Implications of a 2005 Measles Outbreak in Indiana for Sustained Elimination of Measles in the United States
New England Journal of Medicine·
- DOI
- 10.1056/nejmoa060775
- PMID
- 16885548
- PMCID
- —
- OpenAlex
- W2133965262
- Study type
- Journal article
- Publisher
- Massachusetts Medical Society
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The report illustrates how imported measles can spread among unvaccinated subgroups while high community coverage limits wider transmission, underscoring the need for sustained coverage and improved communication with vaccine-refusing persons.
Structured evidence summary
Research question
The study examines how a 2005 measles outbreak in Indiana occurred and what factors limited its spread, to inform efforts to sustain measles elimination in the United States.
Study design
A case-series investigation combined with molecular typing of viral isolates, surveys of vaccination coverage, interviews about vaccination attitudes, and cost surveys.
Population and setting
The setting was a 2005 outbreak in Indiana, United States, originating from an unvaccinated 17-year-old index patient returning from Romania; approximately 500 persons attended an associated gathering and 34 cases were confirmed over six weeks.
Main findings
Among roughly 50 susceptible gathering attendees, 32% acquired measles, yielding 34 confirmed cases; 94% of patients were unvaccinated, 88% were under 20 years of age, and 9% were hospitalized, with 71% of school-aged patients home-schooled. The identified virus was genotype D4, endemic in Romania, and containment costs were at least $167,685, including $113,647 at a hospital with an infected employee. High surrounding-community coverage (92% in preschoolers, 98% in sixth graders) and low vaccine failure (two persons) confined spread largely to children whose parents had declined vaccination.
Public-health relevance
The report illustrates how imported measles can spread among unvaccinated subgroups while high community coverage limits wider transmission, underscoring the need for sustained coverage and improved communication with vaccine-refusing persons.
Important limitations
The abstract does not state explicit limitations of the investigation. This summary is limited to the supplied single-article abstract and metadata and requires the original paper for decision-grade interpretation.
GIDS interpretation
From a discoverability standpoint, this article is a peer-reviewed outbreak investigation indexed under measles and vaccination topics for the United States and Romania and may be relevant context for searches on importation-related measles outbreaks and vaccine refusal, but it should not be interpreted as a live surveillance signal.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 13 auditable classifier relationships to diseases, places, topics, and study design.