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Measles outbreak in the Republic of the Marshall Islands, 2003

Terri B Hyde1, Gustavo H Dayan, Justina R Langidrik

  • 1Viral Vaccine Preventable Diseases Branch, National Immunization Program, NIP, Centers for Disease Control and Prevention, CDC, Atlanta, GA 30333, USA. thyde@cdc.gov

International Journal of Epidemiology
|November 22, 2005
PubMed
Abstract

Insights

A 2003 measles outbreak in the Republic of the Marshall Islands highlights the risk of measles in unvaccinated populations. High vaccination coverage is crucial to prevent future measles outbreaks.

Area of Science:

  • Epidemiology
  • Public Health
  • Infectious Diseases

Background:

  • Measles is a highly contagious viral infection preventable by vaccination.
  • The Republic of the Marshall Islands (RMI) experienced a significant measles outbreak in 2003 after a period of no reported cases.
  • Vaccine coverage in RMI varied significantly between 1990 and 2000, indicating potential pockets of susceptibility.

Purpose of the Study:

  • To describe the epidemiology of the 2003 measles outbreak in the RMI.
  • To identify risk factors and affected populations during the outbreak.
  • To evaluate the effectiveness of the vaccination campaign for outbreak control.

Main Methods:

  • A descriptive epidemiological study was conducted using reported measles cases in RMI from July to November 2003.
  • Case definition included fever, rash, and respiratory or conjunctival symptoms.
  • A vaccination campaign was implemented for outbreak control.

Main Results:

  • A total of 826 measles cases were reported, with 92% concentrated in the capital, Majuro.
  • Infants and individuals aged 15 years and older were significantly affected, with the highest attack rate among infants.
  • Of measles cases aged 1-14 years, 59% were unvaccinated, and the outbreak resulted in 100 hospitalizations and 3 deaths.

Conclusions:

  • Populations lacking endemic measles transmission can develop significant susceptibility, increasing outbreak risk upon virus introduction.
  • Maintaining high vaccination coverage (>=95%) is essential to prevent measles outbreaks and protect vulnerable groups, including infants and adults.
  • The vaccination campaign achieved 93% coverage, underscoring the importance of sustained public health interventions in maintaining herd immunity.

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