title: Measles outbreak on a college campus transmitted through internet cafés.
abstract: BACKGROUND
  During March 2008, a college in Urumqi, capital of Xinjiang Uygur Autonomous Region in China, reported a measles outbreak, amid a city-wide outbreak involving >2700 cases.
  
  
  METHODS
  Suspected case patients were defined as patients with onset of fever (≥38°) and rash between 7 March and 30 April 2008. Probable case patients were defined as suspected case patients with >3 days of rash or known exposure to someone with laboratory-confirmed measles. Confirmed case patients were defined as suspected or probable case patients with Koplik spots or positive titer for immunoglobulin M antibody. We conducted a case-control investigation to identify risk factors for transmission.
  
  
  RESULTS
  We identified 162 suspected (attack rate, 1.9%), 99 probable, and 62 confirmed case patients. The epidemic curve indicated a point source initially, followed by person-to-person transmission. Approximately 63% of 90 probable case patients and 27% of 150 asymptomatic student controls randomly selected among classmates of student case patients visited internet cafés during the exposure period (odds ratio [OR], 4.5; 95% confidence interval [CI], 2.6-8.0); 66% of case patients and 45% of student controls reported close contact with a measles case patient (OR, 2.3; 95% CI, 1.3-3.9). In stratified analysis, visiting internet cafés (OR, 4.0; 95% CI, 1.5-11) remained significantly associated with disease, but contact with case patients (OR, 1.9; 95% CI, .79-4.4) became nonsignificant.
  
  
  CONCLUSIONS
  This measles outbreak was transmitted in internet cafés, followed by secondary transmission. Chinese universities should require proof of immunity or 2 doses of measles vaccine at college entry.
authors.affiliation: Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Jin
authors.forename: Huilai
authors.initials: H
authors.lastname: Ma
authors.forename: Lijie
authors.initials: L
authors.lastname: Zhang
authors.forename: Hua
authors.initials: H
authors.lastname: He
authors.forename: Mahemuti
authors.initials: M
authors.lastname: Yisimaer
authors.forename: Min
authors.initials: M
authors.lastname: Chen
authors.forename: Baoling
authors.initials: B
authors.lastname: Rui
authors.forename: Bateer
authors.initials: B
authors.lastname: Axigeburen
authors.forename: Jinggong
authors.initials: J
authors.lastname: Hao
authors.forename: Meiying
authors.initials: M
authors.lastname: Sun
authors.forename: Feng
authors.initials: F
authors.lastname: Gao
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Abudureyimu
authors.initials: A
authors.lastname: Abudukelimu
authors.forename: Jinglin
authors.initials: J
authors.lastname: Chen
authors.forename: Qiong
authors.initials: Q
authors.lastname: Li
authors.forename: Mei
authors.initials: M
authors.lastname: Shen
authors.forename: Yanping
authors.initials: Y
authors.lastname: Shi
authors.forename: Zurexi
authors.initials: Z
authors.lastname: Hezati
authors.forename: Tiejun
authors.initials: T
authors.lastname: Li
authors.forename: Haiying
authors.initials: H
authors.lastname: Chen
authors.forename: Juan
authors.initials: J
authors.lastname: Chen
authors.forename: Bao-Ping
authors.initials: BP
authors.lastname: Zhu
mesh_terms: D000391:Air Microbiology; D000914:Antibodies, Viral / Q000097:blood; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D020407:Internet; D008297:Male; D008457:Measles / Q000453:epidemiology* / Q000635:transmission*; D008459:Measles virus / Q000276:immunology; D016017:Odds Ratio; D012307:Risk Factors; D013334:Students / Q000145:classification; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M