Abstract
The Republic of Korea declared measles elimination in 2006. However, a measles outbreak occurred in 2013. This study aimed to identify the epidemiological characteristics of the sources of infection and the pattern of measles transmission in 2013 in South Korea. We utilized surveillance data, epidemiological data, immunization registry data, and genetic information. We describe the epidemiological characteristics of all measles case patients (sex, age distribution, vaccination status, sources of infection) as well as details of the outbreak (the pattern of transmission, duration, mean age of patients, and generation time). In 2013, a total of 107 measles cases were notified. Most patients were infants (43.0%) and unvaccinated individuals (60.7%). We identified 4 imported and 103 import-related cases. A total of 105 cases were related to four outbreaks that occurred in Gyeongnam, northern Gyeonggi, southern Gyeonggi, and Seoul. The predominant circulating genotype was B3 type, which was identified in the Gyeongnam, northern Gyeonggi, and southern Gyeonggi outbreaks. The B3 type had not been in circulation in South Korea in the previous 3 years; virologic evidence suggests that these outbreaks were import-related. Most measles cases in South Korea have been associated with imported measles virus. Although Korea has maintained a high level of herd immunity, clustering of susceptible people can cause such measles outbreaks.
Highlights
The incidence of measles declined markedly worldwide after introduction of the measles vaccine
In 2013, a total of 107 measles cases were reported in South Korea, of which 92.5% occurred in Gyeongsangnam-do (Gyeongnam) and Gyeonggi-do (Gyeonggi) provinces (Figs 1 and 2)
The age group 13–19 years was important with respect to the two doses of MMR vaccine required for school entry; no patients in this age group were identified in the IR system as having completed the twodose MMR schedule
Summary
The incidence of measles declined markedly worldwide after introduction of the measles vaccine. Measles was eliminated in the Americas in the year 2000 and in 2014 among four countries in the Western Pacific region [2, 3]. After implementing a 5-year plan, which included mandatory epidemiologic investigation, a school entry requirement for two doses of MMR vaccination, and active laboratory surveillance, measles incidence has decreased to less than one case per million. South Korea has achieved almost all interim target of measles elimination, as defined in 2004 by the World Health Organization Regional Office for the Western Pacific (WHO/WPRO). This plan has resulted in the elimination of endemic measles virus transmission in South Korea [6]
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