The Reduction of Measles Transmission During School Vacations.
Epidemiology
; 29(4): 562-570, 2018 07.
Article
em En
| MEDLINE
| ID: mdl-29629940
ABSTRACT
BACKGROUND:
Historically, measles incidence has shown clear seasonal patterns driven by the school calendar, but since the start of mass vaccination in developed countries there are only occasional outbreaks, which may have changed the effect of school vacations on transmission. In 2013-2014, a large measles epidemic took place in a low vaccination coverage area in The Netherlands, allowing us to quantify current-day measles transmission and the effect of school vacations.METHODS:
We fitted a dynamic transmission model to notification and hospitalization time series data of the Dutch 2013-2014 measles epidemic. Our primary aim was to estimate the reduction in contact rate during school vacations and the number of cases averted due to the vacation. In addition, because the summer vacations were time-staggered in three regions, we could distinguish within-region from across-region effects of school vacations.RESULTS:
We estimated a 53% (95% credible interval 45%, 60%) reduction in contact rate during school vacations, resulting in 4900 (3400-7100) averted cases (estimated outbreak size 16,600 [12,600-23,200]). There was a shift from mainly local transmission during school term to mainly cross-regional transmission during vacations. With seroprevalence data, we derived a current-day estimate of 15 to 27 for R0 (number of secondary cases per primary case in a susceptible population).CONCLUSIONS:
School vacations are associated with greatly reduced overall measles transmission. However, transmission is not eliminated, and increased long-distance travel may even promote spread to other areas. Therefore, we estimate that school closure is unlikely to prevent measles epidemics unless there are still few cases and the community is well vaccinated.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Recreação
/
Suscetibilidade a Doenças
/
Sarampo
Tipo de estudo:
Incidence_studies
/
Prognostic_studies
Limite:
Child
/
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
Epidemiology
Assunto da revista:
EPIDEMIOLOGIA
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Holanda