Identical genotype B3 sequences from measles patients in 4 countries, 2005.Surveillance of measles virus measles virus
An RNA virus of the genus Morbillivirus that causes measles in humans. Also called rubeola virus. detected an epidemiologic link between a refugee from Kenya and a Dutch tourist in New Jersey, USA. Identical genotype B3 sequences from patients with contemporaneous cases in the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. , Canada, and Mexico in November and December 2005 indicate that Kenya was likely to have been the common source of virus.
Identification of measles virus genotypes is a valuable tool for epidemiologic investigations and evaluation of control activities in countries that have eliminated indigenous measles. Many of the 23 recognized genotypes of measles are associated with countries or regions with endemic measles (1). Measles genotypes in clade clade Cladus, subtype Genetics A branch of biological taxa or species that share features inherited from a common ancestor; a single phylogenetic group or line. See Inheritance, Species. B (genotypes B1, B2, B3) are associated with endemic circulation of measles in various countries in sub-Saharan Africa (2). The prototype clade B viruses were isolated in 1983 in Cameroon (B1) and in 1984 in Gabon (B2). Hanses et al. (3) proposed a new genotype, B3, after characterization of several viruses collected in 1997 and 1998 in Ghana and Nigeria. Sequencing studies of additional viruses from Africa demonstrated that the proposed subdivision of the B3 viruses into subgroups B3.1 and B3.2 was epidemiologically useful for describing 2 distinct clusters of contemporary B3 viruses (4,5).
Because measles is highly infectious, international travel originating from measles-endemic areas can result in sporadic cases of measles in countries that have eliminated indigenous transmission. International visitors may infect other travelers while moving through transportation hubs or tourist areas; such cases would not be detected unless the traveler sought medical attention or additional cases were detected. Thus, in many of these instances, the source of virus is unknown. We describe the contribution of global surveillance for measles virus genotypes in identifying a common source of virus among contemporaneous cases identified in the United States, Canada, Mexico, and the Netherlands.
On November 9, 2005, a 17-year-old man who arrived at the airport in Newark, New Jersey, United States, had symptoms consistent with measles. The man was part of a group of 148 refugees from the Eastleigh community in Nairobi, Kenya, who arrived in the United States from November 3 through 15. Genotype B3 (subgroup B3.1) was identified from virus samples from this patient; the sequence was identical to sequences from measles viruses collected in Nairobi and Machakos, Kenya, in October 2005 (Figure). All but 1 of the 6 viruses collected from Nairobi (Figure, MVi/Nairobi.KEN.xx.05) were from patients from the Eastleigh area of Nairobi, where an outbreak of measles had been reported in the Somali and Ethiopian communities (6).
Also in November 2005, a single case of measles was reported in the Netherlands. This patient had visited New York City New York City: see New York, city.
New York City
City (pop., 2000: 8,008,278), southeastern New York, at the mouth of the Hudson River. The largest city in the U.S. , returned to the Netherlands on November 15, noted a rash on November 23, and was hospitalized with pneumonia and fever on November 24. The initial investigation focused on potential settings where exposure may have occurred in New York City. The source of infection was traced to an unrecognized exposure to the patient in New Jersey only after analysis of the Netherlands viral sequence demonstrated complete identity with the New Jersey genotype B3 virus. The possibility of an epidemiologic link between the 2 cases led to the discovery that the Dutch visitor had arrived at the Newark airport on November 9 and waited in the arrival area for 1 h, along with the group of refugees from Nairobi.
Subsequently, genotype B3 was identified from patients who had had measles during December 2005 in Texas, Canada, and Mexico. In Texas, during the first 2 weeks of December, 3 cases of measles were reported in members of a family from Houston. The patients had flown directly from Houston to the resort area of Cabo San Lucas Cabo San Lucas (popularly known as just Cabo) is a small city at the southern tip of the Baja California peninsula at , in the municipality of Los Cabos in the state of Baja California Sur, Mexico. , Mexico, where they stayed from November 22 through 27. In Mexico, health authorities reported 5 cases of measles beginning on December 12 among baggage handlers and other airport workers at the Mexico City Mexico City
Spanish Ciudad de México
City (pop., 2000: city, 8,605,239; 2003 metro. area est., 18,660,000), capital of Mexico. Located at an elevation of 7,350 ft (2,240 m), it is officially coterminous with the Federal District, which occupies 571 sq mi airport. In New Brunswick New Brunswick, province, Canada
New Brunswick, province (2001 pop. 729,498), 28,345 sq mi (73,433 sq km), including 519 sq mi (1,345 sq km) of water surface, E Canada. , Canada, a patient developed a rash on December 19.
Although the earlier cases in New Jersey and in the Netherlands could be traced directly to the outbreak in Kenya, the sources of the cases in Texas, Canada, and Mexico were unknown. However, the sequences from Texas, Canada, and Mexico were identical to the sequences directly linked to the outbreak in Kenya (Figure). Measles viruses in the same chain of transmission have identical sequences (7,8), which indicates that the source of the virus for the cases in Texas, Mexico, and Canada was likely to have been the outbreak in Kenya.
