title: Measles outbreaks affecting children in Jewish ultra-orthodox communities in Jerusalem.
abstract: In 2003 and 2004 two measles outbreaks occurred in Jewish ultra-orthodox communities in Jerusalem. The index case of the first outbreak (March 2003) was a 2-year-old unvaccinated child from Switzerland. Within 5 months, 107 cases (mean age 8.3+/-7.5 years) emerged in three crowded neighbourhoods. The first cases of the second outbreak (June 2004) were in three girls aged 4-5 years in one kindergarten in another community. By November 2004, 117 cases (mean age 7.3+/-6.5 years) occurred. The virus genotypes were D8 and D4 respectively. Altogether, 96 households accounted for the two outbreaks, with two or more patients per family in 79% of cases. Most cases (91.5%) were unvaccinated. Immunization coverage was lower in outbreak than in non-outbreak neighbourhoods (88.3% vs. 90.3%, P=0.001). Controlling the outbreaks necessitated a culture-sensitive approach, and targeted efforts increased MMR vaccine coverage (first dose) to 95.2%. Despite high national immunization coverage (94-95%), special attention to specific sub-populations is essential.
authors: Jerusalem District Health Office, Ministry of Health, Jerusalem, Israel. chen@lbjer.health.gov.il
authors: C
authors: C
authors: Stein-Zamir
authors: G
authors: G
authors: Zentner
authors: N
authors: N
authors: Abramson
authors: H
authors: H
authors: Shoob
authors: Y
authors: Y
authors: Aboudy
authors: L
authors: L
authors: Shulman
authors: E
authors: E
authors: Mendelson
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017053:Infection Control / Q000379:methods; D007557:Israel / Q000453:epidemiology; D008297:Male; D008457:Measles / Q000453:epidemiology* / Q000276:immunology; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage / Q000276:immunology; D018103:Morbillivirus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*
chemical_list: D022542:Measles-Mumps-Rubella Vaccine