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Epidemiologic Notes and Reports Measles Outbreak -- Chicago, 1989

As of August 23, 1989, 1123 confirmed cases of measles have been reported to the Chicago Department of Health. Information is available for 1019 (91%) of these cases; 799 (78%) have occurred in preschool-aged children ( less than 5 years old), including 340 (33%) children less than 16 months of age (i.e., too young for routine immunization). Blacks and Hispanics have accounted for 955 (94%) of the cases. Four measles-associated fatalities have been reported.

Outbreak-control activities have included intensified surveillance and lowering of the recommended age for measles vaccination to 6 months during the outbreak, with revaccination at age 15 months for children vaccinated before the first birthday. Single-antigen measles vaccine is being used for children before the first birthday, and measles-mumps-rubella vaccine (MMR) is administered to older children. Seven new vaccination clinics have been established and have administered approximately 21,000 doses of vaccine; door-to-door vaccination teams in high-risk communities have administered an additional 2000 doses of vaccine. Hospital emergency department vaccination clinics have been set up in four locations. Reported by: RM Krieg, PhD, RW Biek, MD, CR Catania, JW Masterson, MPH, Chicago Dept of Health; R March, Immunization Program, RJ Martin, DVM, Div of Infectious Diseases, Illinois Dept of Public Health. Div of Immunization, Center for Prevention Svcs, CDC.

Editorial Note

Editorial Note: This outbreak is similar to others among inner-city populations in the United States in that it involves primarily unvaccinated black and Hispanic preschool-aged children (1-3). The Chicago Department of Health has implemented aggressive outbreak strategies directed toward reaching the highest-risk group, i.e., unvaccinated preschool-aged children. Such children are also likely to be a reservoir for transmitting virus to other age groups. As part of the extensive outbreak-control efforts, children are being vaccinated in emergency departments. Provision of vaccine to inner-city children who use these facilities for their primary source of health care should help to increase vaccination levels in patients who receive sporadic health care and may reduce the transmission of measles in emergency department settings. References

  1. CDC. Measles--Dade County, Florida. MMWR 1987;36:45-8.

  2. CDC. Measles--Los Angeles County, California, 1988. MMWR 1989;38:49-52,57.

  3. Markowitz LE, Preblud SR, Orenstein WA, et al. Patterns of transmission in measles outbreaks in the United States, 1985-1986. N Engl J Med 1989;320:75-85.

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