MEASLES EPIDEMICS TN KERMAN, IRAN

In early 1990, an outbreak of measles occurred in Kerman, (population 257, 284) Iran. Overall, 475 cases were identified and four died (case fatality ratio 5.4 per thousand). Illness was limited primarily to children below 15 years of age 166 (22.3%) were in children under five, 573 (77%) between 5-14 and six (0.8%) above 15 years of age. The age of the cases ranged from five months to 35 years. The agespecific attack rates were 3.9, 1.8,7.3 and 2.8 per 1,000 for children under I, 1-4, 5-9, and 10-14 years of age, respectively. Overall, 14 (1.9%) children with measles were hospitalized for severe complications which consisted mainly of pneumonia, otitis and gastroenteritis. Based on 745 cases with an immunization record vaccine efficacy was calculated at 88%, indicating a slight problem with the cold chain or the vaccine. The outbreak has been primarily related to low immunization coverage during the last 10 years. This outbreak again indicates the need to improve vaccine coverage with the AIK -C existing vaccine, and also the advisability of a revaccination programme at school age will need to be considered.