title: Measles Outbreak Associated with Vaccine Failure in Adults--Federated States of Micronesia, February-August 2014.
abstract: On May 15, 2014, CDC was notified of two laboratory-confirmed measles cases in the Federated States of Micronesia (FSM), after 20 years with no reported measles. FSM was assisted by the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), and CDC in investigating suspected cases, identify contacts, conduct analyses to guide outbreak vaccination response, and review vaccine cold chain practices. During February–August, three of FSM’s four states reported measles cases: Kosrae (139 cases), Pohnpei (251), and Chuuk (3). Two thirds of cases occurred among adults aged ≥20 years; of these, 49% had received ≥2 doses of measles-containing vaccine (MCV). Apart from infants aged <12 months who were too young for routine vaccination, measles incidence was lower among children than adults. A review of current cold chain practices in Kosrae revealed minor weaknesses; however, an absence of historical cold chain maintenance records precluded an evaluation of earlier problems. Each state implemented vaccination campaigns targeting children as young as age 6 months through adults up to age 57 years. The preponderance of cases in this outbreak associated with vaccine failure in adults highlights the need for both thorough case investigation and epidemiologic analysis to guide outbreak response vaccination. Routine childhood vaccination coverage achieved in recent years limited the transmission of measles among children. Even in areas where transmission has not occurred for years, maintaining high 2-dose MCV coverage through routine and supplemental immunization is needed to prevent outbreaks resulting from increased measles susceptibility in the population.
authors.forename: Lucy
authors.initials: L
authors.lastname: Breakwell
authors.forename: Edna
authors.initials: E
authors.lastname: Moturi
authors.forename: Louisa
authors.initials: L
authors.lastname: Helgenberger
authors.forename: Sameer V
authors.initials: SV
authors.lastname: Gopalani
authors.forename: Craig
authors.initials: C
authors.lastname: Hales
authors.forename: Eugene
authors.initials: E
authors.lastname: Lam
authors.forename: Umid
authors.initials: U
authors.lastname: Sharapov
authors.forename: Maribeth
authors.initials: M
authors.lastname: Larzelere
authors.forename: Eliaser
authors.initials: E
authors.lastname: Johnson
authors.forename: Carolee
authors.initials: C
authors.lastname: Masao
authors.forename: Eleanor
authors.initials: E
authors.lastname: Setik
authors.forename: Lisa
authors.initials: L
authors.lastname: Barrow
authors.forename: Samantha
authors.initials: S
authors.lastname: Dolan
authors.forename: Tai-Ho
authors.initials: TH
authors.lastname: Chen
authors.forename: Minal
authors.initials: M
authors.lastname: Patel
authors.forename: Paul
authors.initials: P
authors.lastname: Rota
authors.forename: Carole
authors.initials: C
authors.lastname: Hickman
authors.forename: William
authors.initials: W
authors.lastname: Bellini
authors.forename: Jane
authors.initials: J
authors.lastname: Seward
authors.forename: Greg
authors.initials: G
authors.lastname: Wallace
authors.forename: Mark
authors.initials: M
authors.lastname: Papania
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D004356:Drug Storage / Q000592:standards; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008457:Measles / Q000453:epidemiology* / Q000517:prevention & control; D008458:Measles Vaccine / Q000276:immunology*; D008849:Micronesia / Q000453:epidemiology; D008875:Middle Aged; D055815:Young Adult
chemical_list: D008458:Measles Vaccine