Epidemiologic Notes and Reports
Measles Outbreak -- Chicago, 1989
As of August 23, 1989, 1123 confirmed cases of measles have
been
reported to the Chicago Department of Health. Information is
available
for 1019 (91%) of these cases; 799 (78%) have occurred in
preschool-aged children ( less than 5 years old), including 340
(33%)
children less than 16 months of age (i.e., too young for routine
immunization). Blacks and Hispanics have accounted for 955 (94%) of
the
cases. Four measles-associated fatalities have been reported.
Outbreak-control activities have included intensified
surveillance
and lowering of the recommended age for measles vaccination to 6
months
during the outbreak, with revaccination at age 15 months for
children
vaccinated before the first birthday. Single-antigen measles
vaccine is
being used for children before the first birthday, and
measles-mumps-rubella vaccine (MMR) is administered to older
children.
Seven new vaccination clinics have been established and have
administered approximately 21,000 doses of vaccine; door-to-door
vaccination teams in high-risk communities have administered an
additional 2000 doses of vaccine. Hospital emergency department
vaccination clinics have been set up in four locations.
Reported by: RM Krieg, PhD, RW Biek, MD, CR Catania, JW Masterson,
MPH,
Chicago Dept of Health; R March, Immunization Program, RJ Martin,
DVM,
Div of Infectious Diseases, Illinois Dept of Public Health. Div of
Immunization, Center for Prevention Svcs, CDC.
Editorial Note
Editorial Note: This outbreak is similar to others among inner-city
populations in the United States in that it involves primarily
unvaccinated black and Hispanic preschool-aged children (1-3). The
Chicago Department of Health has implemented aggressive outbreak
strategies directed toward reaching the highest-risk group, i.e.,
unvaccinated preschool-aged children. Such children are also likely
to
be a reservoir for transmitting virus to other age groups. As part
of
the extensive outbreak-control efforts, children are being
vaccinated
in emergency departments. Provision of vaccine to inner-city
children
who use these facilities for their primary source of health care
should
help to increase vaccination levels in patients who receive
sporadic
health care and may reduce the transmission of measles in emergency
department settings.
References
CDC. Measles--Dade County, Florida. MMWR 1987;36:45-8.
CDC. Measles--Los Angeles County, California, 1988. MMWR
1989;38:49-52,57.
Markowitz LE, Preblud SR, Orenstein WA, et al. Patterns of
transmission in measles outbreaks in the United States, 1985-1986.
N
Engl J Med 1989;320:75-85.
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