Virus transmission may have occurred through contact with international travelers in airports or during transit because epidemiologic investigations did not detect other measles cases in Cabo San Lucas or Texas. The exception to possible air travel-related exposure was the single case that occurred in Canada. This patient had traveled by car, although investigations found no measles cases in the areas visited: Bangor, Maine For other places with the same name, see Bangor.
Bangor is a city in and the county seat of Penobscot County, MaineGR6, United States. It is the major commercial center for eastern and northern Maine. For U.S. (December 2); Boston, Massachusetts “Boston” redirects here. For other uses, see Boston (disambiguation).
Boston is the capital and most populous city of Massachusetts. The largest city in New England, Boston is considered the unofficial economic and cultural center of the entire New (December 3-6); and Portsmouth, New Hampshire Portsmouth, New Hampshire is a city in Rockingham County, New Hampshire in the United States of America. It is the fourth-largest community in the county, with a population of 20,784 as of the 2000 census. (December 6). Two refugees from Eastleigh settled in a state visited by the Canadian patient. They entered Massachusetts on November 10, 2005, and by 21 days after arrival, measles had not developed. However, a measles outbreak was detected in southern Germany The term Southern Germany (German: Süddeutschland) is used to describe a region in the south of Germany. The exact area defined by the term is not constant, but it usually includes Bavaria, Baden-Württemberg, and the southern part of Hesse. in January 2006 (9), and the viral sequence matched that of the Kenya outbreak virus (Figure; MVs/Stuttgart.DEU/ 4.06), which indicates that the source of this outbreak was also likely to have been Kenya. Therefore, B3 viruses with identical sequences could have been introduced into Texas, Mexico, or Canada by travelers infected with B3 virus in Europe.
Although genotype B3 has been the most frequently detected measles genotype in western and central Africa (4, 10-12), ours is the first report of the detection of geno type B3 in Kenya. Moreover, the sequence from a virus isolated in Nigeria in June 2005 (Figure; MVs/Yola.NIE/ 25.05) was identical to the sequences in the Kenya outbreak group. Although a link has not been established between Nigeria and Kenya, a survey of measles genotypes in Kenya in 2002 detected only genotype D4 viruses (13). Sequences of viruses isolated during 2004 and 2005 from Cote d'Ivoire and Benin (this study) were included in our analysis (Figure) because these B3 sequences represent closely related viruses from western Africa.
The analysis and dissemination of viral sequences from measles cases led to the identification of an unrecognized epidemiologic link at an airport and linked sporadic cases in 4 countries that do not have endemic measles to an ongoing outbreak in Kenya. Investigators in the field need to collect adequate specimens for virus isolation. Timely communication of sequence data among epidemiologists and microbiologists is critical for identifying possible links among sporadic cases of measles. The potential for rapid transmission of measles during brief encounters with international travelers underscores the importance of global surveillance of measles virus.
We gratefully acknowledge the following persons for support with the investigations: Cathy Cuomo-Cecere, Marsha McGowan, Zofia Lesczyniecka, Jim Oleske, Polly Thomas, Tong Wey n. 1. Way; road; path.
v. t. & i. 1. To weigh.
n. 1. A certain measure of weight. , Nancy Borsuk, Wendy Sessions Wendy Sessions is a British ice dancer. She won the 1977 World Junior Championships with partner Mark Reed. She won the 1980 Nebelhorn Trophy with partner Stephen Williams. , Tim Kram, Christine Teel, Beverly Howe, Mary Jane Lowrey, Shola Adeleye, Steve Long For the game designer, see Steve Long (game designer)
"Big" Steve Long (died October 28, 1868) was a western lawman, outlaw, and one of the earliest examples of an Old West gunman, achieving his fame in the Wyoming Territory during the late 1860s. , Anthony Ehofonie, Salma Khuwaja, Debo Awosika-Olumo, Cindy Kilborn, Sherry Jin, Heather Martin Heather Martin is a Gospel singer, and a current member of the gospel group Virtue with her sisters Ebony Holland and Karima Kibble. Early years
A native of New Orleans, Louisiana, Heather was born on February 2, 1977 and is the youngest child born into Trotter family. , and Teresa York. We also thank Traore Ibrahima, Herve Kadjo, Tieoulou Leontine, Koffi Signo Paul, Agnes Langat, Mary Njeri, Peter Maritim, Ronald Seguya, Theopista Kabaliisa, Martin Khargi, Esther Mooi-Kokenberg, and Henny Peltenburg.
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(10.) El Mubarak HS, van de Bildt MWG MWG Men with Guts (sports apparel company)
MWG Match-Winning Goal (soccer)
mWG Microworld of Gems (e-commerce business)
MWG Measurements Working Group
MWG Model Working Group , Mustafa OA, Vos HW, Mukhtar Mukhtar, meaning "chosen" in Arabic, refers to the head of a village or mahalle (urban district) in many Arab countries. The name refers to the fact that mukhtars are usually selected by some consensual or participatory method, often involving an election. MM, Ibrahim SA, et al. Genetic characterization of wild-type measles viruses circulating in suburban Khartoum, 1997-2000. J Gen Virol. 2002;83:1437-43.
