64 A Measles Epidemic In A Sub-Optimally Vaccinated Population And Predictors Of Consulting The Gp

Ted GA van Essen
Julius Centre for General Practice and Patient Oriented Research, University Medical Centre Utrecht, The Institute for Research in Extramural Medicine, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands
Aim: To describe a measles outbreak in a sub-optimally vaccinated community, and to determine reasons for encounter with a measles child.
Methods. The study focuses on children younger than 14 years of age. Cases of measles were identified via questionnaires, the general practitioners' (GPs') records, and the public health authorities. Factors predicting GP consultation were determined by using univariate and multivariate regression analyses.
Results. An incidence of 105 cases of measles per 1,000 children younger than 14 years of age was found. Only 10% of these cases have been registered at the public health authorities. The best predictor for contacting the general practice was ‘the experienced seriousness of that illness’ (adj OR: 45.1). This corresponded to the higher complication rate amongst cases that consulted the GP, which was twice as high as in the population, while a high 'inclination to consult the GP for RT symptoms’ was an independent predictor for consulting the GP too (adj OR: 8.1). The attack rate (AR) depended on vaccination status (MMR), number of previous epidemics encountered, and age. The overall AR was 10.0%, ranging from 0% to 78.6% amongst MMR negative children.
The combination of data acquired in the population as well as at the GP makes this study unique. In this way, cases in both groups could be compared to one another, and factors that predict GP consultation could be determined. Furthermore, the apparent influence of views about RT symptoms on the factual consultation behaviour was clearly demonstrated.
64 A measles epidemic in a sub-optimally vaccinated population and predictors of consulting the GP