[an error occurred while processing this directive]
International Journal of Infectious Diseases: Volume 3, Number 2
Post Mass-Immunization Measles Outbreak in Taoyuan County, Taiwan: Dynamics of Transmission, Vaccine Effectiveness, and Herd Immunity
Min-Shi Lee, MPH; Li-Li Lee, MSc; Hour-Young Chen, PhD; Ying-Chang Wu, MSc; and Chi-Byi Horng, PhD

Int J Infect Dis 1999; 3:64-69.

Objectives: Analysis of national surveillance data and a seroepidemiologic investigation were conducted to elucidate the causes and epidemiologic characteristics of a measles outbreak in Taoyuan, Taiwan, 1994. Methods: Measles cases were identified through a national surveillance system. Reported cases and their physician or school nurses were interviewed to trace additional suspect cases and were sampled for serologic diagnosis. Measles-specific IgG and IgM were assayed. A confirmed case was defined as being positive for measles IgM test but not having received measles vaccination within the previous 3 months. Results: The outbreak began in Taoyuan City in December 1993 and continued to spread in primary schools and kindergartens, but caused only sporadic cases in neighboring towns. Among 42 confirmed cases, 15 (38%) were primary school children and 16 (38%) were kindergarten children. Among 24 confirmed cases with a vaccination record, 7 had one dose of vaccination, 4 had two doses of vaccination, and 13 (54%) were unvaccinated. The overall measles susceptible proportion at a kindergarten before the outbreak was 8.1% (17/209) and the overall measles cumulative incidence among susceptibles was 0.65 (11/17). Conclusions: A measles vaccination coverage of 82% with the first dose at 9 months of age and 63% with the second dose (measles, mumps, and rubella) at 15 months was inadequate to block measles virus circulation in Taoyuan City in 1994. The city center, with a growing population, represents a high risk as an epicenter for measles outbreaks. Measles outbreaks may occur in a school population with 92% herd immunity.

KEYWORDS: herd immunity, measles outbreak, seroepidemiology, vaccine efficacy

Back to Table of Contents

The International Journal of Infectious Diseases is owned by
the International Society for Infectious Diseases.
The Journal is published quarterly for the ISID by B.C. Decker Inc.