A disease that is coming back: measles

Abstract

After the tremendous decrease of measles due to vaccination, it reappeared in 2008, with 604 cases reported at the Institut de veille sanitaire (InVS), 1,482 cases reported in 2009, and more than 4,500 cases reported in 2010 (provisional data). The measles virus (MeV) was detected in parallel at the Centre national de référence (CNR). This outbreak was characterized by a specific attack among infants (4% in 2008 versus 9% in 2010) and young adults (17% in 2008 versus 38% in 2010). Most of the cases (82%) occurred in nonvaccinated persons. The number of hospitalized cases increased from 18% in 2008 to 34% in 2010. MeV genotype during this outbreak was D4. It appeared in 2008, spread in 2009, and represented 98.8% of the strains in 2010. The epidemiological MeV strain is identical to the one called MVs/Montaigu. FRA/43.08(D4) that caused a small outbreak of measles in the Vendee region during the last trimester of 2008. Molecular diagnosis from a nasopharyngeal or salivary sample is an early, sensitive, and specific way to prove measles in patients, allowing the identification of MeV genotypes as well.