Epidemiological Update - Measles - 24 October 2018

Situation Summary

In 2018, as of 23 October, a total of 8,091 confirmed measles cases, including 85 deaths, have been reported in 11 countries of the Region of the Americas: Antigua and Barbuda (1 case), Argentina (14 cases), Brazil (2,192 cases, including 12 deaths), Canada (25 cases), Colombia (129 cases), Ecuador (19 cases), Guatemala (1 case), Mexico (5 cases), Peru (38 cases), the United States of America (142 cases), and the Bolivarian Republic of Venezuela (5,525 cases, including 73 deaths).

Since the 21 September 2018 Epidemiological Update on Measles, an additional 1,462 confirmed measles cases were reported, including 13 deaths, in 7 countries of the Region (3 cases in Argentina, 457 cases and 2 deaths in Brazil, 3 cases in Canada, 44 cases in Colombia, 17 cases in Peru, 18 cases in the United States, and 920 cases and 11 deaths in Venezuela).

The genotype D8, lineage MVi/HuluLangat.MYS/26.11, which was initially identified among cases in Venezuela, has since been reported among confirmed cases in Argentina, Brazil, Colombia, Ecuador, and Peru (the countries are listed in alphabetical order and not by the outbreak dates of onset).

In Argentina, between epidemiological week (EW) 11 and EW 38 of 2018, a total of 14 confirmed measles cases were reported, all among residents of the province of Buenos Aires and the city of Buenos Aires. Ages ranged from 5 months to 26 years (median 7 months), and 7 of the cases are female. The dates of rash onset were between 11 March and 21 September 2018. All of the cases were laboratory-confirmed by viral genome detection using polymerase chain reaction (PCR) in urine and respiratory samples. Three cases were IgM-negative.

The first three cases were imported (2 cases) or import-related (1 case). The remaining 11 confirmed cases were related to a second importation, whose origin has not been identified, and 9 of these were identified as genotype D8, lineage Mvi/Hulu Langat.MYS/26.11.

In Brazil, the outbreak began in EW 6 of 2018 in the state of Roraima and spread to Amazonas State three weeks later (Figure 2). Subsequently, cases were reported in 7 states: Pará, Pernambuco, Rio de Janeiro, Rio Grande do Sul, Rondônia, São Paulo, and Sergipe (the states are listed in alphabetical order and not in the order of the occurrence of cases), and most recently in the Federal District. Genotype D8 was identified, with an identical lineage to the cases reported in Venezuela (2017 and 2018), in the states of Amazonas, Rio Grande do Sul, Rio de Janeiro, Pernambuco, Rondônia, Roraima, and São Paulo.