Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 26, Number 11—November 2020
Synopsis

Challenges to Achieving Measles Elimination, Georgia, 2013–2018

Nino KhetsurianiComments to Author , Ketevan Sanadze, Rusudan Chlikadze, Nazibrola Chitadze, Tamar Dolakidze, Tamta Komakhidze, Lia Jabidze, Shahin Huseynov, Myriam Ben Mamou, Claude Muller, Khatuna Zakhashvili, and Judith M. Hübschen
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (N. Khetsuriani); CDC South Caucasus Office, Tbilisi, Georgia (N. Khetsuriani); National Center for Disease Control and Public Health, Tbilisi (K. Sanadze, R. Chlikadze, N. Chitadze, T. Dolakidze, T. Komakhidze, L. Jabidze, K. Zakhashvili); South Caucasus Field Epidemiology and Laboratory Training Program, Tbilisi (T. Komakhidze); World Health Organization European Regional Office, Copenhagen, Denmark (S. Huseynov, M. Ben Mamou); World Health Organization European Regional Reference Laboratory for Measles and Rubella, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg (C. Muller, J.M. Hübschen)

Main Article

Figure 8

Genetic diversity of measles virus strains identified in Georgia, 2013–2018. Genotype D8 cluster of a phylogenetic tree is based on 450 nt of the measles virus nucleoprotein gene. The Kimura 2-parameter model and the neighbor-joining method in MEGA7 (14) were used, and only bootstrap values >70 are shown. The closest matches of the Georgia sequence variants identified by BLAST (https://blast.ncbi.nlm.nih.gov/Blast.cgi) are marked with a diamond; named strains of genotype D8 are marked with a square. For identical sequences, only the oldest and the most recent strains found in a certain location in a certain year are shown. The total number of sequences identified in each cluster are included in parentheses. Year of virus detection is indicated by colored circles: black for 2013, red for 2014, green for 2015, yellow for 2016, blue for 2017, pink for 2018. Scale bar indicates genetic distance, calculated based on the Kimura 2-parameter model, measured in nucleotide substitutions per site.

Figure 8. Genetic diversity of measles virus strains identified in Georgia, 2013–2018. Genotype D8 cluster of a phylogenetic tree is based on 450 nt of the measles virus nucleoprotein gene. The Kimura 2-parameter model and the neighbor-joining method in MEGA7 (14) were used, and only bootstrap values >70 are shown. The closest matches of the Georgia sequence variants identified by BLAST (https://blast.ncbi.nlm.nih.gov/Blast.cgi) are marked with a diamond; named strains of genotype D8 are marked with a square. For identical sequences, only the oldest and the most recent strains found in a certain location in a certain year are shown. The total number of sequences identified in each cluster are included in parentheses. Year of virus detection is indicated by colored circles: black for 2013, red for 2014, green for 2015, yellow for 2016, blue for 2017, pink for 2018. Scale bar indicates genetic distance, calculated based on the Kimura 2-parameter model, measured in nucleotide substitutions per site.

