Measles: effect of a two-dose vaccination programme in Catalonia, Spain

Abstract

The study reports incidences of measles in Catalonia, Spain, as detected by surveillance, and analyses the speci®c characteristics of the outbreaks reported for the period 1986±95. Incidences per 100 000 inhabitants were calculated for the period 1971±95. The following variables were studied: year of presentation, number of cases, median age, transmission setting, cases with a record of vaccination and preventable cases. Associations between variables were determined using odds ratios (OR). The incidence of measles declined from 306.3 cases in 1971 to 30.9 in 1995. A total of 50 outbreaks were investigated. The outbreaks that occurred in the last two years of the study had a higher likelihood of having a transmission setting other than primary school (OR = 3.9); a median case age > 10 years (OR = 7.2); and fewer than 6 cases (OR = 2.3). The characteristics of recent outbreaks, marked by a rise both in transmission outside the primary-school setting and in median age, indicate the need for the introduction of a speci®c vaccination programme at the end of adolescence in addition to control of school-related outbreaks.