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

• Published in: Clinical infectious diseases Vol. 47; no. 9; pp. 1143 - 1149
• Main Authors: Domínguez, Angela, Torner, Nuria, Barrabeig, Irene, Rovira, Ariadna, Rius, Cristina, Cayla, Joan, Plasencia, Elsa, Minguell, Sofia, Sala, M. Rosa, Martínez, Ana, Costa, Josep, Mosquera, Mar, Cabezas, Carmen
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.11.2008; University of Chicago Press; Oxford University Press
• Subjects: Adolescent; Adult; Articles and Commentaries; Biological and medical sciences; Child; Child, Preschool; Children; Disease outbreaks; Disease Outbreaks - prevention & control; Dosage; Epidemics; Epidemiology; Exanthema; Female; Genotype & phenotype; Human viral diseases; Humans; Immunization; Immunization Schedule; Infant; Infectious diseases; Male; Measles; Measles - epidemiology; Measles - immunology; Measles - prevention & control; Measles Vaccine - administration & dosage; Measles virus - genetics; Measles virus - isolation & purification; Medical sciences; Middle Aged; Native peoples; Polymerase chain reaction; Spain - epidemiology; Studies; Surveillance; Time Factors; Urine; Vaccination; Viral diseases; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye; Spain; Catalonia Spain; Infection; Epidemic; Vaccination coverage; Viral disease; Measles; Vaccination schedule
• ISSN: 1058-4838; 1537-6591; 1537-6591
• DOI: 10.1086/592258

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.