title: [Investigation on the risk factors for reported rising of measles incidence during November, 2011 to February, 2012, in some areas of Hubei province].
abstract: OBJECTIVE
  To identify the risk factors for reported sudden rise of measles incidence in November, 2011, in some areas of Hubei province.
  
  
  METHODS
  We analyzed all measles patients reported in the measles surveillance system from November 2011 to February 2012 in two prefectures with highest attack rates and their vaccination history by reviewing vaccination records. We interviewed patients' parents by telephone to obtain the history of visiting health care within 7 to 21 days before onset. We also used case-crossover study to estimate the relative risk (RR) of hospital acquired infection and to compare the exposure to health care between 7-21 days before onset to 37-51 days before onset among measles patients.
  
  
  RESULTS
  Totally 140 patients were reported in the two prefectures. Reported measles incidence rates among the population aged <8 m(69/100 000) and 8 m to 17 m (72/100 000) were higher than other age groups (rang from 0 to 5.8 per 100 000). Among the population aged 8 m to 17 m, estimated vaccination coverage was lower than 75%, and it was lower than 90% among those aged 18 m to 3 yrs. During 7-21 days before onset, 58% (29/50) of the patients had an exposure to health care settings, compared to 14% (7/50) of patients during 37 to 51 days before onset (MH RR = 5.4, 95% confidence interval = 2.1-14.0).
  
  
  CONCLUSIONS
  Under the condition of measles vaccination coverage lower than 95%, iatrogenic infection was a risk factor for measles in Hubei.
authors.affiliation: Wuhan Center for Disease Control and Prevention, Wuhan 430015, China; Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention.
authors.forename: Bang-hua
authors.initials: BH
authors.lastname: Chen
authors.forename: Xu-hua
authors.initials: XH
authors.lastname: Guan
authors.forename: Fa-xian
authors.initials: FX
authors.lastname: Zhan
authors.forename: Xue-sen
authors.initials: XS
authors.lastname: Xing
authors.forename: Ming-jiang
authors.initials: MJ
authors.lastname: Zhao
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.forename: Li-jie
authors.initials: LJ
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D016001:Confidence Intervals; D006801:Humans; D015994:Incidence; D007223:Infant; D008457:Measles / Q000453:epidemiology* / Q000517:prevention & control; D012307:Risk Factors