A Seroepidemiological Study of Measles: Some Practical Implications for Measles Immunization Program, Kingdom of Saudi Arabia

Abstract

It was hypothesized that the recent outbreaks of measles in a geographically defined area of Al-Qassim might reflect significant changes in the epidemiology of measles and cast doubt upon the real protective value of measles vaccines. Therefore, the two objectives of this research were to study some epidemiological parameters of cases of measles (n=993) and the current immunological status of immunized children (n=2810). The crossmatched data about measles patients were collected on an official proforma and 3 mL of blood were extracted from each child for determining the measles IgG and IgM antibodies. The results showed that female patients were significantly overrepresented (51.3%). The majority of patients encountered at primary health care centers (PHCCs) (81.3%) were more than five years of age (76.5%). Among nonvaccinated measles cases, 54.9% (n=402) were from rural/desert areas. The measles vaccine failure rate was 26.3%. The results of the surveyed children showed that 2% of them were not vaccinated. The measles IgM levels were detected significantly in recently vaccinated females (n=29/51, 56.9%). The measles IgG positivity unaffected by age, sex, and residence was found in 87.4% of children. A significant portion of children from rural/desert areas were not vaccinated (n=44/57, 77.2%). Though there were apparently high seroconversion rates in children under two years of age following Edmonston-Zagreb vaccine, overall it did not achieve any statistical significance when compared with seroconversion rates in all children following Schwartz vaccine. We conclude that besides at age six months, and MMR containing measles vaccine at 12 months, children at school entry (six years) should also be considered for measles vaccination. Ann Saudi Med 1994;14(5):399-404.

Systematic Review of Measles and Rubella Serology Studies

“…We identified over 220 studies that provided cross‐sectional data and nearly 180 studies that reported on immunity for women of child‐bearing age, primarily for rubella. Table summarizes the over 400 cross‐sectional and women of child‐bearing age measles and rubella serological studies…”

Mobile nomadic families

“…However, the most important implication of this finding is that if this minority of nomadic children under five years of age is in fact not vaccinated in time (n=19.9, 89%), it might lead to future episodic outbreaks of several infectious diseases, for instance measles. 12 Globally, about 10% of nomads are not familiar with the concept of medical diseases and also the availability of therapeutic and curative services including primary healthcare services, hence they tend to seek non-medical pathways including traditional healers, as mentioned earlier, whose practices have yet to be studied scientifically. They in fact need an intensive awareness campaign via the media or alternative suitable ways such as providing relevant and basic public health information through lectures by their trained leaders or primary care physicians at their places of aggregation.…”