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Measles epidemic from failure to immunize

L G Dales1, K W Kizer, G W Rutherford

  • 1Immunization Branch, California Department of Health Services, Berkeley 94704.

The Western Journal of Medicine
|October 1, 1993
PubMed
Summary

California

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Area of Science:

  • Epidemiology
  • Public Health
  • Infectious Disease Control

Background:

  • California experienced a severe measles epidemic from 1988-1990, with over 16,400 cases and 75 deaths.
  • The epidemic disproportionately affected young children, particularly infants under 12 months, and low-income Hispanic communities.
  • Low immunization rates among preschool-aged children and young adults were identified as the primary cause.

Purpose of the Study:

  • To analyze the epidemiology and impact of the 1988-1990 California measles epidemic.
  • To evaluate the effectiveness of outbreak control measures and identify challenges.
  • To highlight the public health and economic consequences of low vaccination coverage.

Main Methods:

  • Retrospective analysis of reported measles cases, hospital admissions, and deaths.
  • Examination of demographic data, focusing on age and community demographics.
  • Assessment of immunization levels and outbreak control strategies.

Main Results:

  • The epidemic resulted in 16,400 cases, 3,390 hospitalizations, and 75 deaths, with highest incidence in infants.
  • Complication, hospitalization, and mortality rates were notably high.
  • Outbreak control efforts faced challenges including underfunding and poor public engagement, with limited success.
  • The estimated cost of medical care and control was $30.9 million.

Conclusions:

  • Low immunization coverage is a critical factor driving recurrent measles epidemics.
  • Sustained efforts to increase immunization rates in young children are essential for prevention.
  • Future outbreaks pose a significant public health and economic burden if vaccination levels do not improve.

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