title: Measles incidence estimations based on the notification by general practitioners were suboptimal.
abstract: OBJECTIVE
  The aim of this study was to determine the notification by general practitioners (GPs) to the Municipal Health Service (MHS) and the presentation of measles complaints by patients to the GP during a measles epidemic in a 78% vaccinated population.
  
  
  METHODS
  Measles cases in children under 13 years were identified via questionnaires, GPs' records, and MHS's records. Consultation rate, notification rate, and completeness of notification were determined. Determinants of consultation were identified by multivariable logistic regression analysis.
  
  
  RESULTS
  Among 1654 responders, 164 measles cases were identified. Consultation rate: 30%; notification rate: 30% (range among GPs: 0-62%); completeness of notification: 9%. Determinants of GP consultation: perceived seriousness of illness (adjusted OR 45; 95% CI: 6-347), self-reported complications (adjusted OR 9; 95% CI: 1-70), and need to consult for respiratory tract infections (adjusted OR 8; 95% CI: 1-51).
  
  
  CONCLUSIONS
  Incidence estimations based on the notification by GPs to the MHS are suboptimal for measles in The Netherlands. Perceived seriousness of illness seemed to be the most important factor to consult.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85060, Utrecht 3508 AB, The Netherlands.
authors.forename: Chantal E D
authors.initials: CE
authors.lastname: van Isterdael
authors.forename: Gerrit A
authors.initials: GA
authors.lastname: van Essen
authors.forename: Marijke M
authors.initials: MM
authors.lastname: Kuyvenhoven
authors.forename: Arno W
authors.initials: AW
authors.lastname: Hoes
authors.forename: Wim A B
authors.initials: WA
authors.lastname: Stalman
authors.forename: Niek J
authors.initials: NJ
authors.lastname: de Wit
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D018563:Disease Notification / Q000706:statistics & numerical data; D004196:Disease Outbreaks; D005191:Family Characteristics; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008457:Measles / Q000175:diagnosis / Q000453:epidemiology*; D009426:Netherlands / Q000453:epidemiology; D012680:Sensitivity and Specificity; D012737:Sex Factors; D014611:Vaccination