Epidemic Potential of Measles and Rubella

Abstract

Although there have been major declines in the incidence of measles and rubella in the United States since licensure of vaccines, the incidence of disease in adolescents and young adults has not declined nearly as markedly as that in younger children. As a result, an increasing proportion of cases have occurred in adolescents and young adults. In 1978, 26% of all reported measles cases in which age was known occurred in those 15 years of age and older, and 76% reported rubella cases occurred in this age group. Outbreaks of both diseases have been reported from high schools, military bases, colleges, and universities. During a recent outbreak of measles involving a university, a 22-year-old university employee contracted measles and died of measles encephalitis. In addition to the direct effects of these diseases, the implications of the current pattern of occurrence of two infections known to have adverse effects on the developing fetus are obvious.

Improvements in immunization levels and declines in disease incidence have been brought about effectively by the enactment and enforcement of immunization requirements for school-age children and military recruits. Colleges and universities should also institute immunization requirements as a condition of enrollment.