<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Laura Cornelissen</style></author><author><style face="normal" font="default" size="100%">Tine Grammens</style></author><author><style face="normal" font="default" size="100%">S Leenen</style></author><author><style face="normal" font="default" size="100%">C Schirvel</style></author><author><style face="normal" font="default" size="100%">Veronik Hutse</style></author><author><style face="normal" font="default" size="100%">Demeester, R</style></author><author><style face="normal" font="default" size="100%">B Swennen</style></author><author><style face="normal" font="default" size="100%">T Asikainen</style></author><author><style face="normal" font="default" size="100%">Chloé Wyndham-Thomas</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">High number of hospitalisations and non-classical presentations: lessons learned from a measles outbreak in 2017, Belgium.</style></title><secondary-title><style face="normal" font="default" size="100%">Epidemiol Infect</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">ADOLESCENT</style></keyword><keyword><style  face="normal" font="default" size="100%">Adult</style></keyword><keyword><style  face="normal" font="default" size="100%">Aged</style></keyword><keyword><style  face="normal" font="default" size="100%">Aged, 80 and over</style></keyword><keyword><style  face="normal" font="default" size="100%">Belgium</style></keyword><keyword><style  face="normal" font="default" size="100%">Child</style></keyword><keyword><style  face="normal" font="default" size="100%">Child, Preschool</style></keyword><keyword><style  face="normal" font="default" size="100%">Cross Infection</style></keyword><keyword><style  face="normal" font="default" size="100%">Disease Outbreaks</style></keyword><keyword><style  face="normal" font="default" size="100%">Disease Transmission, Infectious</style></keyword><keyword><style  face="normal" font="default" size="100%">Female</style></keyword><keyword><style  face="normal" font="default" size="100%">Hospitalization</style></keyword><keyword><style  face="normal" font="default" size="100%">Humans</style></keyword><keyword><style  face="normal" font="default" size="100%">Infant</style></keyword><keyword><style  face="normal" font="default" size="100%">Infant, Newborn</style></keyword><keyword><style  face="normal" font="default" size="100%">Male</style></keyword><keyword><style  face="normal" font="default" size="100%">Measles</style></keyword><keyword><style  face="normal" font="default" size="100%">middle aged</style></keyword><keyword><style  face="normal" font="default" size="100%">Young adult</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2020</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2020 02 24</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">148</style></volume><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;We describe and analyse an outbreak of measles that affected Belgium early 2017. In total, 289 cases were reported, mostly (53%) in people 15 years or older. For 133 (46%) vaccination status was unknown and a further 117 (41%) were not vaccinated. According to national guidelines, 83 of the unvaccinated cases (29% of total cases) should have received minimum one dose of vaccine, but did not. One in five cases (21%) did not present with the classical triad of fever, rash and any of coryza, conjunctivitis or cough. Rash was the most sensitive symptom, being absent in only six cases. A large proportion of cases (125/289, 43%) required hospitalisation. In hospitalised patients, the most commonly observed complications were hepatic disorders (present in 58/125 hospitalised patients, 46%). Thirty-six of the cases (12%) were in healthcare workers and nosocomial spread contributed importantly to the outbreak. Older age at presentation, altered clinical presentations and presence of complications like hepatitis can delay the correct diagnosis of measles. Clinicians should maintain a high index of suspicion in any individual presenting with rash. If the elimination target is to be reached, catch-up vaccination campaigns should be intensified and target young adults and health care workers.&lt;/p&gt;
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