title: Implementation of a national measles elimination program in Iran: Phylogenetic analysis of measles virus strains isolated during 2010-2012 outbreaks.
abstract: Measles virus (MV) causes small and large outbreaks in Iran. Molecular assays allow identifying and the sources of measles imported from neighboring countries. We carried out a phylogenetic analysis of measles virus circulating in Iran over the period 2010-2012. Specimens from suspected cases of measles were collected from different regions of Iran. Virus isolation was performed on urine and throat swabs. Partial nucleoprotein gene segments of MV were amplified by RT-PCR. PCR products of 173 samples were sequenced and analyzed. The median age of confirmed cases was 2 years. Among all confirmed cases, 32% had unknown vaccination status, 20% had been vaccinated, and 48% had not been vaccinated. Genotypes B3 and D8 (for the first time), H1 and D4 were detected mainly in unvaccinated toddlers and young children. Genotype B3 became predominant in 2012 and was closely related to African strains. H1 strains were also found in small and large outbreaks during 2012 but were not identical to Iranian H1-2009 strains. A majority of the Iranian D4 strains during 2010-2012 outbreaks were linked to the D4 strain identified in the Pakistan in 2007. We identified a single case in 2010 belonging to D8 genotype with 99.7% identity to Indian isolates. Although the vaccination program is currently good enough to prevent nationwide epidemics and successfully decreased measles incidence in Iran, the fraction of protected individuals in the population was not high enough to prevent continuous introduction of cases from abroad. Due to increasing number of susceptible individuals in some areas, sustained transmission of the newly introduced viral genotype remains possible.
authors.affiliation: Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; National Reference Laboratory for Measles and Rubella, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Vahid
authors.initials: V
authors.lastname: Salimi
authors.affiliation: Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Simin
authors.initials: S
authors.lastname: Abbasi
authors.affiliation: Vaccine Preventable Diseases Department, Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran.
authors.forename: Seyed Mohsen
authors.initials: SM
authors.lastname: Zahraei
authors.affiliation: National Reference Laboratory for Measles and Rubella, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ghazal
authors.initials: G
authors.lastname: Fatemi-Nasab
authors.affiliation: National Reference Laboratory for Measles and Rubella, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Adjaminezhad-Fard
authors.affiliation: National Reference Laboratory for Measles and Rubella, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Azadeh
authors.initials: A
authors.lastname: Shadab
authors.affiliation: Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Nastaran
authors.initials: N
authors.lastname: Ghavami
authors.affiliation: Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Raziyeh
authors.initials: R
authors.lastname: Zareh-Khoshchehre
authors.affiliation: Vaccine Preventable Diseases Department, Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran.
authors.forename: Rambod
authors.initials: R
authors.lastname: Soltanshahi
authors.affiliation: Department of Pediatrics and Department of Immunology, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Louis
authors.initials: L
authors.lastname: Bont
authors.affiliation: Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; National Reference Laboratory for Measles and Rubella, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Talat
authors.initials: T
authors.lastname: Mokhtari-Azad
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007492:Iran / Q000453:epidemiology; D008297:Male; D008457:Measles / Q000453:epidemiology* / Q000517:prevention & control*; D008459:Measles virus / Q000235:genetics* / Q000302:isolation & purification* / Q000502:physiology; D010802:Phylogeny; D013045:Species Specificity
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