Outbreak of Measles in vaccinated population in Southeastern Nigeria

Background: Outbreaks of respiratory disease, febrile illness and rash occurred in two adjoining rural communities of Imo State, Southeastern, Nigeria, at different times between 2006 and 2020. Laboratory investigation was carried out to determine the aetiological agent of the outbreak. Methodology: Oropharyngeal swabs were collected from 6 individuals showing symptoms of disease, within 3-4 days of appearance of rash. Venous blood samples were also collected from a total of 41 symptomatic persons, their contacts and individuals with resolved infections. Swabs were inoculated into Vero, HEp-2c, B95a and MDCK cell lines. Sera were analyzed using enzyme-linked immunosorbent assay (ELISA) for immunoglobulin G and M to rubella and measles viruses, while immunofluorescence assay was used to detect Lassa fever virus immunoglobulins. Descriptive data were analyzed using the Statistical Package for the Social Sciences (SPSS). Results: Four of the 6 (66.7%) swab samples showed viral activity or cytopathic effect characterized by clumping of cells in Vero cells while 2 (33.3%) in Hep-2c characterized by rounding up of cells. Thirty-nine (95.1%) sera were positive for measles IgG while 13 (31.7%) were positive for IgM. Thirty-six (87.8%) sera were positive for rubella IgG but none was positive for IgM. None of the sera was positive for Lassa fever virus IgG and IgM. Conclusion: Measles virus was responsible for the outbreak among previously vaccinated population in the communities, while Rubella and Lassa fever viruses were excluded as the etiological agents of the outbreak. Keywords: Epidemics; IgG and IgM; Cell lines; Vaccination; Measles virus   French title: Épidémie de rougeole dans la population vaccinée du sud-est du Nigéria Contexte: Des flambées de maladies respiratoires, de maladies fébriles et d'éruptions cutanées sont survenues dans deux communautés rurales voisines de l'État d'Imo, dans le sud-est du Nigéria, à des moments différents entre 2006 et 2020. Une enquête en laboratoire a été menée pour déterminer l'agent étiologique de l'épidémie. Méthodologie: Des écouvillons oropharyngés ont été prélevés sur 6 individus présentant des symptômes de maladie, dans les 3 à 4 jours suivant l'apparition de l'éruption cutanée. Des échantillons de sang veineux ont également été prélevés sur un total de 41 personnes symptomatiques, leurs contacts et des personnes souffrant d'infections résolues. Des écouvillons ont été inoculés dans des lignées cellulaires Vero, HEp-2c, B95a et MDCK. Les sérums ont été analysés en utilisant un test immuno-enzymatique (ELISA) pour les immunoglobulines G et M contre les virus de la rubéole et de la rougeole, tandis que le test d'immunofluorescence a été utilisé pour détecter les immunoglobulines du virus de la fièvre de Lassa. Les données descriptives ont été analysées à l'aide du progiciel statistique pour les sciences sociales (SPSS). Résultats: Quatre des 6 échantillons sur écouvillon (66,7%) ont montré une activité virale ou un effet cytopathique caractérisé par l'agglutination des cellules dans les cellules Vero, tandis que 2 (33,3%) dans Hep-2c étaient caractérisés par un arrondissement des cellules. Trente-neuf (95,1%) sérums étaient positifs pour les IgG contre la rougeole tandis que 13 (31,7%) étaient positifs pour les IgM. Trente-six (87,8%) sérums étaient positifs pour les IgG contre la rubéole, mais aucun n'était positif pour les IgM. Aucun des sérums n'était positif pour les IgG et IgM du virus de la fièvre de Lassa. Conclusion: Le virus de la rougeole était responsable de l'épidémie parmi la population précédemment vaccinée dans les communautés, tandis que les virus de la rubéole et de la fièvre de Lassa ont été exclus comme agents étiologiques de l'épidémie. Mots clés: épidémies; IgG et IgM; Lignées cellulaires; Vaccination; Virus de la rougeol

Transmissão materno-fetal de diferentes subtipos de HIV-1 entre gestantes infectadas na Nigéria

The rate of mother-to-child transmission (MTCT) of HIV as well as the implications of the circulating multiple subtypes to MTCT in Nigeria are not known. This study was therefore undertaken to determine the differential rates of MTCT of HIV-1 subtypes detected among infected pregnant women before ARV intervention therapy became available in Nigeria. Twenty of the HIV-positive women who signed the informed consent form during pregnancy brought their babies for follow-up testing at age 18-24 months. Plasma samples from both mother and baby were tested for HIV antibody at the Department of Virology, UCH, Ibadan, Nigeria. All positive samples (plasma and peripheral blood mononuclear cells - PBMCs) were shipped to the Institute of Tropical Medicine, Antwerp, Belgium, where the subtype of the infecting virus was determined using the HMA technique. Overall, a mother-to-child HIV transmission rate of 45% was found in this cohort. Specifically, 36.4%, 66.7% and 100% of the women infected with HIV-1 CRF02 (IbNg), G and B, respectively, transmitted the virus to their babies. As far as it can be ascertained, this is the first report on the rate of MTCT of HIV in Nigeria. The findings reported in this paper will form a useful reference for assessment of currently available therapeutic intervention of MTCT in the country.A taxa de transmissão materno-fetal (MTCT) do HIV bem como as implicações dos múltiplos subtipos circulantes para MTCT na Nigéria não são conhecidos. Este estudo foi realizado para determinar as diferentes taxas de MTCT dos subtipos de HIV-1 detectados entre gestantes infectadas antes que a administração da terapia ARV estivesse disponível na Nigéria. Vinte das mulheres HIV positivas que assinaram o consentimento durante a gravidez trouxeram seus filhos para seguimento na idade de 18-24 meses. Amostras de plasma de ambos, mãe e filho foram testadas para anticorpos HIV no Departamento de Virologia, UCH, Ibadan, Nigéria. Todas as amostras positivas (plasma e células mononucleares do sangue periférico - PBMCs) foram enviadas para o Instituto de Medicina Tropical da Antuérpia, Bélgica, onde os subtipos de vírus infectantes foram determinados utilizando-se a técnica HMA. No conjunto, uma taxa de transmissão de HIV, materno-fetal, de 45% foi encontrada neste grupo. Especificamente, 36,4%, 66,7% e 100% das mulheres infectadas com HIV-1 CRF02 (IbNg), G e B, respectivamente, transmitiram o vírus para seus filhos. Até onde pode ser verificado, este é o primeiro relato da taxa de MTCT do HIV na Nigéria. Os achados relatados neste trabalho serão uma útil referência para estimar a qualidade das terapêuticas atuais disponíveis para MTCT neste país