title: Measles outbreak in the Lazio region of Italy: surveillance and impact on emergency departments and hospitalizations.
abstract: BACKGROUND
  The World Health Organization's (WHO) Regional Office for Europe had committed to 2015 as the year to eliminate measles from the region but several outbreaks have been reported recently from several areas of the continent. Here we describe an outbreak that occurred in 2010-2011 in Lazio region, Central Italy, and its impact on some health care services (i.e., Emergency Departments (EDs) and hospital clinics).
  
  
  METHODS
  We analyzed cases of measles reported to the infectious diseases surveillance system and accesses to EDs and hospitalizations for measles in the Lazio Region (central Italy, population of about 5,730,000 people).
  
  
  RESULTS
  In 2010-2011, 2,956 cases were reported to the surveillance system (incidence rate: 18.4 and 33.3 per 100,000 in 2010 and 2011, respectively). The incidence rates varied greatly with the territory. The outbreak occurred mainly among children <1 year old and among adolescents, most unvaccinated and did not seem to be related to cases imported from Eastern Europe. Complications were reported in 37.4% of the cases. The epidemic was mainly related to an accumulation of adolescents susceptible to measles due to unsatisfactory vaccination coverage in the early nineties. The outbreak had a strong impact on the health system with 2,881 ED visits and 1,168 hospitalizations. Outbreak-associated costs were considerable.
  
  
  CONCLUSIONS
  An additional intervention should be considered aimed at improving routine immunization coverage in children and at planning catch-up vaccination of 6-18 year olds not previously vaccinated. Further, timely surveillance is needed and specific protocols should be implemented to limit secondary cases.
authors.affiliation: Laziosanita' - Agenzia di Sanita' Pubblica, Rome, Italy. pezzotti@asplazio.it
authors.forename: P
authors.initials: P
authors.lastname: Pezzotti
authors.forename: S
authors.initials: S
authors.lastname: Valle
authors.forename: F
authors.initials: F
authors.lastname: Perrelli
authors.forename: M P
authors.initials: MP
authors.lastname: Guerra
authors.forename: S
authors.initials: S
authors.lastname: Pozzato
authors.forename: F
authors.initials: F
authors.lastname: Chini
authors.forename: P
authors.initials: P
authors.lastname: Borgia
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D008457:Measles / Q000453:epidemiology*; D008875:Middle Aged; D011159:Population Surveillance; D055815:Young Adult