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Measles outbreak in Juneau, Alaska, 1996: implications for future outbreak control strategies
1Division of Applied Public Health Training, Epidemiology Program Office, New Mexico Department of Health, Las Cruces, NM 88001, USA.
Pediatrics
|December 2, 1998
Summary
Targeted or community-wide school revaccination effectively controlled measles outbreaks. As two-dose measles-containing vaccine (MCV) coverage rises, public health strategies for school outbreaks require reevaluation for optimal response.
Area of Science:
- Epidemiology
- Public Health
- Vaccinology
Background:
- Measles outbreaks in schools pose a significant public health challenge.
- Increasing two-dose measles-containing vaccine (MCV) coverage necessitates reevaluation of existing outbreak control strategies.
Purpose of the Study:
- To determine the most effective outbreak control strategy for school-based measles outbreaks.
- To assess strategies in the context of rising two-dose MCV coverage.
Main Methods:
- Retrospective evaluation of a 1996 measles outbreak in Juneau, Alaska.
- Analysis of chain-of-transmission data for three control strategies: no revaccination, targeted school revaccination, and community-wide school revaccination.
- Estimation of two-dose MCV coverage using school records and parent surveys.
Main Results:
- Two-dose MCV coverage was 44% before and 53% after the outbreak.
- Targeted and community-wide revaccination could have prevented an estimated 24-31 cases.
- Both strategies could have reduced outbreak duration by one month, sparing unvaccinated children and affected schools.
Conclusions:
- Both targeted and community-wide school revaccination are effective control strategies for measles outbreaks.
- Targeted school revaccination is recommended for larger communities with higher two-dose MCV coverage.
- Public health control measures for school measles outbreaks must adapt to increasing vaccination rates.