370 MEASLES IN A PARTIALLY IMMUNIZED POPULATION

Abstract

During the investigation of an outbreak of measles in a partially immunized rural community, a spectrum of illness was observed which ranged in severity from a brief febrile illness to one characteristic of measles. Unimmunized children had more illness (p = 0.009) and more measles (p < 0.001) than immunized children. However, a large proportion of both the immunized and unimmunized children developed a milder illness epidemiologically and serologically associated with measles. The proportion of immunized and unimmunized children who developed the milder, measles-associated illness was not statistically different (p = 0.20).

Employing a trichotomous logistic model, it was demonstrated that the probability of developing both measles and measles-associated illness decreased with increasing age of immunization (p < 0.001) but was unaffected by the interval since immunization (p ≥ 0.12). The age at which immunization could be expected to prevent measles in 95% of cases was 5 years. Reimmunization against measles after 5 years of age may be necessary to effect eradication of epidemic measles. Based upon this model, reimmunization would also be expected to reduce the occurence of measles-associated illness.

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