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Identifying risk factors associated with acquiring measles in an outbreak among age-appropriately vaccinated school children: a cohort analysis

Irish Journal of Medical Science (1971 -) volume 188, pages 193–199 (2019)Cite this article

Abstract

Background

A measles outbreak occurred in age-appropriately vaccinated children in a school in a town in the South East of Ireland in September–November 2013.

Aims

The purpose of this study was to investigate the risk factors associated with catching measles during the outbreak.

Methods

Ninety-five children (4–5 years) in three classes, in the first year of primary school, were included in the study. Immunisation records on the South East Child Health Information System for first Measles Mumps and Rubella (MMR) vaccine for the 95 children were reviewed. Data collected included age at MMR, date of administration of MMR, MMR brand and batch number, and the General Practice at which MMR was administered. The risk factors analysed included age at vaccination, time of vaccination, class and the GP practice where MMR was administered. Statistical analysis was performed using Epi info 7 and SPSS v24.

Results

Thirteen children in the cohort developed measles during the outbreak. All children in the cohort were age-appropriately vaccinated, with one dose of MMR vaccine. Analysis demonstrated statistically significant differences in the relative risk of developing measles according to the class a child was in, and the General Practice at which they were vaccinated.

Conclusions

The reason for intense measles activity in one class was not established. Although a concurrent investigation into cold chain and vaccine stock management did not identify a cause for the high relative risk of measles in children vaccinated, recommendations were made for improving cold chain and vaccine stock management in General Practices.

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Acknowledgements

The authors acknowledge Dr. Elyce McGovern and Dr. Helena Murray and thank all the members of the outbreak and incident control teams, the Child Health Office, Consultant Microbiologists, General Practitioners, HSE South East Information and Communications Technology Department, schools, National Immunisation Office, National Virus Reference Laboratory and the Health Protection Surveillance Centre.

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Affiliations

  1. Department of Public Health, Health Service Executive South East, Lacken, Dublin Road, Kilkenny, R95 P231, Ireland

    Bernadette O’Connor & Sarah Doyle

Authors
  1. Bernadette O’Connor
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  2. Sarah Doyle
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Corresponding author

Correspondence to Sarah Doyle.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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O’Connor, B., Doyle, S. Identifying risk factors associated with acquiring measles in an outbreak among age-appropriately vaccinated school children: a cohort analysis. Ir J Med Sci 188, 193–199 (2019). https://doi.org/10.1007/s11845-018-1803-4

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  • DOI: https://doi.org/10.1007/s11845-018-1803-4

Keywords

  • Cohort
  • Measles
  • Outbreak
  • Vaccination