Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Comparative Epidemiologic Survey of Measles in Two Primary Schools

2000년 영덕군 홍역 유행시 유행 차이에 따른 2개 초등학교 일부 학생에 대한 역학 조사

  • Park, Sue-Kyung (Department of Preventive Medicine, Dongguk University College of Medicine) ;
  • Kim, Jee-Hee (Laboratory of Respiratory Viruses, Department of Viral Diseases, National Institute of Health) ;
  • Lee, Joo-Yeon (Laboratory of Respiratory Viruses, Department of Viral Diseases, National Institute of Health) ;
  • Na, Byoung-Kuk (Laboratory of Respiratory Viruses, Department of Viral Diseases, National Institute of Health) ;
  • Kim, Woo-Joo (Laboratory of Respiratory Viruses, Department of Viral Diseases, National Institute of Health) ;
  • Cheong, Hae-Kwan (Department of Preventive Medicine, Dongguk University College of Medicine)
  • 박수경 (동국대학교 의과대학 예방의학교실) ;
  • 김지희 (국립보건원 바이러스질환부 호흡기계 바이러스과) ;
  • 이주연 (국립보건원 바이러스질환부 호흡기계 바이러스과) ;
  • 나병국 (국립보건원 바이러스질환부 호흡기계 바이러스과) ;
  • 김우주 (국립보건원 바이러스질환부 호흡기계 바이러스과) ;
  • 정해관 (동국대학교 의과대학 예방의학교실)
  • Published : 2001.06.01
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Abstract

Objectives : During March-May, 2000, a measles outbreak occurred at Youngduk, Korea. This county is divided into two areas with different historical and socioeconomic background. The outbreak occurred in one of these areas. We conducted a comparative epidemiologic study on the two areas in order to evaluate the factors related to the epidemic. Materials and Methods : We selected two groups, grades 3 and 5 in a primary schools in each area. We investigated outbreak-related factors using parent-questionnaires, the vaccination history from the student's health record and the records concerning the recent measles-outbreak from the local health center. Serologic test on measles-IgG and -IgM antibody was done. Results : The infection rate was 31.5% for the epidemic area and 3.7% for non-the epidemic area according to clinical or serological criteria (p<0.001). No difference was seen in the measles vaccination rate, residence at the time of vaccination or past measles infection history between the two areas. In the epidemic area, the attack rate for the 4-6 year-old MMR booster group(20.5%) was higher than the non-booster group(32.4%), but was not found significantly. Vaccine efficacy was 29.6% in the epidemic area and 87.0% in the non-epidemic area (p<0.001). The IgG level and positive rate were significantly different between the two areas (median 10727 IU/ml, 98.9% in epidemic area; median 346 IU/ml, 85.9% in the non-epidemic area, p<0.001). However, the IgG level and positive rate between the measles-cases and non-cases were not significantly different. Conclusions : This outbreak took place in mostly vaccinated children. These results suggest that a reduction of herd immunity for immunity failure after vaccination may be one of the feasible factors related to the outbreak pattern in the two areas. The results of the IgG level and positive rate suggest that re-establishment of a normal value for IgG level and of a qualitative method for IgG are needed.

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