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Successful control of a school based measles outbreak by immunization

Published online by Cambridge University Press:  15 May 2009

R. A. Lyons ,
H. I. Jones  and
R. L. Salmon
R. A. Lyons
Affiliation:
PHLS Communicable Disease Surveillance Centre (Welsh Unit), Abton House, Wedal Road, Cardiff CF4 3QX
H. I. Jones
Affiliation:
Gwynedd Health Authority, Coed Mawr, Bangor, Gwynedd LL57 4TP
R. L. Salmon*
Affiliation:
PHLS Communicable Disease Surveillance Centre (Welsh Unit), Abton House, Wedal Road, Cardiff CF4 3QX
*
* Author for correspondence.
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Summary

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In an outbreak of measles in North Wales centred on a secondary school in 1991, 74 cases occurred over a period of 51 days. Before the outbreak started, 27 % pupils did not have a history of measles or immunization and were considered susceptible. Active case rinding and identification and vaccination of susceptible contacts commenced after the fourth generation of cases and further reduced the pool of susceptible schoolchildren from 17%, at the onset of the vaccination campaign, to 8%. A fifth generation of cases did not occur. Delays in diagnosis (mean 2·8 days) and notification (mean 6·1 days) hampered control. There was no evidence of primary vaccine failure (observed vaccine efficacy 97%). Sixty-nine (93%) cases were considered preventable. Reasons for the apparent success of the intervention are discussed.

Type
Research Article
Information
Epidemiology & Infection , Volume 113 , Issue 2 , October 1994 , pp. 367 - 375
Copyright
Copyright © Cambridge University Press 1994

References

REFERENCES

1.Measles surveillance. Commun Dis Rep 1993; 5: 21.Google Scholar
2.Carter, H, Gorman, D, Measles, mumps and rubella vaccine: time for a two stage policy ? BMJ 1992; 304: 637.CrossRefGoogle ScholarPubMed
3.Hill, A, Measles, mumps and rubella vaccination. BMJ 1992; 304: 779.CrossRefGoogle ScholarPubMed
4.Gustafson, TL, Lievens, AW, Brunell, PA et al. , Measles outbreaks in a fully immunized secondary-school population. N Engl J Med 1987; 316: 771–4.CrossRefGoogle Scholar
5.Chen, RT, Goldbaum, GM, Wassilak, SGF et al. , An explosive pointsource measles outbreak in a highly vaccinated population. Am J Epidemiol 1989; 129: 173–81.CrossRefGoogle Scholar
6.Edmonson, MB, Addiss, DG, McPhearson, JT et al. , Mild measles and secondary vaccine failure during a sustained outbreak in a highly vaccinated population. JAMA 1990; 264: 2467–71.CrossRefGoogle Scholar
7.Hutehins, SS, Markowitz, LE, Mead, P et al. , A school-based measles outbreak: the effect of a selective revaccination policy and risk factors for vaccine failure. Am J Epidemiol 1990; 202: 157–68.CrossRefGoogle Scholar
8.Measles surveillance. Commun Dis Rep 1991; 50: 221.Google Scholar
9.Markowitz, LE, Preblud, SR, Orenstein, WA et al. , Patterns of transmission of measles outbreaks in the United States. N Engl J Med 1989; 320: 75–81.CrossRefGoogle ScholarPubMed
10.Field evaluation of vaccine efficacy. Geneva: World Health Organization, 1984.Google Scholar
11.Perry, KR, Brown, DWG, Parry, JV et al. , The detection of measles, mumps and rubella antibodies in saliva using antibody capture radioimmunoassay. J Med Virol. In Press.Google Scholar
12. Epi-Info, version 5: a word processing, database, and statistics program for epidemiology on microcomputers. USD Incorporated, Stone Mountain, Georgia. 1990.Google Scholar
13.Gardner, MJ, Gardner, S, Winter, P, Confidence interval analysis. Microcomputer program. London: British Medical Association, 1989.Google Scholar
14.Anderson, RM, May, RM, Infectious diseases of humans: dynamics and control. Oxford: Oxford University Press, 1991.CrossRefGoogle Scholar
15.Fernandes, V, Gill, ON, Prevention of measles: vaccine efficacy and potential effectiveness of a vaccination programme on entry to school. BMJ 1985: 291: 1685.CrossRefGoogle ScholarPubMed
16.White, JM, Porter, J, Biffin, AH et al. , Measles in a susceptible population: notification efficiency, vaccine efficacy and control measures. Epidemiol Infect. In Press.Google Scholar
17.Rao, M, Wilkinson, J, Millar, M, Richards, G, Measles vaccination in primary schools - the Colchester project. Public Health 1988; 102: 477–83.CrossRefGoogle ScholarPubMed
18.Riley, EC, Murphy, G, Riley, RL, Airborne spread of measles in a suburban elementary school. Am J Epidemiol 1978; 107: 421–32.CrossRefGoogle Scholar
19.Sloan, DSG, Measles, mumps and rubella vaccine: time for a two stage policy? BMJ 1992; 304: 916.CrossRefGoogle ScholarPubMed
20.Miller, E, Nokes, DJ, Anderson, RM, Measles, mumps and rubella vaccination. BMJ 1992; 304: 1440–1.CrossRefGoogle ScholarPubMed