Patterns of Transmission in Measles Outbreaks in the United States, 1985–1986

Abstract

Since the licensing of measles vaccine in 1963, the incidence of reported measles in the United States has declined to less than 2 percent of previous levels. To characterize the current epidemiology of measles in the United States, we analyzed measles outbreaks that occurred during 1985 and 1986. There were 152 outbreaks (defined as five or more cases related epidemiologically), which accounted for 88 percent of the cases reported during those two years. There were two major types of outbreaks: those in which most of the cases occurred among preschool-age children (those under 5 years of age) (26 percent) and those in which most of the cases occurred among school-age persons (those 5 to 19 years of age) (67 percent). The outbreaks among preschool-age children ranged in size from 5 to 945 cases (median, 13); a median of only 14 percent of the cases occurred in vaccinated persons, and a median of 45 percent of the cases were classified as preventable according to the current strategy. Outbreaks among school-age persons ranged in size from 5 to 363 cases (median, 25); a median of 60 percent of the cases occurred in vaccinated persons, and a median of only 27 percent of the cases were preventable. The outbreaks among preschool-age children indicate deficiencies in the implementation of the national measles-elimination strategy. However, the extent of measles transmission among highly vaccinated school-age populations suggests that additional strategies, such as selective or mass revaccination, may be necessary to prevent such outbreaks.

Successful control of a school based measles outbreak by immunization

“…In outbreaks occurring between 1985 and 1986, 60 % of cases were due to vaccine failure, with vaccination prior to 12 or 15 months of age and vaccinations before 1979 (when the vaccine was less heat stable), being identified as risk factors [4,7,9]. There was, by contrast, no evidence of vaccine failure in our outbreak.…”

“…Since the introduction of measles vaccine in the UK in 1968 and measles, mumps, rubella (MMR) vaccination in 1988, the number of cases of measles reported annually has fallen from 80999 in 1986 [8] to 10264 in 1992 [1] but there has been a shift in the age distribution of notified cases. In 1992 15% of cases occurred in children aged a 104 years compared with only 7 % in 1986 [1,8], a trend similar to that seen in the United States [9]. This has resulted in school outbreaks [1].…”

Epidemiology of measles in Taiwan: dynamics of transmission and timeliness of reporting during an epidemic in 1988–9

“…National data on disease notification are valuable for evaluating the effectiveness of control programmes and monitoring their future trends, even if such systems are incomplete [33][34][35][36]. Completeness of measles reporting in Taiwan is poor, with a physician reporting rate of 6 % and sensitivity of 4% in rural areas [14].…”

Childhood Immunization Status Related to Social and Educational Status of Parents in a Peripheral Northern Town of Saudi Arabia

“…Still, some three million children die each year from vaccine-preventable diseases and another three million are permanently disabled [2]. Even in the developed countries like the USA, recent outbreaks of measles [3][4][5], mumps [6], and pertussis [7] have been reported. Immunization rates among United States preschool children are disappointingly low and appear to be falling steadily [8].…”

“…Immunization rates among United States preschool children are disappointingly low and appear to be falling steadily [8]. Immunization rates are particularly low among poor minority children in urban settings [3].…”