Epidemiology and Infection

Original Papers

Measles/rubella

High risk of a large measles outbreak despite 30 years of measles vaccination in The Netherlands

L. MOLLEMAa1 c1, G. P. SMITSa1, G. A. BERBERSa1, F. R. VAN DER KLISa1, R. S. VAN BINNENDIJKa1, H. E. DE MELKERa1 and S. J. M. HAHNÉa1

a1 National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, The Netherlands

SUMMARY

Our aim was to assess progress towards measles elimination from The Netherlands by studying humoral measles immunity in the Dutch population. A population-based seroepidemiological study was conducted in 2006–2007 (N = 7900). Serum samples were analysed by a bead-based multiplex immunoassay. IgG levels ≥0·2 IU/ml were considered protective. The overall seroprevalence in the Dutch population was 96%. However, 51% of socio-geographically clustered orthodox Protestant individuals aged <10 years were susceptible. Infants might be susceptible to measles between ages 4 months and 14 months, the age at which maternal antibodies have disappeared and the first measles, mumps, rubella (MMR) vaccination is administered, respectively. Waning of antibody concentrations was slower after the second MMR vaccination than after the first. The Netherlands is at an imminent risk of a measles outbreak in the orthodox Protestant minority. To prevent subsequent transmission to the general population, efforts to protect susceptible age groups are needed.

(Received January 29 2013)

(Revised May 15 2013)

(Accepted May 30 2013)

(Online publication August 06 2013)

Key words

  • Infectious disease epidemiology;
  • measles (rubeola);
  • MMR vaccination;
  • serology;
  • vaccine preventable diseases

Correspondence

c1 Author for correspondence: Dr L. Mollema, National Institute for Public Health and the Environment, Epidemiology and Surveillance Unit, P.O. Box 1 (internal P.O. Box 75), 3720 BA Bilthoven, The Netherlands. (Email: Liesbeth.Mollema@rivm.nl)

Metrics