Abstract
A 1999-2000 measles epidemic in the Netherlands started with an outbreak in an orthodox reformed elementary school with 7% vaccine coverage. The overall attack rate was 37%: 213 clinical cases among the 255 participating pupils (response 62%) and 327 household members. The attack rate ranged from 0% for the oldest groups of pupils to 88% for the youngest, who had not been exposed in previous measles epidemics. None of 25 vaccinated pupils had clinical symptoms. Among pupils with clinical symptoms, the self-reported complication rate was 25%. These data confirm that measles infection causes severe disease and that vaccination is the most effective means of preventing the disease and its complications. The data also show that clusters of persons refraining from vaccination interfere with measles elimination even in populations with very high overall vaccine coverage (96%).
Full Text
The Full Text of this article is available as a PDF (374.9 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bijkerk H., Bilkert-Mooiman M. A., Houtters H. J. De inentingstoestand bij aangegeven patiënten met mazelen tijdens de epidemie 1987/'88. Ned Tijdschr Geneeskd. 1989 Jan 7;133(1):29–32. [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]
- Helfand R. F., Kim D. K., Gary H. E., Jr, Edwards G. L., Bisson G. P., Papania M. J., Heath J. L., Schaff D. L., Bellini W. J., Redd S. C. Nonclassic measles infections in an immune population exposed to measles during a college bus trip. J Med Virol. 1998 Dec;56(4):337–341. doi: 10.1002/(sici)1096-9071(199812)56:4<337::aid-jmv9>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
- Huiss S., Damien B., Schneider F., Muller C. P. Characteristics of asymptomatic secondary immune responses to measles virus in late convalescent donors. Clin Exp Immunol. 1997 Sep;109(3):416–420. doi: 10.1046/j.1365-2249.1997.00137.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Santibanez S., Heider A., Gerike E., Agafonov A., Schreier E. Genotyping of measles virus isolates from central Europe and Russia. J Med Virol. 1999 Jul;58(3):313–320. [PubMed] [Google Scholar]
- Vardas E., Kreis S. Isolation of measles virus from a naturally-immune, asymptomatically re-infected individual. J Clin Virol. 1999 Aug;13(3):173–179. doi: 10.1016/s1386-6532(99)00026-8. [DOI] [PubMed] [Google Scholar]
- Wallinga J., van den Hof S. Epidemiologie van mazelen in Nederland: een verkennende analyse van aangiften. Ned Tijdschr Geneeskd. 2000 Jan 22;144(4):171–174. [PubMed] [Google Scholar]
- van den Hof S., Berbers G. A., de Melker H. E., Conyn-van Spaendonck M. A. Sero-epidemiology of measles antibodies in the Netherlands, a cross-sectional study in a national sample and in communities with low vaccine coverage. Vaccine. 1999 Dec 10;18(9-10):931–940. doi: 10.1016/s0264-410x(99)00348-5. [DOI] [PubMed] [Google Scholar]