title: Measles epidemic in the Netherlands, 1999-2000.
abstract: In 1999-2000, a measles epidemic occurred in The Netherlands, with 3292 reported cases; 94% of the affected patients had not been vaccinated. Only 1 patient had received 2 doses of vaccine. Three patients died, and 16% had complications. For the unvaccinated population, the incidence per 1000 inhabitants 15 months to 14 years old increased from 83 (95% confidence interval [CI], 53-113), in municipalities with vaccine coverage rates < or =90%, to 200 (95% CI, 153-247), in municipalities with coverage rates >95%; for the vaccinated population, the incidence increased from 0.2 (95% CI, 0.1-0.4) to 1.4 (95% CI, 0.9-1.9). Unvaccinated individuals were 224 times (95% CI, 148-460 times) more likely to acquire measles than were vaccinated individuals; the relative risk increased with decreasing vaccine coverage. Herd immunity outside unvaccinated clusters was high enough to prevent further transmission. More case patients came from the vaccine-accepting population living among unvaccinated clusters than from individuals who declined vaccination and who lived among the vaccine-accepting population.
authors.affiliation: National Institute of Public Health and the Environment, Department of Infectious Diseases Epidemiology, Bilthoven, The Netherlands. Susan.van.den.Hof@rivm.nl
authors.forename: Susan
authors.initials: S
authors.lastname: van den Hof
authors.forename: Marina A E
authors.initials: MA
authors.lastname: Conyn-van Spaendonck
authors.forename: Jim E
authors.initials: JE
authors.lastname: van Steenbergen
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008457:Measles / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D008458:Measles Vaccine / Q000008:administration & dosage; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011014:Pneumonia / Q000209:etiology; D014611:Vaccination
chemical_list: D008458:Measles Vaccine