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Interpretation of serological surveillance data for measles using mathematical models: implications for vaccine
N J Gay1, L M Hesketh, P Morgan-Capner
1Immunisation Division, PHLS Communicable Disease Surveillance Centre, London, UK.
Abstract:
Serological surveillance of measles immunity has been carried out in England since 1986/7. Results from sera collected in 1989-91 revealed that the proportion of school age children who were susceptible to measles was increasing, following the introduction of the measles, mumps and rubella vaccination programme in October 1988. Mathematical models are used to interpret these data and determine whether this increasing susceptibility is sufficient to allow a resurgence of disease from the low levels achieved by 1993. The models summarize serological profiles by a single parameter, the reproduction number R, which quantifies the level of herd immunity in the population. Results showed that there was cause for concern over the levels of susceptibility to measles, with an epidemic of over 100,000 cases likely in 1995/6. These predictions are consistent with trends in the incidence and age distribution of measles and have enabled the planning of a major vaccination campaign.
Insights
Measles immunity surveillance in England showed increasing susceptibility in children after the measles, mumps, and rubella vaccine introduction. Mathematical models predicted a potential measles epidemic, prompting a vaccination campaign.
Area of Science:
- Epidemiology
- Immunology
- Public Health
Background:
- Serological surveillance of measles immunity in England began in 1986/7.
- The measles, mumps, and rubella (MMR) vaccination program was introduced in October 1988.
Purpose of the Study:
- To analyze trends in measles immunity following the MMR vaccine introduction.
- To predict potential measles resurgence using mathematical modeling.
- To inform public health strategies for disease control.
Main Methods:
- Serological data from England (1989-91) were analyzed.
- Mathematical models were employed to interpret immunity data.
- The reproduction number (R) was used to quantify herd immunity.
Main Results:
- An increasing proportion of school-aged children were susceptible to measles post-MMR introduction.
- Mathematical models indicated a high likelihood of a measles epidemic (over 100,000 cases) in 1995/6.
- Predictions aligned with observed incidence and age distribution trends.
Conclusions:
- Rising measles susceptibility poses a significant public health concern.
- Predictive modeling is crucial for anticipating disease outbreaks.
- These findings supported the planning of a large-scale vaccination campaign to prevent a measles resurgence.