Large outbreak of measles in a community with high vaccination coverage: implications for the vaccination schedule

Clin Infect Dis. 2008 Nov 1;47(9):1143-9. doi: 10.1086/592258.

Abstract

Background: Attempts to eliminate measles from a country or region may be disrupted by an imported case that affects indigenous persons. The objective of this study was to analyze epidemiological and clinical characteristics of a measles outbreak in Catalonia, Spain, in 2006.

Methods: Data on cases of measles reported to the Department of Health, Generalitat of Catalonia, during the period 28 August 2006 through 8 July 2007 were collected. Suspected cases were confirmed by determination of measles-specific immunoglobulin M antibodies and/or detection of virus genome. Incidences were calculated using the estimated population of Catalonia for 2006, and 95% confidence intervals were determined assuming a Poisson distribution. The association between proportions was determined using the chi(2) test and Fisher's exact test. The level of statistical significance was set at alpha = .05.

Results: A total of 381 cases were confirmed, for an incidence of 6.6 cases per 100,000 persons. A total of 89.5% of cases occurred in nonvaccinated persons, mainly those aged < or =15 months (incidence, 278.2 cases per 100,000 persons; mean age of patients, 12 months). Indigenous subjects accounted for 89.8% of cases, and laboratory confirmation of results was obtained for 87.1%. Measles genotype D4 was identified in all sequenced samples.

Conclusions: The age distribution of cases of measles among children aged <15 months suggests that the first dose of vaccine should be routinely administered at the age of 12 months.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Disease Outbreaks* / prevention & control
  • Female
  • Humans
  • Immunization Schedule*
  • Infant
  • Male
  • Measles / epidemiology*
  • Measles / immunology
  • Measles / prevention & control*
  • Measles Vaccine / administration & dosage*
  • Measles virus / genetics
  • Measles virus / isolation & purification
  • Middle Aged
  • Spain / epidemiology
  • Time Factors
  • Vaccination

Substances

  • Measles Vaccine