Abstract
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 finding 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.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Carter H., Gorman D. Measles, mumps, and rubella vaccine: time for a two stage policy? BMJ. 1992 Mar 7;304(6827):637–637. doi: 10.1136/bmj.304.6827.637. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chen R. T., Goldbaum G. M., Wassilak S. G., Markowitz L. E., Orenstein W. A. An explosive point-source measles outbreak in a highly vaccinated population. Modes of transmission and risk factors for disease. Am J Epidemiol. 1989 Jan;129(1):173–182. doi: 10.1093/oxfordjournals.aje.a115106. [DOI] [PubMed] [Google Scholar]
- Edmonson M. B., Addiss D. G., McPherson J. T., Berg J. L., Circo S. R., Davis J. P. Mild measles and secondary vaccine failure during a sustained outbreak in a highly vaccinated population. JAMA. 1990 May 9;263(18):2467–2471. [PubMed] [Google Scholar]
- Fernandes V., Gill O. N. Prevention of measles: vaccine efficacy and potential effectiveness of a vaccination programme on entry to school. Br Med J (Clin Res Ed) 1985 Dec 14;291(6510):1685–1685. doi: 10.1136/bmj.291.6510.1685. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gustafson T. L., Lievens A. W., Brunell P. A., Moellenberg R. G., Buttery C. M., Sehulster L. M. Measles outbreak in a fully immunized secondary-school population. N Engl J Med. 1987 Mar 26;316(13):771–774. doi: 10.1056/NEJM198703263161303. [DOI] [PubMed] [Google Scholar]
- Hill A. Measles, mumps, and rubella vaccination. BMJ. 1992 Mar 21;304(6829):779–779. doi: 10.1136/bmj.304.6829.779. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hutchins S. S., Markowitz L. E., Mead P., Mixon D., Sheline J., Greenberg N., Preblud S. R., Orenstein W. A., Hull H. F. A school-based measles outbreak: the effect of a selective revaccination policy and risk factors for vaccine failure. Am J Epidemiol. 1990 Jul;132(1):157–168. doi: 10.1093/oxfordjournals.aje.a115627. [DOI] [PubMed] [Google Scholar]
- Markowitz L. E., Preblud S. R., Orenstein W. A., Rovira E. Z., Adams N. C., Hawkins C. E., Hinman A. R. Patterns of transmission in measles outbreaks in the United States, 1985-1986. N Engl J Med. 1989 Jan 12;320(2):75–81. doi: 10.1056/NEJM198901123200202. [DOI] [PubMed] [Google Scholar]
- Miller E., Nokes D. J., Anderson R. M. Measles, mumps, and rubella vaccination. BMJ. 1992 May 30;304(6839):1440–1441. doi: 10.1136/bmj.304.6839.1440-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rao M., Wilkinson J., Millar M., Richards G. Measles vaccination in primary schools--the Colchester project. Public Health. 1988 Sep;102(5):477–483. doi: 10.1016/s0033-3506(88)80086-6. [DOI] [PubMed] [Google Scholar]
- Riley E. C., Murphy G., Riley R. L. Airborne spread of measles in a suburban elementary school. Am J Epidemiol. 1978 May;107(5):421–432. doi: 10.1093/oxfordjournals.aje.a112560. [DOI] [PubMed] [Google Scholar]
- Sloan D. S. Measles, mumps, and rubella vaccine: time for a two stage policy. BMJ. 1992 Apr 4;304(6831):916–916. doi: 10.1136/bmj.304.6831.916-b. [DOI] [PMC free article] [PubMed] [Google Scholar]