Measles outbreaks affecting children in Jewish ultra-orthodox communities in Jerusalem

Chen Stein-Zamir*, G. Zentner, N. Abramson, H. Shoob, Y. Aboudy, L. Shulman, E. Mendelson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


In 2003 and 2004 two measles outbreaks occurred in Jewish ultra-orthodox communities in Jerusalem. The index case of the first outbreak (March 2003) was a 2-year-old unvaccinated child from Switzerland. Within 5 months, 107 cases (mean age 8.3±7.5 years) emerged in three crowded neighbourhoods. The first cases of the second outbreak (June 2004) were in three girls aged 4-5 years in one kindergarten in another community. By November 2004, 117 cases (mean age 7.3±6.5 years) occurred. The virus genotypes were D8 and D4 respectively. Altogether, 96 households accounted for the two outbreaks, with two or more patients per family in 79% of cases. Most cases (91.5%) were unvaccinated. Immunization coverage was lower in outbreak than in non-outbreak neighbourhoods (88.3% vs. 90.3%, P=0.001). Controlling the outbreaks necessitated a culture-sensitive approach, and targeted efforts increased MMR vaccine coverage (first dose) to 95.2%. Despite high national immunization coverage (94-95%), special attention to specific sub-populations is essential.

Original languageEnglish
Pages (from-to)207-214
Number of pages8
JournalEpidemiology and Infection
Issue number2
StatePublished - Feb 2008
Externally publishedYes


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