Assignment:
The purpose of this assignment is to get some experience describing and analyzing a typical measles outbreak.
Scenario:
You are an epidemiologist with the state immunization program. Your Division Director wants information on a recent measles outbreak. In particular, this outbreak has been in the news and your Director wants an analysis so he can respond to questions (eg "how come a third of the cases are in vaccinated persons - does the vaccine work?"). The template attached is a very typical example of how you might respond to this request. Fill in the rest of the template including:
• a graph representing the epidemiological curve of the outbreak,
• a narrative description of the salient features of the outbreak and the epi curve,
• an analysis of vaccine efficacy (including a calculation of vaccine efficacy for this outbreak), and
• a list of conclusions and recommendations for your Director based on your description and analyses.
The results of the case and contact investigations are below:
Case investigation:
A pediatrician had evaluated a 10-year-old child in the emergency department on May 10th, 2016 who was suspected to have Kawasaki disease. The child had arrived from India on May 8th and had developed a rash on May 9th. A review of medical records led the investigators to reconsider the rash illness in the 10-year-old child as a possible measles case following the laboratory confirmation of measles by IgM testing.
A total of 108 contacts were identified as exposed to the index case or to the siblings. Of the 108, 100 were vaccinated and 7 were unvaccinated. A total of twelve measles cases were diagnosed in this outbreak. All cases are summarized in the table below.
|
Case Description
|
Age
|
Onset date
|
Vaccination h/o
|
Lab Confirmed y/n
|
|
Index
|
10
|
09-May
|
no vaccine
|
y
|
|
sibling 1
|
7
|
23-May
|
no vaccine
|
y
|
|
sibling 2
|
9
|
26-May
|
no vaccine
|
n
|
|
father
|
34
|
26-May
|
1 MMR (no record)
|
y
|
|
contact - index
|
12 mo
|
27-May
|
no vaccine
|
y
|
|
pediatrician
|
51
|
28-May
|
3 MMRs
|
y
|
|
contact - siblings
|
47
|
03-Jun
|
1 MMR (no record)
|
y
|
|
contact - siblings
|
8
|
04-Jun
|
no vaccine
|
y
|
|
contact - siblings
|
7
|
05-Jun
|
no vaccine
|
y
|
|
contact - siblings
|
9
|
05-Jun
|
no vaccine
|
y
|
|
contact - siblings
|
10
|
06-Jun
|
2 MMRs
|
y
|