Current Trends Measles -- United States, First 17 Weeks,
1984
From January 1, 1984, to May 5, 1984 (the year's first 17
reporting weeks), a provisional total of 968 measles cases was
reported in the United States. This is a 46.2% increase from the
same
period in 1983 (Figure 1).
Seventy-nine (2.5%) of the nation's 3,138 counties reported
measles in the 17-week period, compared with 56 (1.8%) in the same
period of 1983. Of the 968 cases, 831 (85.8%) were part of 14
chains
of transmission. The three largest chains--in California,
Michigan,
and Texas--accounted for 56.2% (544/968) of the total cases (Figure
2). The chains in California and Michigan primarily involved
junior
and senior high-school students. The Texas outbreak is still under
investigation.
A provisional total of 42 international importations was
reported
during the first 17 weeks of 1984, an average of 2.5 cases per
week,
compared with 95 (5.6 cases per week) in the same period in 1983.
Reported by Div of Immunization, Center for Prevention Svcs, CDC.
Editorial Note
Editorial Note: Chains of measles transmission in 1984 have been
concentrated primarily among school-aged children. This is a
change
from 1983, when most documented transmission occurred outside
primary
and secondary schools (1). While lack of enforcement of
immunization
laws factored in some of the outbreaks, some of the 1984
school-based
chains of transmission occurred in schools with high immunization
levels (in excess of 95%). The reasons for these outbreaks are not
yet clear and are currently under investigation. Nevertheless,
county-specific data indicate that most areas of the country are
still
free of measles.
The observation that measles outbreaks sometimes can occur
among
the small proportion of vaccine failures demonstrates the
importance
of strict adherence to immunization requirements to minimize the
remaining number of susceptibles. Whenever students are admitted
to
school provisionally, their immunization records should be
completed
promptly. Noncompliant students should be excluded from school
attendance. Experience has demonstrated that strict exclusion of
such
students results in high immunization levels, with minimal delay
and
minimal disruption of routine activities (2). School officials
should
maintain a permanent register of students who are not vaccinated
because of medical, religious, or philosophic exemption, to allow
rapid identification and exclusion of such students during an
outbreak.
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