Risk factors for measles in children younger than age 8 months: A case-control study during an outbreak in Guangxi China 2013.

Monday, 18th of January 2016

Am J Infect Control. 2015 Dec 28. pii: S0196-6553(15)01155-4. doi: 10.1016/j.ajic.2015.11.005.

Risk factors for measles in children younger than age 8 months: A case-control study during an outbreak in Guangxi China 2013.

Tang ZZ¹ Xie YH² Jiraphongsa C³ Liu XH¹ Li ZY¹ Chongsuvivatwong V⁴.

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Abstract

BACKGROUND:

Following a period (2009-2012) during which zero measles cases were reported a measles outbreak occurred in 2013 in Bama County Guangxi China that involved more than 100 children younger than age 8 months. We aimed to identify the pitfalls and risk factors while implementing the control measures.

METHODS:

An outbreak investigation and a case-control study was conducted among children younger than age 8 months. The serum specimens of the study subjects and their mothers were tested for measles immunoglobulin M and immunoglobulin G.

RESULTS:

The attack rate was 2.3/1000 population. The median (interquartile range) age was 18.6 months (7.9-52.8 months). The coverage of 2-dose measles-containing vaccine was only 34%. The case-control study revealed 2 independent risk factors: low education level of main caregiver (odds ratio [OR] 2.86; 95% confidence interval [CI] 1.31-6.22) and visiting a hospital 7-21 days before the date of symptoms onset (OR 9.84; 95% CI 4.27-22.67). The population attributable fraction of the latter was 52.8%. The mothers of the cases had nonsignificantly higher levels of immunoglobulin M and were significantly more likely to have protective levels of immunoglobulin G than those of the controls. This suggests a reactive rather than protective role of the antibody to the childs infection.

CONCLUSIONS:

In a near-elimination but low measles-containing vaccine coverage community supplementary immunization activities should be emphasized for children and women who are potential future mothers. The minimum age of measles-containing vaccine should be further reduced. Hospital measles transmission must also be strictly prevented.

Copyright © 2015 Association for Professionals in Infection Control and Epidemiology Inc. Published by Elsevier Inc. All rights reserved.