@article{83030a8d328b44adba95c4284dd12313,
title = "Diagnostic challenges and pockets of susceptibility identified during a measles outbreak, Luxembourg, 2019",
abstract = "Luxembourg was among the first countries in the World Health Organization (WHO) European Region documenting interruption of endemic measles transmission, but an increased incidence was registered in spring 2019. The outbreak started with an unvaccinated student who had been to a winter sports resort in a neighbouring country, where a measles outbreak was ongoing. Subsequently, 12 secondary and two tertiary cases were confirmed among students from the same school, relatives and healthcare workers, as well as six probably unrelated cases. Only 11 cases initially fulfilled the WHO definition for suspected measles cases. Fourteen of 20 cases with information on country of birth and the majority of unvaccinated cases (10/12) were born outside of Luxembourg. Measles IgM antibody results were available for 16 of the confirmed cases, and five of the eight IgM negative cases had been vaccinated at least once. All 21 cases were PCR positive, but for three previously vaccinated cases with multiple specimen types, at least one of these samples was negative. The outbreak highlighted diagnostic challenges from clinical and laboratory perspectives in a measles elimination setting and showed that people born abroad and commuters may represent important pockets of susceptible people in Luxembourg.",
author = "Michel Kohnen and Patrick Hoffmann and Caroline Frisch and Emilie Charpentier and Aur{\'e}lie Sausy and H{\"u}bschen, {Judith M.}",
note = "Funding Information: The authors thank the patients for providing samples and information, the clinicians for collecting specimens and providing clinical data, the different laboratories in Luxembourg for sharing their test results with the Division de l'inspection sanitaire (DIS) and the Luxembourg Ministry of Health for ensuring the funding of the RRL-Lux. We highly appreciate the contribution of all people from DIS involved in patient follow-up, contact tracing and sample collection. Our sincere thanks go to Dr Th?r?se Staub, Patrick Schmit, Dr Chantal Tsobo and Jean-Hugues Fran?ois from the Centre Hospitalier de Luxembourg for providing their expertise and support. We would also like to thank P?lagie Huchon for her help with the preparation of Figure 1 and Dr Fran?oise Berthet from the Direction de la Sant? for critically reviewing the manuscript. Publisher Copyright: {\textcopyright} 2021 European Centre for Disease Prevention and Control (ECDC). All rights reserved.",
year = "2021",
month = jun,
day = "3",
doi = "10.2807/1560-7917.ES.2021.26.22.2000012",
language = "English",
volume = "26",
journal = "Eurosurveillance",
issn = "1025-496X",
publisher = "European Centre for Disease Prevention and Control (ECDC)",
number = "22",
}