Epidemic measles in Shetland during 1977 and 1978.

Abstract

During 1977 and1978 an unusual epidemic of measles occurred in Shetland, affecting 1032 (5%) of the population. All age groups were represented, and 309 cases occurred in people over 15. Geographical distribution of notified cases ranged from 1% to over one-third of the population aged under 65. All the recognised complications occurred, with a significant excess of respiratory troubles (p < 005). Complications were much less common in female patients (p < 0-05). Only abQut 30% of children under 5 had been vaccinated against the disease, and, based on a sample population, vaccination was found to have had a protective effect of 92%.On cost effectiveness alone, uptake of vaccination by a community as susceptible as that of Shetland should clearly be encouraged and probably given high priority. IntroductionVaccination against measles was introduced over a decade ago as a standard component of the nationally recommended vaccination schedule' for infants in Britain. In Scotland, however, the

Age-related changes in the rate of disease transmission: implications for the design of vaccination programmes

“…Some exposure to infection had occurred in the past and a proportion of the population had been immunized. However, the population had an unusually high proportion of susceptible individuals prior to the epidemic (Macgregor et al 1981). The second concerns an epidemic of measles in Southern Greenland in a totally susceptible population in 1951 ( Fig.…”

“…Epidemics in 'virgin' populations. An epidemic of measles in the Shetlands, U.K. during the period 1977-8 (data source; Macgregor et al 1981). (a) Case reports; (b) predicted serological profile after the epidemic; (c) age-specific forces of infection (year-').…”

An assessment of methods for routine local monitoring of vaccine efficacy, with particular reference to measles and pertussis

“…Furthermore, most appear sufficiently similar to published estimates of measles (MRC, 1968) and pertussis (Fine & Clarkson, in press) vaccine efficacies as to be credible. Though we have no detailed local independent information against which to validate our estimates, we can be reasonably confident from other studies that the measles vaccines used in England and Wales have 85-95% efficacy (MacGregor et al 1981;Marks, Halpin & Orenstein, 1978) and thus use this as an expected range against which to judge our results. This suggests that the Hampstead and Paddington/North Kensington estimates based on Child Register controls, and the Shropshire estimate based on Notification Register controls, are too low.…”

Systematic Review of Health Economic Analyses of Measles and Rubella Immunization Interventions

“…After review of papers, we further excluded 39 studies that focused on cost minimization for strategies related to: screening of health‐care workers, women of child‐bearing age (for rubella), military recruits, college students, children prior to revaccination, or students before school entry; communications and other measures to encourage vaccination; alternative delivery or vaccine presentations (including hypothetical options); treatment; and different screening tests . We also excluded 13 papers that reported costs only for outbreaks (including any outbreak response efforts that occurred) without analysis of a comparator . In addition, we excluded 14 studies that presented theoretical economic analyses, including early efforts to explore the dynamics of rubella, the first analysis to demonstrate the importance of using a dynamic model in CEA, several analyses that explored game‐theoretic aspects, and a study providing a generic tool for measles CEAs …”