Measles and rubella immunity in the population of Bhutan, 2017 |
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| Affiliation: | 1. Royal Centre for Disease Control, Ministry of Health, Royal Government of Bhutan, Wangchutaba, Serbithang, Thimphu, Bhutan;2. World Health Organization Consultant, C/Juan de Austria, 13, 28010 Madrid, Spain;3. Ministry of Health, Royal Government of Bhutan, P.O. Box: 726, Kawajangsa, Thimphu, Bhutan;4. Global Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, United States;5. Expanded Programme on Immunization, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland;1. Laboratory of Biotechnology, Research Institute of Green Science and Technology, Shizuoka University, 836 Ohya, Suruga-ku, Shizuoka 422-8529, Japan;2. Laboratory of Biotechnology, Graduate School of Integrated Science and Technology, Shizuoka University, 836 Ohya, Suruga-ku, Shizuoka 422-8529, Japan;3. Laboratory of Biotechnology, Graduate School of Science and Technology, Shizuoka University, 836 Ohya, Suruga-ku, Shizuoka 422-8529, Japan;4. Laboratory of Veterinary Parasitology, Nippon Veterinary and Life University, Musashino, Tokyo 180-8602, Japan;1. Graduate Institute of Veterinary Pathobiology, College of Veterinary Medicine, National Chung Hsing University, 145 Xingda Road, Taichung 40227, Taiwan, Republic of China;2. Graduate Institute of Microbiology and Public Health, College of Veterinary Medicine, National Chung Hsing University, 145 Xingda Road, Taichung 40227, Taiwan, Republic of China;3. Research Center for Animal Medicine, National Chung Hsing University, 145 Xingda Road, Taichung 40227, Taiwan, Republic of China;1. Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA;2. BlueWillow Biologics, Ann Arbor, MI, USA;3. University of Pennsylvania, Philadelphia, PA, USA;1. Food Animal Health Research Program, Ohio Agricultural Research and Development Center, The Ohio State University, Wooster, OH, USA;2. Poultry Diseases Department, Faculty of Veterinary Medicine, Cairo University, Cairo, Egypt;3. Division of Infectious Diseases, Cincinnati Children''s Hospital Medical Center, Cincinnati, OH, USA;4. Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA;1. National Reference Center for Sanitary Dermatology and Leprosy, Clinics Hospital, Federal University of Uberlandia, Uberlandia, MG 38.413-018, Brazil;2. Postgraduate Program in Health Sciences, School of Medicine, Federal University of Uberlandia, Uberlandia, MG 38400-902, Brazil |
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| Abstract: | ![]()
BackgroundIn 2017, measles elimination was verified in Bhutan, and the country appears to have sufficiently high vaccination coverage to achieve rubella elimination. However, a measles and rubella serosurvey was conducted to find if any hidden immunity gaps existed that could threaten Bhutan’s elimination status.MethodsA nationwide, three-stage, cluster seroprevalence survey was conducted among individuals aged 1–4, 5–17, and >20 years in 2017. Demographic information and children’s vaccination history were collected, and a blood specimen was drawn. Serum was tested for measles and rubella immunoglobulin G (IgG). Frequencies, weighted proportions, and prevalence ratios for measles and rubella seropositivity were calculated by demographic and vaccination history, taking into account the study design.ResultsOf the 1325 individuals tested, 1045 (81%, 95% CI 78%–85%) were measles IgG seropositive, and 1290 (97%, 95% CI 95%–99%) were rubella IgG seropositive. Rubella IgG seropositivity was high in all three age strata, but only 47% of those aged 5–17 years were measles IgG seropositive. Additionally, only 41% of those aged 5–17 years who had documented receipt of two doses of measles– or measles-rubella–containing vaccine were seropositive for measles IgG, but almost all these children were rubella IgG seropositive.ConclusionsAn unexpected measles immunity gap was identified among children 5–17 years of age. It is unclear why this immunity gap exists; however, it could have led to a large outbreak and threatened sustaining of measles elimination in Bhutan. Based on this finding, a mass vaccination campaign was conducted to close the immunity gap. |
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| Keywords: | Measles Rubella Seroprevalence Bhutan |
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