Control of a measles outbreak in an elementary school. Baltimore County, Md. 1975 (original) (raw)
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Journal of Infectious …, 2004
A measles outbreak occurred among a highly vaccinated population in Alaska during 1998, providing an opportunity to determine the incremental efficacy of у2 doses of measles-containing vaccine (MCV) compared with 1 dose. Of 33 confirmed case patients identified, 31 had been vaccinated with 1 dose of MCV, 1 had received 2 doses, and vaccination status was unknown in 1 case. Seventy percent of cases were school-associated; 58% of cases occurred in 2 high schools. Of 3679 students attending the 2 schools, 50.4% and 45.5% had received у2 doses of MCV before measles introduction at the schools. The relative risk of developing measles among persons vaccinated with у2 doses of MCV compared with 1 dose was 0.06 (95% confidence interval, 0.01-0.44;), yielding an estimated incremental vaccine efficacy of 94.1% (95% confidence interval, P ! .001 55.9%-99.2%;). Rapid implementation of a mandatory second-dose MCV requirement probably limited P ! .001 the extent of this outbreak. In August-November 1998, the largest outbreak of measles in the United States since 1996 occurred in Anchorage, Alaska [1]. Most cases were associated with 2 high schools. A state law requiring 2 doses of measlescontaining vaccine (MCV) for all students entering kindergarten or first grade had been in effect since September 1996; therefore, 2-dose coverage was high among Alaska students in kindergarten through grade 3 but unknown among students in grades 4-12. Outbreaks among highly vaccinated populations have been reported elsewhere [2, 3]; however, relatively few data are available to estimate the incremental effectiveness of 2 doses of MCV compared with 1 dose. This outbreak provided a unique opportunity for such an estimate.
Letter to the editor: PREVALENCE OF MEASLES IN VACCINATED AND NON-VACCINATED CHILDREN
2015
Measles is a highly infectious and contagious disease of the respiratory system caused by Morbilivirus which belongs to family Paramyxoviridae (Hashiguchi et al., 2011). The disease is a common cause of childhood morbidity and mortality across the globe, particularly in developing countries and has been characterized by high fever, cough, conjunctivitis, coryza, malaise and maculopapular rash along with erythematous patches throughout the body (Ellison, 1931; Yanagi et al., 2006; Fazlalipour et al., 2008). Measles infection has been controlled by introduction of live attenuated measles vaccine in United States and Europe (Gindler et al., 2004). However, measles is still affecting the developing countries due to insufficient coverage and improper handling of vaccines (Poland and Jocobson, 1994; Muscat et al., 2009). Historically, immunization against vaccine preventable diseases (VPDs) in children has been started by WHO in 1974, and it was initiated in Pakistan during 1978 (Ali, 2000; Bugvi et al., 2014). In general the vaccine coverage against VPDs in Pakistan ranged between 56 to 88 % which significantly varied among various Provinces (Sheikh et al., 2011). Recently, increased number of measles outbreaks with high morbidity and mortality has been observed in various regions of Pakistan during recent years (Khan and Khan, 2012; Khan and Qazi, 2014). These particular episodes of higher incidence of measles were started in Thatta, Mirpurkhas and Jacobabad Districts of Sindh Province by the end of 2012, which later on spread towards Punjab Province (Khan and Khan, 2012; Khan and Qazi, 2014). The spread of measles was reported to be higher in both rural as well as developed cities of Pakistan along with high incidence of mortality and morbidity (Khan and Qazi, 2014). The important factors considered for these outbreaks were associated with vaccination failure due to several reasons i.e. low vaccination coverage, malnutrition and vitamin-A deficiencies, poor vaccination facilities in remote and rural areas, mishandling of vaccines and lack of immunization awareness among parents due to lower levels of education in various areas of country (Cohen et al., 2009; Khan and Khan, 2012; Khan and Qazi, 2014). To combat the situation extensive supplementary immunization activities have been initiated which targets the chil
Measles outbreaks: Who are at risk and why
Journal of Pediatric Health Care, 1989
After the introduction of measles vaccine in the United States in 1963 the reported incidence of measles (rubeola) decreased substantially. The disease, however, has not been eliminated. Since 1983, when the lowest number of cases was reported, slight increases in incidence have been observed. Outbreaks are occurring among previously immunized school-and college-age children and unimmunized preschool children and infants. This article describes measles occurrence, transmission, diagnosis, development of measles immunity, the 1989 Centers for Disease Control recommendations for immunization, and implications for health care providers for preventing measles outbreaks. j PEDIATR HEALTH CARE. (1989).
Measles and the Modern History of Vaccination
Public Health Reports, 2019
The modern era of vaccination was heralded with the licensure of the first 2 measles vaccines in 1963. This new era was distinct from the preceding era of vaccination for 4 main reasons. First, federal leadership in support of immunization at the local level grew. Second, immunization proponents championed the required vaccination of children as the best means of ensuring a protected population. Third, immunization proponents championed the idea that mass vaccination would not only help manage infectious diseases but also eradicate them. Fourth, the focus of local and federally supported immunization initiatives began to extend to the “mild” and “moderate” diseases of childhood (eg, measles), so-called because they were seen as less severe than previous targets of mass vaccination, such as smallpox, polio, and diphtheria. This article follows the history of measles to explore immunization successes and challenges in this modern era, because measles was the first of the mild and mode...
A measles outbreak at a college with a prematriculation immunization requirement
American Journal of Public Health, 1991
BACKGROUND. In early 1988 an outbreak of 84 measles cases occurred at a college in Colorado in which over 98 percent of students had documentation of adequate measles immunity (physician diagnosed measles, receipt of live measles vaccine on or after the first birthday, or serologic evidence of immunity) due to an immunization requirement in effect since 1986. METHODS. To examine potential risk factors for measles vaccine failure, we conducted a retrospective cohort study among students living in campus dormitories using student health service vaccination records. RESULTS. Overall, 70 (83 percent) cases had been vaccinated at greater than or equal to 12 months of age. Students living in campus dormitories were at increased risk for measles compared to students living off-campus (RR = 3.0, 95% CI = 2.0, 4.7). Students vaccinated at 12-14 months of age were at increased risk compared to those vaccinated at greater than or equal to 15 months (RR = 3.1, 95% CI = 1.7, 5.7). Time since vac...