title: High risk of a large measles outbreak despite 30 years of measles vaccination in The Netherlands.
abstract: Our aim was to assess progress towards measles elimination from The Netherlands by studying humoral measles immunity in the Dutch population. A population-based seroepidemiological study was conducted in 2006-2007 (N = 7900). Serum samples were analysed by a bead-based multiplex immunoassay. IgG levels ⩾0·2 IU/ml were considered protective. The overall seroprevalence in the Dutch population was 96%. However, 51% of socio-geographically clustered orthodox Protestant individuals aged <10 years were susceptible. Infants might be susceptible to measles between ages 4 months and 14 months, the age at which maternal antibodies have disappeared and the first measles, mumps, rubella (MMR) vaccination is administered, respectively. Waning of antibody concentrations was slower after the second MMR vaccination than after the first. The Netherlands is at an imminent risk of a measles outbreak in the orthodox Protestant minority. To prevent subsequent transmission to the general population, efforts to protect susceptible age groups are needed.
authors.affiliation: National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Mollema
authors.affiliation: National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, The Netherlands.
authors.forename: G P
authors.initials: GP
authors.lastname: Smits
authors.affiliation: National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, The Netherlands.
authors.forename: G A
authors.initials: GA
authors.lastname: Berbers
authors.affiliation: National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, The Netherlands.
authors.forename: F R
authors.initials: FR
authors.lastname: Van Der Klis
authors.affiliation: National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, The Netherlands.
authors.forename: R S
authors.initials: RS
authors.lastname: Van Binnendijk
authors.affiliation: National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, The Netherlands.
authors.forename: H E
authors.initials: HE
authors.lastname: De Melker
authors.affiliation: National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, The Netherlands.
authors.forename: S J M
authors.initials: SJ
authors.lastname: Hahné
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008457:Measles / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D022542:Measles-Mumps-Rubella Vaccine / Q000276:immunology*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial; D022542:Measles-Mumps-Rubella Vaccine
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