title: [Measles epidemic in a highly developed country: low mortality, high morbidity and extensive costs].
abstract: BACKGROUND
  Vaccination with 2 doses of > 95% of the population is necessary to eliminate measles. In Switzerland and especially in the central part, vaccine coverage is low (2006: 65%). This led 2006-2009 to a measles epidemic with thousands of cases and high costs. One death was noted in a formerly healthy 12 year old girl.
  
  
  METHODS
  All measles cases, either hospitalized or reported to the authority, in the canton Lucerne between 2006 and 2009 were included. Course, complications, immunization rates and costs of the hospitalized children were analyzed.
  
  
  RESULTS
  A total of 1 041 cases of measles were recorded; 758 (73%) were children < 16 years of age. 56 (6%) of the patients were admitted to hospital; half of them were children (n=26, admission rate 3.4%). Main complications were pneumonia with oxygen requirement (n=19), bacterial infections of the base of the skull (n=2) and acute measles encephalitis (n=3). One child each developed acute appendicitis and diabetes mellitus type 1. No death was noted. Median hospitalisation costs were 18 780 CHF. The surveillance system was incomplete: Every third admitted child was not reported to the authority.
  
  
  CONCLUSIONS
  Due to low vaccine coverage measles still account for epidemics with high morbidity and extensive costs. Instant reporting of all cases is crucial for disease control. Early identification of persons at risk allows timely immunization. Switzerland will remain of central importance to eliminate measles in Europe by 2015.
authors.affiliation: Pädiatrie, Kinderspital Luzern, Schweiz.
authors.forename: A
authors.initials: A
authors.lastname: Donas
authors.affiliation: AMN Public Health Consulting, Luzern, Schweiz.
authors.forename: A
authors.initials: A
authors.lastname: Marty-Nussbaumer
authors.affiliation: Gesundheits- und Sozialdepartement, Dienststelle Gesundheit, Kanton Luzern, Schweiz.
authors.forename: H-P
authors.initials: HP
authors.lastname: Roost
authors.affiliation: Pädiatrie, Kinderspital Luzern, Schweiz.
authors.forename: T J
authors.initials: TJ
authors.lastname: Neuhaus
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019049:Developed Countries; D018563:Disease Notification; D058872:Epidemics / Q000191:economics* / Q000706:statistics & numerical data*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007117:Immunization, Secondary / Q000706:statistics & numerical data; D007223:Infant; D008297:Male; D032541:Mass Vaccination / Q000706:statistics & numerical data; D008457:Measles / Q000150:complications / Q000191:economics* / Q000401:mortality* / Q000517:prevention & control; D008458:Measles Vaccine / Q000008:administration & dosage; D012189:Retrospective Studies; D016019:Survival Analysis; D013557:Switzerland; D014600:Utilization Review / Q000706:statistics & numerical data
chemical_list: D008458:Measles Vaccine