Epidemiologic Notes and Reports Measles Outbreak -- New
York City
Thirty-four confirmed and probable cases of measles were
identified among residents of East Harlem by the New York City
Department of Health from February 8, to May 23, 1984. Eighteen
cases
occurred among females; ages of all patients ranged from 8 months
to
24 years (median 5 years) (Figure 2). Thirty-one cases (91%)
occurred
among Hispanics. Onsets of rash occurred between February 8 and
May
23. No additional suspected cases have occurred.
Measles was discovered simultaneously in two areas of East
Harlem;
a common source of infection was not identified. Exposure occurred
in
several hospitals and in the community but not in any single
location;
elementary schools were affected but had no concentrated outbreaks.
Nineteen cases were confirmed serologically or through
confirmed
epidemiologic links; other cases could not be conclusively linked.
Thirteen cases were vaccine failures; nine occurred among children
under 16 months old; and one occurred in a schoolchild who had not
been vaccinated because of a history of physician-diagnosed
measles.
None of the cases was imported. Of the 11 (32%) preventable cases,
five involved children under 6 years old who were not enrolled in
day-care centers or preschool, and four involved adults 19-24 years
old. These nine cases were defined as "hard-to-reach." Although
conclusive epidemiologic links have been shown for only 19 (56%) of
the 34 cases, this outbreak probably represents a single extended
chain of transmission involving up to seven generations of spread.
Editorial Note
Editorial Note: nA previous large outbreak of measles, involving
primarily preschool-aged and school-aged Hispanic children,
occurred
in the Bronx in the spring of 1983 (1). Unlike the current East
Harlem outbreak, several Bronx cases were traced to an imported
case
from Puerto Rico.
In early April, to control the spread of measles, particularly
among the young preschoolers involved in the current outbreak, the
New
York City Department of Health increased vaccination clinic hours
from
3 to 24 hours of clinic time and recommended measles vaccination
for
children aged 6 months through 11 months in the outbreak area.
Subsequent reimmunization with measles-mumps-rubella vaccine at 15
months of age was recommended for all children vaccinated before
the
first birthday. The New York City Department of Health also
recommended that Harlem children 12 months old or older be
vaccinated
with combined measles-mumps-rubella vaccine (2). This early
immunization policy was discontinued on June 20 after active
surveillance revealed no new cases for 4 weeks (two incubation
periods
of measles).
Reported by City Health Information, Vol. 3 (August 1-8, 1984), New
York City Dept of Health; Div of Field Svcs, Epidemiology Program
Office, CDC.
References
Rutherford GW, Desilva JM, et al. The epidemiology of measles
in
New York City, 1983: the role of imported cases. 19th Annual
Immunization Conference, Boston, Massachusetts, May 22, 1984.
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