Main Article

References
  1. World Health Organization. Eliminating measles and rubella. Framework for the verification process in the WHO European Region. 2014 [cited 2019 Oct 2]. http://www.euro.who.int/__data/assets/pdf_file/0009/247356/Eliminating-measles-and-rubella-Framework-for-the-verification-process-in-the-WHO-European-Region.pdf
  2. World Health Organization Regional Committee for Europe. Resolution EUR/RC60/R12 on renewed commitment to elimination of measles and rubella and prevention of congenital rubella syndrome by 2015 and sustained support for polio-free status in the WHO European Region. Copenhagen: World Health Organization Regional Office for Europe; 2010 [cited 2019 Oct 2]. http://www.euro.who.int/__data/assets/pdf_file/0016/122236/RC60_eRes12.pdf
  3. Patel  MK, Dumolard  L, Nedelec  Y, Sodha  SV, Steulet  C, Gacic-Dobo  M, et al. Progress toward regional measles elimination—worldwide, 2000–2018. MMWR Morb Mortal Wkly Rep. 2019;68:1105–11. DOIPubMedGoogle Scholar
  4. World Health Organization. Eighth Meeting of the European Regional Verification Commission for Measles and Rubella Elimination. 2019 Jun 12–14. Warsaw, Poland [cited 2019 Oct 2]. http://www.euro.who.int/__data/assets/pdf_file/0019/413236/8th-RVC-Report.pdf
  5. Doshi  S, Khetsuriani  N, Zakhashvili  K, Baidoshvili  L, Imnadze  P, Uzicanin  A. Ongoing measles and rubella transmission in Georgia, 2004-05: implications for the national and regional elimination efforts. Int J Epidemiol. 2009;38:182–91. DOIPubMedGoogle Scholar
  6. World Health Organization. Disease incidence series—measles [cited 2019 Oct 2]. http://apps.who.int/immunization_monitoring/globalsummary/timeseries/tsincidencemeasles.html
  7. Tatochenko  V, Mitjushin  IL. Contraindications to vaccination in the Russian Federation. J Infect Dis. 2000;181(Suppl 1):S228–31. DOIPubMedGoogle Scholar
  8. Khetsuriani  N, Imnadze  P, Dekanosidze  N. Diphtheria epidemic in the Republic of Georgia, 1993-1997. J Infect Dis. 2000;181(Suppl 1):S80–5. DOIPubMedGoogle Scholar
  9. Khetsuriani  N, Imnadze  P, Baidoshvili  L, Jabidze  L, Tatishili  N, Kurtsikashvili  G, et al. Impact of unfounded vaccine safety concerns on the nationwide measles-rubella immunization campaign, Georgia, 2008. Vaccine. 2010;28:6455–62. DOIPubMedGoogle Scholar
  10. Ministry of Labor, Health, and Social Welfare of Georgia. National guidelines for measles, rubella, and congenital rubella syndrome surveillance and outbreak control. Tbilisi, 2017 [in Georgian] [cited 2019 Oct 3]. http://ncdc.ge/Pages/User/News.aspx?ID=71654a22-1b85-4ecf-ade3-fbdf8668113a
  11. Rota  PA, Brown  K, Mankertz  A, Santibanez  S, Shulga  S, Muller  CP, et al. Global distribution of measles genotypes and measles molecular epidemiology. J Infect Dis. 2011;204(Suppl 1):S514–23. DOIPubMedGoogle Scholar
  12. Santibanez  S, Hübschen  JM, Ben Mamou  MC, Muscat  M, Brown  KE, Myers  R, et al. Molecular surveillance of measles and rubella in the WHO European Region: new challenges in the elimination phase. Clin Microbiol Infect. 2017;23:516–23. DOIPubMedGoogle Scholar
  13. Khetsuriani  N, Wannemuehler  K, Geleishvili  M, Komakhidze  T. Final report—immunization coverage survey in Georgia, 2015–2016. Tbilisi (Georgia): US Centers for Disease Control and Prevention, Ministry of Labor, Health, and Social Affairs of Georgia; 2017. pp.1–58 [cited 2020 Apr 12]. https://www.ncdc.ge/Pages/User/Documents.aspx?ID=1d6e5458-6504-4e5c-88a1-e547b79d5b47&language=en-US
  14. Kumar  S, Stecher  G, Tamura  K. MEGA7: Molecular Evolutionary Genetics Analysis Version 7.0 for Bigger Datasets. Mol Biol Evol. 2016;33:1870–4. DOIPubMedGoogle Scholar
