KEYWORDS:
Measles Outbreak, Outreach, Epidemiological Investigation, Registry
BACKGROUND:
In April 2002, two cases of measles were diagnosed in New York City, both related to virus importations from Pakistan. Outbreak investigation included identification of all exposed individuals and determination of their measles immune status. The Citywide Immunization Registry (CIR) was recruited to assist in the investigation by identifying the exposed individuals who had a documented prior dose of a measles-containing vaccine (MCV).
OBJECTIVE(S):
To describe the role of an immunization registry in facilitating an epidemiological investigation of a measles outbreak.
METHOD(S):
A total of 140 persons were identified as being exposed to either one of the index cases; 60 were under age 14 and were searched for in the CIR to determine their vaccination status. Younger children and children without a CIR-documented MCV were contacted first.
RESULT(S):
Forty-two of the 60 children were found in the CIR, and 18 had received an MCV. Of the 40 children under 5, 9 had one MCV in the CIR but 24 children were under one (and hence not yet due for an MCV). Of the 20 children that were over 5, 9 had received at least one MCV according to the CIR. Contact investigation was initially targeted to children under 5 with no CIR-documented MCV or who were under one-year old. Children over 5 were contacted later because of the MMR (Measles-Mumps-Rubella Vaccine) requirement for school entry.
CONCLUSIONS(S):
The CIR helped to target the epidemiological investigation to the two-thirds of children without confirmed vaccination with a MCV.
LEARNING OBJECTIVES:
By eliminating those with confirmed vaccinations and by targeting limited resources to those individuals at greater risk, an immunization registry can help limit the extent of an outbreak.
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