ARTICLES
Clinical and epidemiological findings during a measles outbreak occurring in a population with high vaccination coverage
Solange Artimos de Oliveira; Walquíria Nascimento Soares; Marcos Olivier Dalston; Maria Teresa G.N. de Almeida; Antonio José L. Costa
Adress to correspondence
------------
ABSTRACT
From March 1991 to April 1992, 250 measles suspected cases were studied in the Municipality of Niterói, State of Rio de Janeiro. The median age found was 11 years and 76.0% of the cases were in school age children. Exposure histories were present in 149 patients and schools were the most frequent sites of transmission (45.0%). Vaccination status was known for 127 studied cases and 76.4% of them had received measles vaccine before their first birthday. One or more complications were reported for 68 cases aitd in 8.9% of the studied cases hospitalization was required. Frequency of complications varied according to each age group studied and were more commonly encountered among children < 1 year of age (55.6%). The history of previous vaccination did not diminish the number of complications of the cases studied. The results of this work show changes in age distribution of measles leading to sizeable outbreaks among teenagers and young adults.
Keyworks: Measles epidemiology. Vaccine failure. Measles complications.
------------
RESUMO
No período de março de 1991 a abril de 1992, 250 casos de um total de 293 notificados como sarampo em Niterói, RJ foram estudados. Em 75,9% dos casos o sarampo ocorreu em pessoas de idade escolar (mediana: 11). História de exposição estava presmte em 149 pacientes. O local de transmissão variou de acordo com a idade sendo a escola o mais freqüentemente encoiitrado (45%). Em 127 casos o estado vacinai era conhecido e 76,4% deles tinham sido vacinados antes do primeiro aniversário. Em 68 casos uma ou mais complicações estavam presentes e em 8,9% deles a hospitalização foi necessária. Complicações foram mais freqüentes em menores de um ano de idade (55,6%). História de vacinação prévia não diminuiu o número de complicações dos casos estudados. Os resultados deste trabalho mostram mudanças na epidemiologia do sarampo, com alterações na distribuição etária dos casos da doença, leimido ã ocoiTência de importantes surtos da virose entre adolecentes e adultos jovens.
Palavras-chave: Epidemiologia do sarampo. Falha de vacinação. Complicações do sarampo.
------------
Full text available only in PDF format.
Texto completo disponível apenas em PDF.
REFERENCES
1. Atkinson WL, Hadley SC, Redd SB, Orenstein WA. Measles Surveillance - United States. 1991. Morbidity and Mortality Weekly Report 41:1-12, 1992. [ Links ]
2. Barata PCR, Leal MC. Distribuição etária do sarampo e vacinação: considerações sobre alguns dados do Município do Rio de Janeiro. Cadernos de Saúde Pública 1:50-57,1985. [ Links ]
3. Centers for Diseases Control. US Public Health Service. Measles surveillance report no. 11,1977 - 1981. Atlanta, Georgia, 1982. [ Links ]
4. Centers . for Diseases Control. Measles; Washington, 1990. Morbidity and Mortality Weekly Report 39:473-6,1990. [ Links ]
5. Fundação Municipal de Saúde de Niterói. Superintendência de Ações de Saúde. Departamento de Epidemiologia e Controle de Agravos. Informe Epidemiológico - Sarampo p.l- 8,1992. [ Links ]
6. Gustafson TL, Lievens AW, Brunell PA, Moellenberg RG, Buttery CMG, Schulster LM. Measles outbreak in a fully immunized secondary - school population. The New England Journal of Medicine 316:771-774,1987. [ Links ]
7. Judelsohn R, Fleissner ML, O' Mara DJ. School - based measles outbreaks: Correlations of age at immunization with risk of disease. American Journal Public Health 70:1162-1165,1980. [ Links ]
8. Krause PJ, Cherry JD, Deseda-Tous J, Champion JG, Strassburg M, Sullivan C, Spencer MJ, Bryson YJ, Welliver RC, Boyer KM. Epidemic measles in young adults. Annals of Internal Medicine 90:873- 876,1979. [ Links ]
9. Krugman KD, Meyer BC, Parkman PD, Wittle JJ, Meyer HM. Impotency of live - virus vaccines as a result of improper handling in clinical practice. The Journal of Pediatrics 91:512-514,1974. [ Links ]
10. Krugman S. Present status of measles and rubella immunization in the United States. A medical progress report. The Journal of Pediatrics 78:1, 1971. [ Links ]
11. Linnemannjr CC,RotteTC, Schiff GM,YoutseyJL. A seroepidemiologic study of a measles epidemic in a highly immunized population. American Journal of Epidemiology 95:238-246,1972. [ Links ]
12. Manson WH, Ross LA, Lanson J, Wright Jr HT. Epidemic measles in the postvaccine era: evaluation of epidemiology, clinical presentation and complications during an urban outbreak.The Pediatric Infectious Disease Journal 12:42-48, 1993. [ Links ]
13. Ministério da Saúde. Fundação Nacional de Saúde. Capacitação de Pessoal para a Vigilância Epidemiológica do Sarampo. Módulo Institucional I. Brasília p. 1-77,1992. [ Links ]
14. Nagy G, Kósa S,Takátsy S, Roller M.The use of IgM tests for analysis of the cause of measles failures: experience gained in an epidemic in Hungary in 1980 and 1981.Journal of Medical Virology 13:93- 103,1984. [ Links ]
