title: A unique measles B3 cluster in the United Kingdom and the Netherlands linked to air travel and transit at a large international airport, February to April 2014.
abstract: This report describes a joint measles outbreak investigation between public health officials in the United Kingdom (UK) and the Netherlands following detection of a measles cluster with a unique measles virus strain. From 1 February to 30 April 2014, 33 measles cases with a unique measles virus strain of genotype B3 were detected in the UK and the Netherlands, of which nine secondary cases were epidemiologically linked to an infectious measles case travelling from the Philippines. Through a combination of epidemiological investigation and sequence analysis, we found that measles transmission occurred in flight, airport and household settings. The secondary measles cases included airport workers, passengers in transit at the same airport or travelling on the same flight as the infectious case and also household contacts. This investigation highlighted the particular importance of measles genotyping in identifying transmission networks and the need to improve vaccination, public health follow-up and management of travellers and airport staff exposed to measles.
authors.affiliation: National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, the Netherlands.
authors.forename: Laura
authors.initials: L
authors.lastname: Nic Lochlainn
authors.forename: Sema
authors.initials: S
authors.lastname: Mandal
authors.forename: Rita
authors.initials: R
authors.lastname: de Sousa
authors.forename: Karthik
authors.initials: K
authors.lastname: Paranthaman
authors.forename: Rob
authors.initials: R
authors.lastname: van Binnendijk
authors.forename: Mary
authors.initials: M
authors.lastname: Ramsay
authors.forename: Susan
authors.initials: S
authors.lastname: Hahné
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D064870:Air Travel; D059028:Airports; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D016358:Contact Tracing; D004196:Disease Outbreaks; D005838:Genotype; D006801:Humans; D007223:Infant; D038622:Internationality; D008297:Male; D008457:Measles / Q000453:epidemiology / Q000635:transmission; D008459:Measles virus / Q000145:classification* / Q000302:isolation & purification*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D017421:Sequence Analysis; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: Measles/epidemiology; Measles/prevention & control; Measles/transmission; Outbreaks; travel; vaccine-preventable diseases