Seroepidemiology for MERS coronavirus using microneutralisation and pseudoparticle virus neutralisation assays reveal a high prevalence of antibody in dromedary camels

Reduction of the nosocomial meticillin-resistant Staphylococcus aureus incidence density by a region-wide search and follow-strategy in forty German hospitals of the Despite vaccination coverage over 95%, a measles outbreak started in May 2013 in the Netherlands. As of 28 August, there were 1,226 reported cases, including 82 hospitalisations. It is anticipated that the outbreak will continue. Most cases were orthodox A unique outbreak control intervention was implemented: a personal invitation for measles-mumps-rubella (MMR) vaccination was sent for all children aged 6–14 months living in municipalities with MMR vaccination coverage below 90%. The first two measles cases in this outbreak that were reported, occurred in an orthodox Protestant school in the Netherlands and were reported on 27 May 2013. As of 28 August, a total of 1,226 measles cases (incidence 73.1 per 1 million) who acquired infection in the Netherlands have been reported by 19 Municipal Health Services (Figure 1). The case with the earliest date of onset of exanthema in this outbreak had not travelled abroad and the source of infection remains unknown. The routine measles case definition is based on the presence of clinical measles symptoms (fever and mac-ulopapular rash and cough, coryza or conjunctivitis) in combination with laboratory confirmation or an epidemiological link (contact in the previous three weeks) to a laboratory-confirmed case. Laboratory confirmation is based on either measles-specific IgM serology for venous-or fingerstick-blood samples or specific detection of measles virus RNA by polymerase chain reaction (PCR) in throat swabs, oral fluid or urine specimens. Of the 1,226 cases, 176 (14.4%) had complications including encephalitis (1 case), pneumonia (90 cases) and otitis media (66 cases) and 82 (6.7%) were admitted to hospital. (For a case description of the encephalitis case (in Dutch), see [1].) There were no deaths. The median age of cases was 10 years (range: 0-54). Most cases were 4–12 years of age (n=717; 58.5%), while 200 (16.3%) were aged 13–15 years (Figure 2). Nearly all cases were unvaccinated (1,174; 96.5% of 1,217 with known vaccination status), 39 cases (3.2%) were vaccinated with one dose of a measles-containing vaccine and four cases (0.3%) were vaccinated with two doses. Most cases were orthodox Protestant (1,087; 91.7% of 1,186 cases with information). Reasons for being unvaccinated were: 1,072 (93.6% of 1,145 cases with information) orthodox Protestantism, 3 (0.3%) anthro-posophical, 30 (2.6%) parents' or own critical attitude towards vaccination, and 40 (3.5%) other. Most cases (719; 58.6%) occurred …