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The changing epidemiology of hospitalized pediatric patients in three measles outbreaks

Kyung-Yil Lee1, Hyung-Shin Lee, Jae-Kyun Hur

  • 1Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. leekyungyil@catholic.ac.kr

The Journal of Infection
|April 20, 2006
PubMed
Abstract

Insights

Measles outbreaks show changing age distributions over time, with older children increasingly affected. This suggests secondary vaccine failure may be a significant factor in recent measles cases.

Area of Science:

  • Epidemiology
  • Immunology
  • Public Health

Background:

  • Measles remains a significant public health concern globally.
  • Vaccination is the primary strategy for measles control.
  • Understanding disease epidemiology is crucial for effective public health interventions.

Purpose of the Study:

  • To analyze demographic and clinical characteristics of measles patients across three distinct epidemic periods (1989-2001).
  • To identify trends in measles patient populations over time.
  • To investigate potential factors influencing measles outbreaks.

Main Methods:

  • Retrospective analysis of 520 measles patient medical records.
  • Categorization of patients into three groups based on admission dates: 1989-1990, 1993-1994, and 2000-2001.
  • Comparison of demographic, vaccination, clinical, and laboratory data across the three groups.

Main Results:

  • No significant difference in the proportion of measles patients under 2 years of age across outbreaks.
  • A notable shift in age distribution, with a significant increase in older children (> or = 2 years) in subsequent outbreaks.
  • Increased measles attack rates observed with longer intervals since the initial measles-mumps-rubella (MMR) vaccination in the 2000-2001 outbreak.
  • No significant differences in gender ratio, vaccination rates (in older children), fever duration, complications, or clinical/laboratory parameters between antibody-positive and negative patients.

Conclusions:

  • The age distribution of measles cases has evolved over time, particularly following the introduction of one-dose MMR vaccination.
  • Secondary vaccine failure is a potential contributing factor to measles outbreaks in vaccinated populations.
  • These findings highlight the need for ongoing surveillance and potentially revised vaccination strategies.

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