{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T07:20:16Z","timestamp":1773991216173,"version":"3.50.1"},"reference-count":23,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2012,11,9]],"date-time":"2012-11-09T00:00:00Z","timestamp":1352419200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>We describe the largest outbreak of measles in Central and Eastern Cheshire (North West England) since the MMR vaccine was introduced in 1988, the majority of cases were not vaccinated and more than 20% of the cases belonged to the travelling community. Over 4 months, 147 clinical cases of measles were notified locally to the Cheshire &amp; Merseyside Health Protection Unit (CMHPU). Of these, 67 (45\u00b76%) were laboratory confirmed, 42 (28\u00b76%) were negative, and one was equivocal, leaving 23 probable and 14 possible cases. The primary case was probably an 8-year-old unvaccinated travelling child, symptomatic on 1 October 2008. Measles spread locally and within school-aged children until early February 2009. Most of Central and Eastern Cheshire, including 23 educational institutions (playgroups, nurseries, primary schools, secondary schools, colleges), were affected, showing that there were enough susceptible\/unvaccinated children to sustain an outbreak. Nearly a quarter of the confirmed cases (15\/67, 22\u00b74%) were aged &lt;13 months and too young to be vaccinated under the UK immunization schedule. This outbreak is a reminder of the importance of achieving herd immunity to prevent spread and protect those at risk of severe illness or complications. There were no fatalities in this outbreak and no significant complications were reported.<\/jats:p>","DOI":"10.1017\/s0950268812002300","type":"journal-article","created":{"date-parts":[[2012,11,9]],"date-time":"2012-11-09T04:31:14Z","timestamp":1352435474000},"page":"1849-1856","source":"Crossref","is-referenced-by-count":10,"title":["Outbreak of measles in Central and Eastern Cheshire, UK, October 2008\u2013February 2009"],"prefix":"10.1017","volume":"141","author":[{"given":"S.","family":"GHEBREHEWET","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"HAYHURST","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"KEENAN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"MOORE","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2012,11,9]]},"reference":[{"key":"S0950268812002300_ref8","unstructured":"Health Protection Agency. Confirmed measles cases in England and Wales \u2013 an update to end of May 2008 (http:\/\/www.hpa.org.uk\/hpr\/archives\/2008\/news2508.htm#meas0508). Accessed 14 August 2012."},{"key":"S0950268812002300_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/S0264-410X(01)00097-4"},{"key":"S0950268812002300_ref16","unstructured":"Health Protection Agency. Confirmed measles cases in England and Wales \u2013 an update to end of May 2008. Health Protection Report, 2008; 2; 25 (http:\/\/www.hpa.org.uk\/hpr\/archives\/2008\/hpr2508.pdf). Accessed 2 August 2012."},{"key":"S0950268812002300_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60175-4"},{"key":"S0950268812002300_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(79)80203-6"},{"key":"S0950268812002300_ref23","first-page":"281","article-title":"Traveller gypsies and childhood immunisations: a study in east London","volume":"43","author":"Feder","year":"1993","journal-title":"British Journal of General Practice"},{"key":"S0950268812002300_ref18","unstructured":"NHS Immunisation Statistics 2004\u201305. The NHS Information Services, 2005 (http:\/\/www.ic.nhs.uk\/webfiles\/publications\/immunisaton05\/NHSImmunisationStatistics220905_PDF.pdf Accessed 21\/11\/11)."},{"key":"S0950268812002300_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2011.10.072"},{"key":"S0950268812002300_ref6","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/21.5.998"},{"key":"S0950268812002300_ref17","unstructured":"NHS Immunisation Statistics England 2010\u201311. The NHS Information Services, 2011 (http:\/\/www.ic.nhs.uk\/webfiles\/publications\/003_Health_Lifestyles\/Immunisation%20Stats%202010-11\/Immunisations_Bulletin_2010_1_v1.1_251011.pdf). Accessed 21 November 2011."},{"key":"S0950268812002300_ref1","unstructured":"Parliamentary Office of Science and Technology. Vaccines and public health. Postnote, 2004, No. 219 (http:\/\/www.parliament.uk\/documents\/post\/postpn219.pdf). Accessed 21 November 2011."},{"key":"S0950268812002300_ref2","volume-title":"Immunisation against Infectious Disease","author":"Salisbury","year":"2011"},{"key":"S0950268812002300_ref4","first-page":"3","article-title":"Clinical spectrum of measles and MA","volume":"191","author":"Katz","year":"1995","journal-title":"Current Topics in Microbiology and Immunology"},{"key":"S0950268812002300_ref3","volume-title":"Control of Communicable Disease Manual","author":"Chin","year":"2000"},{"key":"S0950268812002300_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(77)81021-4"},{"key":"S0950268812002300_ref7","unstructured":"World Health Organisation (WHO). Measles fact sheet (http:\/\/www.who.int\/mediacentre\/factsheets\/fs286\/en\/). Accessed 21 November 2011."},{"key":"S0950268812002300_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61849-8"},{"key":"S0950268812002300_ref15","unstructured":"Health Protection Agency. Confirmed measles cases in England and Wales \u2013 an update to end of May 2008. Health Protection Report, 2008; 2; 21 (http:\/\/www.hpa.org.uk\/hpr\/archives\/2008\/news2108.htm#measls). Accessed 25 November 2011."},{"key":"S0950268812002300_ref5","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2003.038489"},{"key":"S0950268812002300_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/S0264-410X(00)00096-7"},{"key":"S0950268812002300_ref21","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c1626"},{"key":"S0950268812002300_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)11096-0"},{"key":"S0950268812002300_ref12","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.324.7334.393"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268812002300","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,23]],"date-time":"2019-04-23T16:24:54Z","timestamp":1556036694000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268812002300\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,11,9]]},"references-count":23,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2013,9]]}},"alternative-id":["S0950268812002300"],"URL":"https:\/\/doi.org\/10.1017\/s0950268812002300","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,11,9]]}}}