Journal Article

Large Outbreak of Measles in a Community with High Vaccination Coverage: Implications for the Vaccination Schedule

Angela Domínguez, Nuria Torner, Irene Barrabeig, Ariadna Rovira, Cristina Rius, Joan Cayla, Elsa Plasencia, Sofia Minguell, M. Rosa Sala, Ana Martínez, Josep Costa, Mar Mosquera and Carmen Cabezas

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 47, issue 9, pages 1143-1149
Published in print November 2008 | ISSN: 1058-4838
Published online November 2008 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/592258
Large Outbreak of Measles in a Community with High Vaccination Coverage: Implications for the Vaccination Schedule

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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 χ2 test and Fisher's exact test. The level of statistical significance was set at a=.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 ≤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.

Journal Article.  4714 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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