Epidemiology of measles in Taiwan: dynamics of transmission and timeliness of reporting during an epidemic in 1988–9

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Abstract
Summary: We analysed nation-wide reported measles cases during the 1988–9 epidemic and found that longer duration and wider spread were two major characteristics of the outbreak. All the 22 county/city index cases were reported with a delay of > 4 days and 64% were aged 5–14 years. This epidemic occurred mainly among 5–14-year-old school-children (59%), infants under 1 year (19%), and pre-school children (18%). The overall attack rate was 0·63 cases per 10000 population, with the highest attack rate (7·4 cases per 10000 population) occurring in infants. Among 280 confirmed cases P < 0·001) and reported from teaching hospitals (OR = 2·6, P < 0·001). The reappearance of high attack rates among 5–9-year-old children in the 1985 and 1988–9 measles epidemics in Taiwan indicated the persistence of pockets of susceptible individuals even after mass immunization.