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(13.) Mbugua FM, Okoth FA, Gray M, Kamau T, Kalu A, Eggers Eggers may refer to:
Jennifer Rota, * Luis Lowe, * Paul Rota, * William Bellini, * Susan Redd, * Gustavo Dayan, * Rob van Binnendijk, [dagger] Susan Hahne, [dagger] Graham Tipples, [double dagger] Jeannette Macey, [subsection] Rita Espinoza, [paragraph] Drew Posey, * Andrew Plummer, * John Bateman, * Jose Gudino, # Edith Cruz-Ramirez, # Irma Lopez-Martinez, # Luis Anaya-Lopez, ** Teneg Holy Akwar, [dagger] [dagger] Scott Giffin, [dagger] [dagger] Veronica Carrion, [double dagger] [double dagger] Ana Maria Bispo de Filippis, [double dagger] [double dagger] Andrea Vicari, [double dagger] [double dagger] Christina Tan, [subsection] Bruce Wolf, [subsectionl] Katherine Wytovich, [subsection] Peter Borus, [paragraphs] Francis Mbugua, [paragraphs] Paul Chege, [paragraphs] Janeth Kombich, [paragraphs] Chantal Akoua-Koffi, ## Sheilagh Smit, *** Henry Bukenya, [dagger] [dagger] [dagger] Josephine Bwogi, [dagger] [dagger] [dagger] Frederick Ndhoga Baliraine, [dagger] [dagger] [dagger] Jacques Kremer, [double dagger] [double dagger] [double dagger] Claude Muller, [double dagger] [double dagger] [double dagger] and Sabine Santibanez [sub.section]
* Centers for Disease Control and Prevention Centers for Disease Control and Prevention (CDC), agency of the U.S. Public Health Service since 1973, with headquarters in Atlanta; it was established in 1946 as the Communicable Disease Center. , Atlanta, Georgia, USA; [dagger] National Institute for Public Health and the Environment, Biltoven, the Netherlands; [double dagger] Public Health Agency of Canada The Public Health Agency of Canada (French: Agence de la santé publique du Canada) is an agency of Health Canada a department of the Government of Canada that is responsible for public health, emergency preparedness, and response and infectious and chronic disease control , Winnipeg, Manitoba, Canada; [section] Public Health Agency of Canada, Tunney's Pasture, Ottawa, Ontario, Canada; [paragraph] Texas Department of State Health Services health services Managed care The benefits covered under a health contract , Austin, Texas, USA; # Instituto de Diagnostico y Referencia Epidemiologicos, Mexico City, Mexico; ** Direccion General de Epidemiologia de la Secretaria de Salud, Mexico City, Mexico; [double dagger] New Brunswick Department of Health, Fredericton, New Brunswick, Canada; [double dagger] [double dagger] Pan American Health Organization The Pan American Health Organization (PAHO) is an international public health agency with 100 years of experience in working to improve health and living standards of the countries of the Americas. It serves as the specialized organization for health of the Inter-American System. , Washington, DC, USA; [subsection] New Jersey Department of Health and Senior Services, Trenton, New Jersey, USA; [paragraphs] Kenya Medical Research Institute The Kenya Medical Research Institute (KEMRI) is one of East Africa's leading medical research centres. It is located in Kenya's capital, Nairobi.
Established in 1979, KEMRI has played an important role in the fight against malaria, HIV/AIDS and other diseases in Kenya, and , Nairobi, Kenya; ## Institut Pasteur, Abidjan, Cote d'lvoire; *** National Institute of Communicable Disease communicable disease
A disease that is transmitted through direct contact with an infected individual or indirectly through a vector. Also called contagious disease. , Johannesburg, South Africa; [dagger] [dagger] [dagger] Uganda Virus Research Institute The Uganda Virus Research Institute (UVRI), located in Entebbe, Uganda, was established in 1936 as the Yellow Fever Research Institute by the Rockefeller Foundation. , Entebbe, Uganda; [dagger] [dagger] [dagger] Laboratoire National de Sante, Luxembourg; and [subsection] Robert Koch-Institute, Berlin, Germany
Address for correspondence: Jennifer Rota; Centers for Disease Control and Prevention, Mailstop C22, 1600 Clifton Rd NE, Atlanta, GA 30333, USA; email: firstname.lastname@example.org
Ms Rota is a public health advisor and laboratory coordinator in the Measles, Mumps, Rubella rubella or German measles, acute infectious disease of children and young adults. It is caused by a filterable virus that is spread by droplet spray from the respiratory tract of an infected individual. , and Herpesviruses Herpesviruses
A family of viruses responsible for cold sores, chicken pox, and genital herpes.
Mentioned in: Skin Resurfacing Laboratory Branch at the Centers for Disease Control and Prevention. Her interests include international public health of infectious diseases, primarily vaccine-preventable diseases, and the molecular epidemiology of measles virus.