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Epidemiology and transmission of measles

Authors
Hayley Gans, MD
Yvonne A Maldonado, MD
Section Editors
Martin S Hirsch, MD
Sheldon L Kaplan, MD
Deputy Editor
Elinor L Baron, MD, DTMH

INTRODUCTION

Measles is a highly contagious viral illness characterized by fever, malaise, rash, cough, coryza, and conjunctivitis [1]. Measles has been targeted for eradication given the favorable biologic characteristic that humans are the only reservoir [2]; however, due to social and political factors and high transmissibility, elimination has been achieved in very few areas of the world [3,4].

The epidemiology and transmission of measles will be reviewed here. The clinical manifestations, diagnosis, prevention, and treatment are discussed separately. (See "Clinical manifestations and diagnosis of measles" and "Prevention and treatment of measles".)

EPIDEMIOLOGY

Measles occurs worldwide. Control efforts have substantially altered the global distribution [5]; measles incidence has decreased substantially in regions where vaccination has been instituted, and, as a result, measles occurs predominantly in areas with low vaccination rates, particularly in the developing world [6].

During the prevaccine era, more than 90 percent of children acquired measles by age 15 [7-9]. Following implementation of routine childhood vaccination in the United States at age 12 to 15 months, the age of peak measles incidence during epidemics in the United States shifted to <12 months. This susceptibility approximates the time at which transplacentally acquired maternal antibodies are no longer present if the mother has vaccine-induced immunity [10-12].

Worldwide, measles is a significant cause of morbidity and mortality. Precise incidence estimates are difficult to obtain because of heterogeneous surveillance systems and probable underreporting [13]. Before the introduction of the measles vaccine, over two million deaths occurred annually, the majority in children <5 years of age [14].

               

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Literature review current through: Jun 2015. | This topic last updated: Jul 8, 2015.
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