A Measles Outbreak in the Tel Aviv District, Israel, 2018-2019

Matanelle Salama*, Vicki Indenbaum, Naama Nuss, Michal Savion, Zohar Mor, Ziva Amitai, Irina Yoabob, Rivka Sheffer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


During a national measles outbreak in 2018-2019, the Tel Aviv District suffered a major upsurge of cases, with 413 patients reported. Among them, 100 (24%) were <1 year, 92 (22%) patients were aged 12 months to 4 years, 47 (11%) were 5-18 years, 169 (41%) were 19-60 years, and 5 (1%) patients were older than 61 years (born before 1957). Among all cases, 230 (56%) were part of the Ultra-Orthodox Jewish community, 55 (13%) were among undocumented African immigrants. Despite high vaccination coverage, sustained measles transmission occurred, due in part to importations and numerous exposures in medical settings by a susceptible birth cohort. The Ultra-Orthodox Jewish community was particularly afflicted due to its condense population, high birth rates, and multiple exposures in crowded religious settings. This outbreak demonstrates the necessity of addressing immunity gaps as well optimal healthcare planning in order to prevent future outbreaks.

Original languageEnglish
Pages (from-to)1649-1656
Number of pages8
JournalClinical Infectious Diseases
Issue number9
StatePublished - 1 May 2021
Externally publishedYes


  • Measles
  • Measles outbreak
  • Vaccine-preventable disease


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