TITLE

Measles transmission from an anthroposophic community to the general population, Germany 2008

AUTHOR(S)
Wadl, Maria; Siedler, Anette; Krämer, Wolfgang; Haindl, Maria E.; Gebrande, Stephan; Krenn-Lanzl, Irene; Mankertz, Annette; Hautmann, Wolfgang
PUB. DATE
January 2011
SOURCE
BMC Public Health;2011, Vol. 11 Issue 1, p474
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: In Germany, measles vaccination coverage with two doses is not yet sufficient to prevent regional outbreaks. Among the 16 German federal states, vaccination coverage was lowest in Bavaria with 85% in 2008. From March to mid-April 2008, four neighbouring Bavarian counties reported 55 measles-cases mostly linked to an ongoing measles outbreak in an anthroposophic school in Austria. We investigated this outbreak to guide future public health action. Methods: We applied the German national case-definition for measles and collected data using the national surveillance system and a questionnaire. Measles cases with disease onset a maximum of 18 days apart and spatial contact (e.g. same household, same school) were summed up in clusters. Two different interventions, which were implemented in schools and kindergartens in Bavaria, were compared by their impact on the size and duration of measles clusters. Susceptible persons were excluded from schools or kindergartens either with the first (intervention A) or second (intervention B) measles case occurring in the respective institution. Results: Among the 217 Bavarian measles cases identified from March-July 2008, 28 (13%) cases were attendees of the anthroposophic school in Austria. In total, vaccination status was known in 161 (74%) cases and 156 (97%) of them were not vaccinated. The main factor for non-vaccination was "fear of vaccine-related adverse events" (33%). Twenty-nine (18%) of 161 cases suffered complications. Exclusively genotype D5 was detected. Overall, 184 cases could be epidemiologically grouped into 59 clusters. Of those, 41 clusters could be linked to households and 13 to schools or kindergartens. The effect of intervention A and B was analysed in 10 school or kindergarten clusters. Depending on the respective intervention A or B, the median number of cases per cluster was 3 versus 13 (p = 0.05), and the median duration of a cluster was 3 versus 26 days (p = 0.13). Conclusions: Introduction of measles virus into a pocket of susceptible persons (e.g. vaccination opponents or sceptics) may lead to large outbreaks in the general population, if the general population's vaccination coverage is below the WHO recommended level. Education on the safety of measles vaccine needs to be strengthened to increase measles vaccination coverage. Early intervention may limit spread in schools or kindergartens. Suspected measles has to be reported immediately to the local health authorities in order to allow intervention as early as possible.
ACCESSION #
63971321

 

Related Articles

  • Investigation of a Measles Outbreak in China to Identify Gaps in Vaccination Coverage, Routes of Transmission, and Interventions. Zheng, Xiang; Zhang, Ningjing; Zhang, Xiaoshu; Hao, Lixin; Su, Qiru; Wang, Haijun; Meng, Kongyan; Zhang, Binglin; Liu, Jianfeng; Wang, Huaqing; Luo, Huiming; Li, Li; Li, Hui; Ma, Chao // PLoS ONE;7/24/2015, Vol. 10 Issue 7, p1 

    Background: A measles outbreak occurred in a western county of China in 2013, the year after China’s historic nadir of measles. We conducted a field investigation to identify gaps in measles vaccination coverage and immunization program weaknesses, and to provide recommendations for...

  • Assessment of measles immunity among infants in Maputo City, Mozambique. Jani, Jagrati V.; Holm-Hansen, Carol; Mussá, Tufária; Zango, Arlinda; Manhiça, Ivan; Bjune, Gunnar; Jani, Ilesh V. // BMC Public Health;2008, Vol. 8 Issue 1, p386 

    Background: The optimum age for measles vaccination varies from country to country and thus a standardized vaccination schedule is controversial. While the increase in measles vaccination coverage has produced significant changes in the epidemiology of infection, vaccination schedules have not...

  • The potential for measles transmission in England. Yoon Hong Choi; Nigel Gay; Fraser, Graham; Ramsay, Mary // BMC Public Health;2008, Vol. 8 Issue 1, p338 

    Background: Since the schools vaccination campaign in 1994, measles has been eliminated from England. Maintaining elimination requires low susceptibility levels to keep the effective reproduction number R below 1. Since 1995, however, MMR coverage in two year old children has decreased by more...

  • Documenting the elimination of measles, rubella and congenital rubella syndrome in Ontario: 2009-12. Lim, G. H.; Deeks, S. L.; Fediurek, J.; Gubbay, J.; Crowcroft, N. S. // Canada Communicable Disease Report;4/17/2014, Vol. 40 Issue 8, p143 

    Background: Under the guidance of the Pan American Health Organization (PAHO), countries of the Americas are currently documenting the elimination of measles, rubella, and congenital rubella syndrome.Objective: This paper describes Ontario's progress in documenting the...

  • Eficacia de la educación lúdica en la prevención del Dengue en escolares.  // Revista de Salud Pública;jul-ago2010, Vol. 12 Issue 3, p558 

    No abstract available.

  • Measles Transmission and Vaccine Effectiveness during a Large Outbreak on a Densely Populated Island: Implications for Vaccination Policy. Marin, Mona; Nguyen, Huong Q.; Langidrik, Justina R.; Edwards, Russell; Briand, Kennar; Papania, Mark J.; Seward, Jane F.; LeBaron, Charles W. // Clinical Infectious Diseases;2/1/2006, Vol. 42 Issue 3, p315 

    Background. The Republic of the Marshall Islands (RMI) is a South Pacific nation freely associated with the United States. In 2003, the RMI experienced the largest measles outbreak within the United States or its associated areas for more than a decade, although the reported coverage of 1-dose...

  • OUTBREAK NEWS.  // Weekly Epidemiological Record;8/18/2000, Vol. 75 Issue 33, p265 

    Focuses on the transmission of Lasssa fever from Sierra Leone to the Netherlands. Nature of the case; Mortality and risk factors of the disease; Reference to the number of reported cases of measles by the National Disease Surveillance Center in Ireland.

  • Scare them to death.  // Science Scope;Nov/Dec2003, Vol. 27 Issue 3, p60 

    The article offers a look at the author's approach in teaching HIV/AIDS transmission to middle school students. It is emphasized that a facilitator should first get parents' permission before beginning the activity program. The students were each given plastic cups filled with liquid, with one...

  • Knowledge, perceived stigma, and care-seeking experiences for sexually transmitted infections: a qualitative study from the perspective of public clinic attendees in Rio de Janeiro, Brazil. Malta, Monica; Bastos, Francisco I.; Strathdee, Steffanie A.; Cunnigham, Shayna D.; Pilotto, Jose Henrique; Kerrigan, Deanna // BMC Public Health;2007, Vol. 7 Issue 1, p18 

    Background: An estimated 12 million sexually transmitted infections (STIs) are documented in Brazil per year. Given the scope of this public health challenge and the importance of prompt treatment and follow-up counseling to reduce future STI/HIV-related risk behavior, we sought to qualitatively...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics