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Health officials devise new strategy to eliminate measles

By KEN SUGAR

ATLANTA -- In the face of sporadic measles outbreaks across the nation, federal health officials announced a new program Thursday to eradicate the disease from the United States, using a two-vaccination strategy.

A 1963 vaccine all but wiped out the sometimes deadly measles virus, and federal officials said they now want to finish the job with a new initiative.

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Since thousands of children age 15 months and younger began receiving the measles vaccine 25 years ago, the reported incidence of the disease has declined 99 percent, according to the national Centers for Disease Control.

Between 1981 and 1987, however, hundreds of children have been afflicted by the malady, with a low incidence of 1,497 cases reported in 1983 and a high of 6,282 cases in 1986.

To reduce measles further, the CDC has recommended a two-dose vaccination schedule for preschoolers. It is expected that the double vaccine will improve immunity levels in high-risk children 15-months-old and younger, the CDC said.

The dual vaccinations -- one recommended for when children reach 9 months and the second at 15 months -- would be administered in counties with five or more reported cases of measles among preschool-aged children during each of the last five years.

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'Health authorities in other urban areas that have experienced recent outbreaks among unvaccinated preschool-aged children may also consider implementing this policy,' the CDC report said.

Before the measles vaccination was instituted, about 500,000 cases of the disease that causes a rash, fever and cough and can lead to pneumonia and ear infection were reported annually, with about 500 people dying from the disease. It is estimated about one in 1,000 measles patients develop a potentially deadly inflammation of the brain called encephalitis.

A measles elimination strategy established in 1977 called for one vaccination shot at 15 months. That effort was aimed at eliminating measles in this country by October 1982 except for imported cases. Although cases dropped to an all-time low that year, measles outbreaks continued to occur, especially in high schools and colleges.

The federal agency also suggested that students and their siblings attending junior high schools and high schools where an outbreak has occurred be revaccinated if they received their first vaccination before 1980.

'This strategy will capture almost all students vaccinated between 12 and 14 months of age, a group known to be at increased risk of primary vaccine failure, since the recommended age for routine vaccination was changed from 12 to 15 months in 1976,' the CDC said. 'It (also) may be easier to identify students by year of vaccination than by age at vaccination.'

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Also, in some outbreak investigations, students vaccinated before 1978-1980 have been found to be at increased risk for measles, the CDC said.

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