  15. The Law of Georgia on Health Care, as amended 14 November, 2018 [in Georgian] [cited 2019 Oct 2]. https://matsne.gov.ge/ka/document/view/29980
  16. Minister of Internally Displaced Persons from the Occupied Territories, Labor, Health, and Social Affairs of Georgia. Decree No. 01–6/N: on approval of the list of occupations subject to mandatory preventive immunizations [in Georgian]. 2019 Jan 2 [cited 2019 Oct 2]. https://www.moh.gov.ge/uploads/files/2019/Failebi/30.01.2019-2.pdf
  17. Khetsuriani  N, Sanadze  K, Abuladze  M, Tatishvili  N. High risk of subacute sclerosing panencephalitis following measles outbreaks in Georgia. Clin Microbiol Infect. 2020;26:737–42. DOIPubMedGoogle Scholar
  18. Khetsuriani  N, Chitadze  N, Russell  S, Ben Mamou  M. Measles and rubella seroprevalence among adults in Georgia in 2015: helping guide the elimination efforts. Epidemiol Infect. 2019;147:e319. DOIPubMedGoogle Scholar
  19. Funk  S, Knapp  JK, Lebo  E, Reef  SE, Dabbagh  AJ, Kretsinger  K, et al. Combining serological and contact data to derive target immunity levels for achieving and maintaining measles elimination. BMC Med. 2019;17:180. DOIPubMedGoogle Scholar
  20. National Statistics Office of Georgia (GEOSTAT). 2014 general population census—main results, general information [cited 2019 Oct 2]. http://census.ge/files/results/Census_release_ENG.pdf
  21. Beaty  SM, Lee  B. Constraints on the genetic and antigenic variability of measles virus. Viruses. 2016;8:109. DOIPubMedGoogle Scholar
  22. Spika  JS, Aidyralieva  C, Mukharskaya  L, Kostyuchenko  NN, Mulders  M, Lipskaya  G, et al. Measles outbreak in the Ukraine, 2005-2006. Euro Surveill. 2006;11:E060309.1.PubMedGoogle Scholar
  23. Velicko  I, Müller  LL, Pebody  R, Gergonne  B, Aidyralieva  C, Kostiuchenko  N, et al. Nationwide measles epidemic in Ukraine: the effect of low vaccine effectiveness. Vaccine. 2008;26:6980–5. DOIPubMedGoogle Scholar
  24. Ministry of Health of Ukraine, Public Health Center. Operational data on the incidence of measles: September 26, 2019 [in Ukrainian] [cited 2019 Oct 3]. https://phc.org.ua/news/kir-ne-vidstupae-ediniy-nadiyniy-zakhist-vakcinaciya-0
  25. World Health Organization. Immunization, vaccines, and biologicals. Data, statistics, and graphics. Case-series [2019 Oct 3]. http://www.who.int/immunization/monitoring_surveillance/data
  26. World Health Organization. Reported incidence time series—measles cases, Bosnia and Herzegovina [2019 Oct 21]. https://apps.who.int/immunization_monitoring/globalsummary/incidences?c=BIH%20=%20BIH%20cases%20of%20VPDs
  27. Salimović-Bešić  I, Šeremet  M, Hübschen  JM, Hukić  M, Tihić  N, Ahmetagić  S, et al. Epidemiologic and laboratory surveillance of the measles outbreak in the Federation of Bosnia and Herzegovina, February 2014-April 2015. Clin Microbiol Infect. 2016;22:563.e1–7. DOIPubMedGoogle Scholar
  28. World Health Organization. Seventh Meeting of the European Regional Verification Commission for Measles and Rubella Elimination (RVC). 2018 Jun 13–15. Paris, France [cited 2019 Oct 2]. http://www.euro.who.int/__data/assets/pdf_file/0008/378926/7th-RVC-Meeting-Report-FINAL.pdf
  29. Khetsuriani  N, Deshevoi  S, Goel  A, Spika  J, Martin  R, Emiroglu  N. Supplementary immunization activities to achieve measles elimination: experience of the European Region. J Infect Dis. 2011;204(Suppl 1):S343–52. DOIPubMedGoogle Scholar

Main Article

Page created: September 14, 2020
Page updated: October 17, 2020
Page reviewed: October 17, 2020
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external