Epidemiology of measles in Taiwan: dynamics of transmission and timeliness of reporting during an epidemic in 1988–9

Abstract

SUMMARYWe analysed nation-wide reported measles cases during the 1988-9 epidemic and found that longer duration and wider spread were two major characteristics of the outbreak. All the 22 county/city index cases were reported with a delay of > 4 days and 64% were aged 5-14 years. This epidemic occurred mainly among 5-14-year-old school-children (59 % ), infants under 1 year (19%), and pre-school children ( 18 %). The overall attack rate was 0-63 cases per 10000 population, with the highest attack rate (7 4 cases per 10000 population) occurring in infants. Among 280 confirmed cases < 15 months of age, 9-month-old infants (42 cases) had a higher risk of measles and peaked at 10 months (49 cases). This epidemic started in March 1988 among 5-9-year-old children in the northern suburban area, then spread to Taipei City and neighbouring counties or cities. It continued to spread from the northern to southern and western areas during the summer vacation and New Year holidays. Multiple logistic regression analysis showed that the delay of measles reporting was strongly associated with the cases infected early in the epidemic (OR = 6-9, P < 0.001) and reported from teaching hospitals (OR = 2 6, P < 0-001). The reappearance of high attack rates among 5-9-year-old children in the 1985 and 1988-9 measles epidemics in Taiwan indicated the persistence of pockets of susceptible individuals even after mass immunization.

Protection against measles virus encephalitis by monoclonal antibodies binding to a cystine loop domain of the H protein mimicked by peptides which are not recognized by maternal antibodies

“…It is conceivable that antibodies were missed which were induced by wild-type MV with non-cross-reactive mutations in the HNE loop. To minimize this possibility in the present study, high titre sera from women of child-bearing age and from patients recovering from measles (Lee et a]., 1992(Lee et a]., , 1995 were reacted here with a set of 30-mer peptides corresponding to most known mutations in this region. Few sera reacted strongly with the longer peptides but none reacted with the 15-mers which fully represented the neutralizing and protective epitope.…”

Protective titres of measles neutralising antibody

“…Sera were collected with consent from parents or guardians and stored at −70°C at the National Serum Bank, National Institute of Preventive Medicine, Taiwan. The only nation-wide measles outbreak during this period occurred from March 1988 to July 1989 [Lee et al, 1992[Lee et al, , 1995.…”

Resurgence of measles in Singapore: Profile of hospital cases

“…This pattern mirrors that seen in other populations using a onedose vaccination program, where measles outbreaks have been reported several years after the implementation of the program. [2][3][4][5]7 It is postulated that herd immunity may have decreased to a critical threshold, hence predisposing to an outbreak.…”