Susceptibility to Measles, Mumps, and Rubella in Newly Arrived Adult Immigrants and Refugees

Christina Greenaway, MD, MSc; Pierre Dongier, MD; Jean-Franois Boivin, MD, ScD; Bruce Tapiero, MD; Mark Miller, MD, MSc; and Kevin Schwartzman, MD, MPH

2 January 2007 | Volume 146 Issue 1 | Pages 20-24

Background: Despite effective vaccination programs for measles, mumps, and rubella in the United States and Canada, outbreaks continue to occur in susceptible subgroups, such as foreign-born persons.

Objective: To determine the susceptibility of newly arrived immigrants and refugees to measles, mumps, and rubella.

Design: Seroprevalence study.

Setting: Two hospitals and three community clinics in Montreal, Quebec, Canada.

Patients: 1480 adult immigrants and refugees who were recruited from October 2002 to December 2004.

Measurements: Sociodemographic and clinical data and serology for measles, mumps, and rubella.

Results: Thirty-six percent (range, 22% to 54%) of the study population was nonimmune to at least 1 of the 3 diseases. This proportion varied by age, sex, and region of origin. In multivariate analysis and after adjustment for region of origin, age, and socioeconomic factors, immigrant women had higher odds (odds ratio, 2.1) of being immune to measles (95% CI, 1.2 to 3.8) and an odds ratio of 1.7 of being nonimmune to rubella (CI, 1.2 to 2.6) compared with immigrant men.

Limitations: The results from the community-based convenience sample of immigrants may not be generalizable to all immigrant populations.

Conclusions: Many new immigrants and refugees, particularly women, are susceptible to measles, mumps, or rubella and may benefit from targeted vaccination programs.

Editors' Notes Context Immigrants from developing countries are likely to be undervaccinated for childhood infectious diseases, such as measles, mumps, and rubella. Contributions The investigators measured antibodies against measles, mumps, and rubella in 1480 adult immigrants in Montreal, Quebec, Canada. They found that 36% were susceptible to at least 1 of the infections. Cautions Participants were selected by convenience. The findings may not be applicable to countries that mandate updated vaccinations before arrival, such as the United States. Implications Many immigrants to Canada are susceptible to measles, mumps, or rubella and may benefit from targeted "catch-up" vaccination programs. —The Editors

 

Author and Article Information

From Sir Mortimer B. Davis Jewish General Hospital, Côte-des-Neiges local community health center, McGill University, and Saint Justine Hospital, Montreal, Quebec, Canada.

Acknowledgments: The authors thank Dr. Alexander Zinca at the Clinique Diamant for referring many of his clinic patients to our study; Ms. Marie Morahan, serology technologist at the Jewish General Hospital, for her hard work running all of the study samples; and the Ontario Public Health Laboratories for running serologic testing for many of the study serum samples to verify the testing and the functioning of the ELISA kits.

Grant Support: By the Fonds de la Recherche en Santé du Québec (grant no. 24002-1836) and GlaxoSmithKline (protocol no. 208133-177). Drs. Greenaway and Schwartzman are recipients of research career awards from the Fonds de la Recherche en Santé du Québec.

Potential Financial Conflicts of Interest: Grants received: C. Greenaway (GlaxoSmithKline). The Fonds de la Recherche en Santé du Québec is a peer-reviewed organization.

Requests for Single Reprints: Christina Greenaway, MD, Division of Infectious Diseases, SMBD-Jewish General Hospital, 3755 Côte Ste. Catherine Road, Room G-143, Montreal, Quebec H3T 1E2, Canada; e-mail, ca.greenaway{at}mcgill.ca.

Current Author Addresses: Dr. Greenaway: Division of Infectious Diseases, SMBD-Jewish General Hospital, 3755 Côte Ste. Catherine Road, Room G-143, Montreal, Quebec H3T 1E2, Canada.

Dr. Dongier: Clinique Santé Acceuil, CLSC Côte-des-Neiges, 5700 Chemin de la Côte-des-Neiges, Montreal, Quebec H3T 2A6, Canada.

Dr. Boivin: Epidemiology and Biostatistics, McGill University, 1020 Pine West, Montreal, Quebec H3A 1A2, Canada.

Dr. Tapiero: CHU Mère-Enfant Sainte-Justine, Service de Maladies Infectieuses, 3175 Cote Ste. Catherine Road, Montreal, Quebec H3T 1C5, Canada.

Dr. Miller: Infectious Diseases, SMBD-Jewish General Hospital, 3755 Côte Ste. Catherine Road, Room G-139, Montreal, Quebec H3T 1E2, Canada.

Dr. Schwartzman: Respiratory Epidemiology Unit, McGill University, Montréal Chest Institute Room K1.23, 3650 St. Urbain, Montreal, Quebec H2X 2P4, Canada.

Author Contributions: Conception and design: C. Greenaway, P. Dongier, J.-F. Boivin, M. Miller, K. Schwartzman.

Analysis and interpretation of the data: C. Greenaway, J.-F. Boivin, M. Miller, K. Schwartzman.

Drafting of the article: C. Greenaway.

Critical revision of the article for important intellectual content: C. Greenaway, J.-F. Boivin, B. Tapiero, M. Miller, K. Schwartzman.

Final approval of the article: C. Greenaway, P. Dongier, J.-F. Boivin, B. Tapiero, M. Miller, K. Schwartzman.

Provision of study materials or patients: C. Greenaway, P. Dongier, B. Tapiero.

Statistical expertise: J.-F. Boivin.

Obtaining of funding: C. Greenaway, J.-F. Boivin.

Administrative, technical, or logistic support: C. Greenaway, P. Dongier, J.-F. Boivin, M. Miller.

Collection and assembly of data: C. Greenaway.

Read all Rapid Responses

susceptibilty to measles, mumps and rubella in newly arrived migrants and refugees

Adrian K Thomas, et al.

Annals Online, 2 Apr 2007 [Full text]

Immunity to measles in female immigrants and refugees

Taufiek K Rajab, et al.

Annals Online, 7 Feb 2008 [Full text]