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Epidemic measles in Chicago in 1983. Sustained transmission in the preschool population
Insights
A 1983 measles epidemic in Chicago was sustained by preschool-aged children with low immunity rates. Improved immunization strategies are crucial for controlling measles in this vulnerable population.
Area of Science:
- Epidemiology
- Public Health
- Pediatrics
Background:
- Measles outbreaks continue to pose a significant public health threat, particularly in urban settings.
- Understanding the transmission dynamics within specific age groups is critical for effective control strategies.
Purpose of the Study:
- To evaluate the epidemiologic features of a measles epidemic in Chicago during 1983.
- To identify the key population driving measles transmission and assess pre-epidemic immunity levels.
Main Methods:
- Retrospective analysis of 54 measles cases at Wyler Children's Hospital.
- Assessment of measles immunity in preschool-aged children using enzyme-linked immunosorbent assay (ELISA).
- Evaluation of the impact of school-based control measures.
Main Results:
- The majority of measles cases (76%) were in children under 5 years old, with 43% under 16 months.
- Pre-epidemic immunity in preschool-aged children was low, with only 62% having detectable measles antibodies.
- School-based control measures did not significantly alter the epidemic's course.
Conclusions:
- Preschool-aged children were the primary drivers of the 1983 Chicago measles epidemic.
- Low immunization rates in this age group highlight the need for enhanced vaccination strategies.
- Findings underscore the importance of targeting preschool populations for measles control in urban areas.
Abstract:
We evaluated epidemiologic features of 54 patients with measles seen at Wyler Children's Hospital during a 1983 measles epidemic in Chicago. Forty-one (76%) were less than 5 years old, and 23 (43%) were less than 16 months old. We found evidence of a low rate of measles immunity in preschool-aged children of immunization age immediately before the epidemic; only 62% of 173 emergency room patients this age had antibody on enzyme-linked immunosorbent assay. These observations, together with failure of school-based control measures to significantly affect the observed course of the epidemic, indicate that the preschool population sustained the epidemic. Unimmunized preschool-aged children are important in the current epidemiology of measles, and improved immunization strategies are needed to control measles in this population in Chicago and perhaps other cities.