Measles in the European region in the last decade - systematic review

Postgraduate Thesis uoadl:3403260 19 Read counter

Κατεύθυνση Παιδιατρική Λοιμωξιολογία
Library of the School of Health Sciences
Deposit date:
Natsiou Maria
Supervisors info:
Σολδάτου Αλεξάνδρα, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Μίχος Αθανάσιος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Σιαχανίδου Σουλτάνα, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Η νόσος της ιλαράς στην περιοχή της Ευρώπης την τελευταία δεκαετία - συστηματική ανασκόπηση
Translated title:
Measles in the European region in the last decade - systematic review
Background: Although categorized as a vaccine-preventable disease, measles remains a major public health issue in the European region. In recent years, there has been a continuous emergence of new outbreaks, resulting in significant consequences. To highlight the severity of the situation, 114 deaths were attributed to this infection during the period 2017-2018 alone.
Objective: The main objective of this study is to outline the epidemiological data concerning measles outbreaks in the European region throughout the past decade.
A secondary objective is to analyze the underlying causes of these outbreaks, derive conclusions and propose future actions. To our knowledge, there is no systematic review in the literature that comprehensively analyzes the epidemiological data of all measles outbreaks for both pediatric and adult populations across the entire European continent during the last decade, specifically from 2012 to 2022.
Methods: We searched PubMed, Elsevier Scopus, and Cochrane databases and documented measles outbreaks in children and adults within the population of Europe from 01/01/2012 to 31/01/2022 and published from 01/01/2012 to 11/10/2023. Through the evaluation of articles using the Prisma system, a total of 62 articles were included, analyzing 62 regional and national epidemics from 27 countries.
Results: We investigated measles outbreaks that occurred in Austria, Belgium, Bosnia and Herzegovina, Bulgaria, France, Germany, Georgia, Denmark, Greece, the United Kingdom, Ireland, Spain, Italy, Croatia, Luxembourg, Montenegro, the Netherlands, Hungary, Ukraine, Poland, Portugal, Romania, Serbia, Slovakia, Slovenia, Sweden, and the Czech Republic. The highest number of cases was recorded in Ukraine during 2017-2019, with 115,283 cases, followed by Romania, Georgia, and Italy. All age groups were affected, and males were predominantly affected. The highest number of deaths was reported in Romania during 2016-2019, with 64 fatalities, mostly children.
The main cause of the outbreaks was lack of vaccination, although fully vaccinated individuals were also affected. Some outbreaks were attributed to religious or ethnic minorities. The predominant strains were B3 and D8.
Notably, healthcare facilities played a crucial role in the transmission of the virus. Numerous studies reported cases among healthcare workers, leading to subsequently infecting hospitalized patients.
Conclusions: Despite efforts, elimination of measles has not been accomplished in Europe. In addition to the existing guidelines, institutions should consider the implementation of new measures, such as monitoring the vaccination coverage of healthcare workers and enforcing compulsory vaccination. As shown, this group of professionals has contributed to the measles reemergence.
Main subject category:
Health Sciences
Epidemic, Outbreak, Measles, Europe, European region
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Natsiou_Maria_MSc 2024.pdf
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