15. Oliveira SA, Homma A, Camillo-Coura L, Loureiro MLR Almeida MTGN. Antimeasles antibodies in children submitted to different vaccination schedules. Revista da Sociedade Brasileira de Medicina Tropical 26:77-82,1993. [ Links ]
16. Oliveira SA, Homma A, Mahul DC, Loureiro MLR Camillo-Coura L. Avaliação das condições de estocagem da vacina contra o sarampo nas unidades sanitárias dos Municípios de Niterói e São Gonçalo - Estado do Rio de Janeiro. Revista do Instituto de Medicina Tropical de São Paulo 33:313-318,1991. [ Links ]
17. Oliveira SA, Loureiro MLR Kiffer CRX Maduro LMF. Re-evaluation of the basic procedures involved in the storage of measles vaccine in public health units of the Municipality of Niterói, State of Rio de Janeiro, Brazil. Revista da Sociedade Brasileira de Medicina Tropical 26:145- 149,1993. [ Links ]
18. Plotkin SA. Failures of protection by measles vaccine. The Journal of Pediatrics 82:908-911, 1973. [ Links ]
19. Schaffner W, Schlederberg AES, Byrne EB. Clinical epidemiology of sporadic measles in a highly immunized population.The New England Journal of Medicine 279:783-789,1968. [ Links ]
20. Shasby M, Shope TC, Downs H, Herrmann KL, Polkowski J. Epidemic measles in a highly vaccinated population.The New England Journal of Medicine 296:585-589, 1977. [ Links ]
21. Smith FR, CurranAS, RacitiAK, Black FL. Reported measles in person immunologically primed by prior vaccination. The Journal of Pediatrics 90:391-393,1982. [ Links ]
22. Wyll SA, Witte JJ. Measles in previously vaccinated children. An epidemiological study.The Journal of American Medical Association 216:1306-1310, 1971. [ Links ]
Recebido para publicação em 10/02/95.
Disciplina de Doenças Infecciosas e Parasitárias da Universidade Federal Fluminense, Niterói, RJ e Fundação Municipal de Saúde de Niterói, RJ, Brasil.
Supported by CNPq grant n° 501840/91-5 and PROPP/Universidade Federal Fluminense.
Adress to correspondence:
Dra Solange Artimos de Oliveira.
Disciplina de Doenças Infecciosas e Parasitárias, Hospital Universitário Antonio Pedro.
R. Marquês do Paraná 303/2° andar, 24033-210
Niterói, RJ ,Brasil.
Fax: (021) 717-4459.
You have requested "on-the-fly" machine translation of selected content from our databases. This functionality is provided solely for your convenience and is in no way intended to replace human translation. Show full disclaimer
Neither ProQuest nor its licensors make any representations or warranties with respect to the translations. The translations are automatically generated "AS IS" and "AS AVAILABLE" and are not retained in our systems. PROQUEST AND ITS LICENSORS SPECIFICALLY DISCLAIM ANY AND ALL EXPRESS OR IMPLIED WARRANTIES, INCLUDING WITHOUT LIMITATION, ANY WARRANTIES FOR AVAILABILITY, ACCURACY, TIMELINESS, COMPLETENESS, NON-INFRINGMENT, MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. Your use of the translations is subject to all use restrictions contained in your Electronic Products License Agreement and by using the translation functionality you agree to forgo any and all claims against ProQuest or its licensors for your use of the translation functionality and any output derived there from. Hide full disclaimer
Copyright Sociedade Brasileira de Medicina Tropical Oct/Dec 1995
Abstract
From March 1991 to April 1992, 250 measles suspected cases were studied in the Municipality of Niterói, State of Rio de Janeiro. The median age found was 11 years and 76.0% of the cases were in school age children. Exposure histories were present in 149 patients and schools were the most frequent sites of transmission (45.0%). Vaccination status was known for 127 studied cases and 76.4% of them had received measles vaccine before their first birthday. One or more complications were reported for 68 cases aitd in 8.9% of the studied cases hospitalization was required. Frequency of complications varied according to each age group studied and were more commonly encountered among children < 1 year of age (55.6%). The history of previous vaccination did not diminish the number of complications of the cases studied. The results of this work show changes in age distribution of measles leading to sizeable outbreaks among teenagers and young adults.
You have requested "on-the-fly" machine translation of selected content from our databases. This functionality is provided solely for your convenience and is in no way intended to replace human translation. Show full disclaimer
Neither ProQuest nor its licensors make any representations or warranties with respect to the translations. The translations are automatically generated "AS IS" and "AS AVAILABLE" and are not retained in our systems. PROQUEST AND ITS LICENSORS SPECIFICALLY DISCLAIM ANY AND ALL EXPRESS OR IMPLIED WARRANTIES, INCLUDING WITHOUT LIMITATION, ANY WARRANTIES FOR AVAILABILITY, ACCURACY, TIMELINESS, COMPLETENESS, NON-INFRINGMENT, MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. Your use of the translations is subject to all use restrictions contained in your Electronic Products License Agreement and by using the translation functionality you agree to forgo any and all claims against ProQuest or its licensors for your use of the translation functionality and any output derived there from. Hide full disclaimer