: Hedwig
authors.initials: H
authors.lastname: Roggendorf
authors.forename: Golubinka
authors.initials: G
authors.lastname: Bosevska
authors.forename: Jasminka
authors.initials: J
authors.lastname: Nedeljkovic
authors.forename: Agata
authors.initials: A
authors.lastname: Makowka
authors.forename: Veronik
authors.initials: V
authors.lastname: Hutse
authors.forename: Heidemarie
authors.initials: H
authors.lastname: Holzmann
authors.forename: Stefan W
authors.initials: SW
authors.lastname: Aberle
authors.forename: Samuel
authors.initials: S
authors.lastname: Cordey
authors.forename: Gheorghe
authors.initials: G
authors.lastname: Necula
authors.forename: Andreas
authors.initials: A
authors.lastname: Mentis
authors.forename: Gulay
authors.initials: G
authors.lastname: Korukluoğlu
authors.forename: Michael
authors.initials: M
authors.lastname: Carr
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Brown
authors.forename: Judith M
authors.initials: JM
authors.lastname: Hübschen
authors.forename: Claude P
authors.initials: CP
authors.lastname: Muller
authors.forename: Mick N
authors.initials: MN
authors.lastname: Mulders
authors.forename: Sabine
authors.initials: S
authors.lastname: Santibanez
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005060:Europe / Q000453:epidemiology; D005838:Genotype; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008457:Measles / Q000453:epidemiology* / Q000635:transmission* / Q000821:virology; D008459:Measles virus / Q000145:classification / Q000235:genetics* / Q000276:immunology / Q000302:isolation & purification; D010802:Phylogeny; D017422:Sequence Analysis, DNA; D014195:Travel; D014944:World Health Organization; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral