Measles Outbreak in a Fully Immunized Secondary-School Population

Gustafson, Tracy L.

doi:10.1097/00006454-198803000-00029

Cited by 29 publications

(41 citation statements)

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“…The abrupt end of the rubella outbreak in our population is intriguing and has an analogy in the publication of Gustafson et al [13]. A systematic error due to lack of case finding amongst the crew seems unlikely.…”

Section: Discussionsupporting

confidence: 68%

An Outbreak of Rubella aboard a Ship of the German Navy

Ziebold¹,

Hassenpflug²,

Wegner-Bröse³

et al. 2003

Infection

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Background: During May and June 1996, an outbreak of rubella occurred offshore aboard a ship of the German Navy. The outbreak spread among 330 crew members over a period of 9 weeks, ending 2 days after the ship's return. This is the first detailed epidemiological investigation of a rubella outbreak on a ship, describing temporal progression, clinical manifestations, immunization status and seroprevalence of the population exposed. Patients and Methods: Outbreak investigation using a questionnaire, health records and rubella serology (hemagglutination inhibition (HI) test and EIA). Results: Of the 330 crew members 298 (90%) participated in the investigation. The outbreak was continuous without a peak and ended abruptly after the ship's return. It resulted in 20 cases, 11 of which were clinically symptomatic. A total of 35 (12%) crew members were susceptible to rubella prior to the outbreak, resulting in an attack rate of 57%. The highest risk for infection was linked to accommodation aboard the ratings deck ( 2 -test, p = 0.004) with most favorable conditions of transmission. Only 9% of the participating crew were able to provide complete proof of their immunization status. The positive predictive value of a past history of rubella for the presence of antibodies against rubella was 59%. Conclusion: The transmission of rubella that we describe aboard a ship was facilitated by the unusually close proximity of the crew and their insufficient immunity.

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Section: Discussionsupporting

confidence: 68%

An Outbreak of Rubella aboard a Ship of the German Navy

Ziebold¹,

Hassenpflug²,

Wegner-Bröse³

et al. 2003

Infection

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“…37 Conclusive evidence that revaccinated individuals have lower measles attack rates has so far been lacking, 1 though many outbreak reports suggest this interpreta-tion. 22 29-31 35 41 42 Our study shows that routine revaccination gives more complete protection, even when the first vaccination is given after 14 months of age.…”

Section: Discussionmentioning

confidence: 99%

Twice vaccinated recipients are better protected against epidemic measles than are single dose recipients of measles containing vaccine

Paunio¹,

Peltola²,

Valle³

et al. 1999

Journal of Epidemiology & Community Health

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Objective-To study measles risk after revaccination. Design-A population-based case-control study during an epidemic season. Main outcome measure-Relative serologically confirmed measles risk. Participants and methods-153 vaccinated cases, mostly from rural areas, were serologically confirmed as measles at the central laboratory in 1988-89. A randomly selected group of 453 controls from either municipalities of vaccinated cases or from areas where measles attack rate was >600/ 10 5 , was identified via the population registry. Vaccination and measles histories of cases and controls were determined from oYcial vaccination cards. Results-Once and twice vaccinated had crude relative risk 15.6 and 2.3 compared with thrice vaccinated. When cases who had received their first vaccination at less than 14 months of age were omitted from analysis, once vaccinated had 4.0 (95% CI 1.2, 16.6) times higher age adjusted measles risk compared with twice vaccinated. When, omission was extended to cases from one particular municipality where even revaccinees had high measles risk during an explosive outbreak the corresponding risk ratio was 17.8 (2.8, 67.8). Conclusions-Twice vaccinated have better protection against epidemic measles compared with single dose recipients. (J Epidemiol Community Health 1999;53:173-178) Indisputable individual level evidence that measles revaccinations increase protection is still lacking, and there is little information upon which to base optimised revaccination schedules, 1 though it has recently even internationally been recommended that there is a need to implement revaccinations against measles.

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“…Moreover, outbreaks have been described also in populations where more than 95% were immune (6). Despite measles immunization requirements in Israel, outbreaks still may occur due to vaccine failure.…”

Section: Discussionmentioning

confidence: 99%

Extent of measles hepatitis in various ages

et al. 1988

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To assess extent of hepatic involvement in measles, we evaluated prospectively 144 patients (ages 0.2 to 43 years) during an outbreak. Liver function parameters (AST, ALT, serum gamma-glutamyl transpeptidase and bilirubin) were determined on presentation and at 2 and 4 weeks. The study comprised 52 pediatric (less than or equal to 14 years) and 92 adult patients. Liver dysfunction was evident quite often (56 to 66%) in adult patients. However, in the pediatric age group, these abnormalities were less frequent and less extensive. Moreover, a significant correlation was noted between age and each of the following parameters: AST (r = 0.61), ALT (r = 0.56) and serum gamma-glutamyl transpeptidase (r = 0.39). In all subjects all parameters normalized after 2 to 4 weeks. The data presented suggest that hepatic dysfunction in measles is probably not rare and is more frequent and more extensive in adults. However, these abnormalities seem to be subclinical, self-limited and probably with no long-term sequelae.

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Measles Outbreak in a Fully Immunized Secondary-School Population

Cited by 29 publications

References 0 publications

An Outbreak of Rubella aboard a Ship of the German Navy

An Outbreak of Rubella aboard a Ship of the German Navy

Twice vaccinated recipients are better protected against epidemic measles than are single dose recipients of measles containing vaccine

Extent of measles hepatitis in various ages

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