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News From the Centers for Disease Control and Prevention
January 27, 1999

Transmission of Measles Among a Highly Vaccinated School Population— Anchorage, Alaska, 1998Preemptive State Tobacco-Control Laws—United States, 1982-1998Update: Multistate Outbreak of Listeriosis—United States, 1998-1999Nosocomial

JAMA. 1999;281(4):315-316. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-4-jwr0127

MMWR. 1999;47:1109-1111

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During August 10-November 23, 1998, 33 confirmed* measles cases were reported to the Anchorage Department of Health and Human Services and the Alaska Department of Health and Social Services (ADHSS). Of these, 26 cases were confirmed by positive rubeola IgM antibody test, and seven met the clinical case definition. This was the largest outbreak of measles in the United States since 1996.1,2 This report summarizes results of the epidemiologic investigation conducted by ADHSS and underscores the importance of second-dose requirements for measles vaccine.

On August 10, a 4-year-old child (index case) visiting from Japan had rash onset of measles while in Anchorage. The child was hospitalized for 1 day, and measles was diagnosed by positive rubeola IgM enzyme-linked immunosorbent assay. No measles virus cultures were obtained. No cases were reported during the following 3 weeks, when secondary cases would have been expected. On September 5, 26 days after onset of the imported case, a 16-year-old high school student developed measles, confirmed by IgM testing. Subsequently, 15 other students and one teacher at the same high school developed measles during September 14-October 4; 12 cases were laboratory confirmed. In addition, four laboratory-confirmed cases and two clinical cases occurred at six other Anchorage schools; one case-patient attended two schools while infectious (from 7 days before to 4 days after rash onset). Eight other confirmed cases occurred among young adults not associated with schools, and one case occurred in a 2-year-old child.