The 1997 Measles Outbreak in Metropolitan São Paulo, Brazil: Strategic Implications of Increasing Urbanization

Moraes, José Cássio de; Camargo, M. C. C.; Mello, Maria Lúcia Rocha de; Hersh, Bradley S.; Glasser, John W.

doi:10.1007/978-3-319-40413-4_16

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…A case-control trial conducted after the 1997 outbreak found that recent immigration to São Paulo was a significant risk factor for measles infection during the outbreak [27]. Further, immigration rates into São Paulo in 1991 were highest among individuals between 15 and 30 years of age [42], which is consistent with the age distribution of the excess susceptibles estimated by our models. While this does not confirm that immigration or gaps in prior immunization were the source of the adult susceptibles during the 1997 outbreak, this analysis does suggest that these adult susceptibles may have played a significant role in the outbreak; absent the excess susceptibles, R e at the start of the outbreak would have been comfortably less than 1.…”

Section: Discussionsupporting

confidence: 85%

Measles outbreak response decision-making under uncertainty: a retrospective analysis

Fonnesbeck

Shea

Carran

et al. 2018

J. R. Soc. Interface.

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Resurgent outbreaks of vaccine-preventable diseases that have previously been controlled or eliminated have been observed in many settings. Reactive vaccination campaigns may successfully control outbreaks but must necessarily be implemented in the face of considerable uncertainty. Real-time surveillance may provide critical information about at-risk population and optimal vaccination targets, but may itself be limited by the specificity of disease confirmation. We propose an integrated modelling approach that synthesizes historical demographic and vaccination data with real-time outbreak surveillance via a dynamic transmission model and an age-specific disease confirmation model. We apply this framework to data from the 1996-1997 measles outbreak in São Paulo, Brazil. To simulate the information available to decision-makers, we truncated the surveillance data to what would have been available at 1 or 2 months prior to the realized interventions. We use the model, fitted to real-time observations, to evaluate the likelihood that candidate age-targeted interventions could control the outbreak. Using only data available prior to the interventions, we estimate that a significant excess of susceptible adults would prevent child-targeted campaigns from controlling the outbreak and that failing to account for age-specific confirmation rates would underestimate the importance of adult-targeted vaccination.

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Section: Discussionsupporting

confidence: 85%

Measles outbreak response decision-making under uncertainty: a retrospective analysis

Fonnesbeck

Shea

Carran

et al. 2018

J. R. Soc. Interface.

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“…A wide range of sophisticated mathematical and statistical techniques [17,18] have also been developed. These include measuring spatial and space-time clustering [19,20] to detect existing high risk areas or areas at risk of disease influx, while mathematical diffusion and epidemic models [21,22] focus especially on the time pattern of disease spread.…”

Section: Analytic Methodsmentioning

confidence: 99%

Spatiotemporal Frameworks for Infectious Disease Diffusion and Epidemiology

Congdon

2016

IJERPH

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The 1997 Measles Outbreak in Metropolitan São Paulo, Brazil: Strategic Implications of Increasing Urbanization

Cited by 2 publications

References 18 publications

Measles outbreak response decision-making under uncertainty: a retrospective analysis

Measles outbreak response decision-making under uncertainty: a retrospective analysis

Spatiotemporal Frameworks for Infectious Disease Diffusion and Epidemiology

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