title: The changing epidemiology of hospitalized pediatric patients in three measles outbreaks.
abstract: OBJECTIVE
  To assess the demographic and clinical findings of measles patients during three epidemics from 1989 to 2001.
  
  
  METHODS
  A total 520 medical records of measles patients were analyzed retrospectively and divided into three groups; those who were admitted during 1989-1990 (group I, 116 patients), those admitted during 1993-1994 (group II, 127 patients), and those admitted during 2000-2001 (group III, 277 patients).
  
  
  RESULTS
  For the age distribution, there was no difference in the proportion of < 2 years of age (61%, 58% and 57%, respectively) for the three groups. However, in each outbreak, there were significant differences in the distribution of > or = 2 years children who had mostly received one-dose measles-mumps-rubella (MMR) vaccination. The age distribution had changed with a significant increase in older children in subsequent outbreaks. In the last 2000-2001 outbreak, there was a pattern for increased attack rates with increasing interval since the initial vaccination. There was no statistical difference between the three groups in gender ratio, MMR vaccination rate in > or = 2 years of age, duration of fever, and complications. No difference was found in all the clinical and laboratory parameters between the anti-measles IgM antibody negative patients and the positive patients.
  
  
  CONCLUSIONS
  The age distribution of admitted children with measles in each outbreak has changed over time since the introduction of one-dose MMR vaccination. This finding suggests that the secondary vaccine failure may have played a large role in the last measles outbreak.
authors.affiliation: Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. leekyungyil@catholic.ac.kr
authors.forename: Kyung-Yil
authors.initials: KY
authors.lastname: Lee
authors.forename: Hyung-Shin
authors.initials: HS
authors.lastname: Lee
authors.forename: Jae-Kyun
authors.initials: JK
authors.lastname: Hur
authors.forename: Jin-Han
authors.initials: JH
authors.lastname: Kang
authors.forename: Byung-Churl
authors.initials: BC
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000914:Antibodies, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007223:Infant; D007231:Infant, Newborn; D007723:Korea / Q000453:epidemiology; D008297:Male; D008457:Measles / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D008459:Measles virus / Q000276:immunology; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage*; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M; D022542:Measles-Mumps-Rubella Vaccine