MEASLES EPIDEMIC FROM FAILURE TO IMMUNIZE

During 1988 through 1990, California experienced its worst measles epi demic in more than a decade, with 16,400 reported cases, 3,390 hospita l admissions, and 75 deaths. More than half of the patients were young er than 5 years; the highest incidence was among infants younger than 12 months. The epidemic centered in low-income Hispanic communities in southern and central California. The major cause of the epidemic was low immunization levels among preschool-aged children and young adults . Rates of complications, admission to hospital, and death were surpri singly high. Outbreak control efforts met with indeterminate success. Problems with these efforts included insufficient funding early in the epidemic and disappointing public response to community-based immuniz ation campaigns. The cost of medical care and outbreak control for the epidemic is conservatively estimated at $30.9 million. Unless the lev el of immunization in preschool-aged children is increased, this type of epidemic will probably recur.