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The Modern Epidemiology of an Ancient Disease

John A. Frank, Jr, MD; Walter A. Orenstein, MD; Kenneth J. Bart, MD; Sandra W. Bart; Nasr El-Tantawy, MD; Ronald M. Davis, MD; Alan R. Hinman, MD, MPH

Am J Dis Child. 1985;139(9):881-888.

Abstract
• Great success has been achieved in controlling measles In the United States with a greater than 99% reduction in incidence rate from the prevaccine era. However, since 1981, the incidence rate of measles in the United States has been relatively stable at approximately 1,500 to 3,000 reported cases annually. We reviewed available information to determine the remaining impediments to elimination of measles. The potential impediments can be divided into two categories: (1) implementation of the current strategy and (2) whether the current strategy needs modification. The major reason for the failure to achieve elimination appears to be the fact that some persons for whom vaccine is indicated have not been vaccinated. While vaccine failures and importations play a role in transmission, sustained transmission in a totally vaccinated community has not been demonstrated. All chains of transmission have involved some unvaccinated persons. Measles elimination will require complete implementation of current strategies and careful monitoring of epidemiologic trends to determine whether future modifications in strategy are needed.

(AJDC 1985;139:881-888)

Author Affiliations
From the Division of Immunization, Center for Prevention Services, Centers for Disease Control, Atlanta. Dr Frank is currently with the Sterling-Winthrop Research Institute, Rensselaer, NY, and Dr El-Tantawy is with the Health Department of Alexandria (Egypt).

Footnotes
Reprint requests to Technical Information Services, Freeway Park, Centers for Disease Control, Atlanta, GA 30333.

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