Document Detail


Explosive school-based measles outbreak: intense exposure may have resulted in high risk, even among revaccinees.
MedLine Citation:
PMID:  9850133     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Even high levels of measles vaccination coverage have not always prevented outbreaks of measles spread by airborne transmission. It has been suggested that a large inoculum might increase vaccine failure risk. Airbome transmission might occasionally entail a large measles inoculum. The epidemiologic relevance of measles among properly vaccinated persons (i.e., those vaccinated after 15 months of age and with live attenuated virus) is increased when they become contagious. The authors studied inoculum intensities as measured by proxy variables and the contagiousness of properly vaccinated persons who contracted measles among 51 measles patients infected in one school, at home, or elsewhere, utilizing preexisting records of measles cases and 214 healthy controls from an explosive school outbreak that occurred in a rural Finnish municipality in 1989. One "super-spreader" infected 22 others in one day, including eight once-vaccinated students and one twice-vaccinated student, probably during an assembly of 144 students in a poorly ventilated hallway with no sunlight. Those infected later at home had high measles risk, even if they were revaccinees. When siblings shared a bedroom with a measles case, a 78 percent risk (seven out of nine children) was observed among vaccinees. Vaccinees had approximately 2 days' shorter incubation time than unvaccinated persons. Vaccinated and unvaccinated students were equally able to infect their siblings. Total protection against measles might not be achievable, even among revaccinees, when children are confronted with intense exposure to measles virus.
Authors:
M Paunio; H Peltola; M Valle; I Davidkin; M Virtanen; O P Heinonen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of epidemiology     Volume:  148     ISSN:  0002-9262     ISO Abbreviation:  Am. J. Epidemiol.     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1998-12-18     Completed Date:  1998-12-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7910653     Medline TA:  Am J Epidemiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1103-10     Citation Subset:  IM    
Affiliation:
Department of Public Health, University of Helsinki, Finland.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Disease Outbreaks / statistics & numerical data*
Female
Finland / epidemiology
Humans
Immunization Schedule
Immunization, Secondary
Male
Measles / epidemiology*,  prevention & control,  transmission
Measles Vaccine / administration & dosage*
Recurrence
Risk
Rural Population
Schools
Chemical
Reg. No./Substance:
0/Measles Vaccine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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