Measles epidemiology in Catalonia (Spain):: implications for a regional vaccination programme

Background To analyse progress in measles control it is recommended that immunization programmes be evaluated by means of specific epidemiological disease surveillance. The aim of the study was to analyse a series of measles cases in Catalonia in the light of vaccination records. Methods Cases were detected by means of the epidemiological surveillance system and then surveyed for information on: age, sex, clinical symptoms, laboratory confirmation, record of vaccination, place of infection and possible outbreak-related links. The relationship between 'record of vaccination' and the remaining variables was determined using the adjusted odds ratio (OR) and its 95% confidence interval (CI). Results The epidemiological survey confirmed that 82.2% of patients (171/208) fulfilled the case criteria. In the multivariate analysis, lack of record of vaccination was associated with age groups <5 years (OR = 4.0; 95% CI : 1.4-11.8) and >14 years (OR = 19.2; 95% CI : 5.1-220.5). Conclusions Improvement in vaccination coverage at 15 months and the introduction of vaccination-status monitoring at school-entry age and among those aged >14 years on entry into the job market, university or military service could contribute to the elimination of measles.