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Outbreak of Measles among School Ages in Yeongju in 2000.
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Hae Kwan Cheong, Geun Ryang Bae, Jin Hwa Jeong, Sue Kyung Park, Byung Chan Park, Jee Hee Kim, Joo Yeon Lee, Byung Kuk Na, Woo Joo Kim
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Korean J Epidemiol. 2004;26(1):69-80.
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Abstract
BACKGROUND
The outbreak of measles from 2000 to 2001 was the biggest epidemic since measles vaccination was introduced in Korea. Outbreak of measles in Yeongju was one of the earliest milestones of the nationwide outbreak in the year 2000. The authors investigated epidemiologic characteristics of the outbreak in this area.METHODS The authors estimated attack rate through the investigation of all the school age cases of measles reported to local health authority between March and May, 2000. Case investigation was done to trace the source of the outbreak. One hundred seventy two cases were examined with medical examination, with interview on their clinical manifestations, and with serologic examination on the anti-measles IgM and IgG antibody.RESULTS Overall attack rate among the school children was 4.3%, with highest attack rate in middle school students (8.5%). The outbreak began in March in middle schools, which spread to elementary and high schools. IgG was positive in 160(93.0%) cases and IgM was positive in 94(54.6%) cases, among which 90 cases (95.7%) were also positive for IgG. IgM positive cases had higher prevalence of rash (91.5%) compared to those without IgM (70.5%). Diagnostic criteria based on the clinical manifestation and contact history showed the highest sensitivity (92.6%) compared to conventional diagnostic criteria in outbreak (40.4-44.7%) CONCLUSIONS: High proportion of susceptible children in the population due to primary or secondary vaccine failure played a key role in this outbreak. Clinical manifestation was milder than classical measles and adjustment of diagnostic criteria can be helpful in the management of outbreak.
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Epidemiologic Investigation of a Mumps Outbreak in a Middle School in Pohang, Korea: Effect of vaccination during outbreak.
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Byung Chan Park, Hae Kwan Cheong, Hyun Sul Lim, Duck Soo Kim, Doohie Kim
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Korean J Epidemiol. 2000;22(2):148-158.
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Abstract
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Abstract
BACKGROUND
There was a widespread outbreak of mumps at elementary and middle schools in Pohang city in March 1999.
We have carried out an epidemiologic survey to trace the source and mode of transmission of the outbreak, as well as evaluating the effect of vaccination as a measure of controlling the outbreak.METHODS Questionnaire survey on 959 students showed that attack rate was 10.7%. There was no significant difference between genders in terms of attack rates. However, second graders outnumbered other groups as 16.9%, comparing to 8.1% among first graders and to 7.0% in the third graders.RESULTS Cases of mumps were reported in 1998, primarily in the neighboring elementary schools. The disease was also reported earlier in 1999, sporadically. In March, however, number of the cases was sharply on the rise as the middle schools opened for a new semester. Our investigation revealed that infection stemmed from more than three different sources, particularly in the classes of second graders, and then spread to all students, corresponding to the distance between students. Effect of vaccination during the outbreak was pretty good: attack rate of the group vaccinated since May 1st, considering the maximum latent period of infections (21 days), was 0.8%, comparing to 5%.
The efficiency of vaccination marked 84.8%.(95% confidence interval 79.66-89.94) Although the authors recommended the students to wear flue masks and wash their hands as often as possible to screen infections among the students, it turned out that such measures had little effect for the prevention of spread.CONCLUSIONS The number of mumps cases dropped remarkably among vaccinated the students the prevalent period of the disease. Authors concluded that is effective to control the outbreak if it is done at early stage.
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