{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:43:58Z","timestamp":1792118638647,"version":"4.4.0"},"reference-count":35,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2017,4,17]],"date-time":"2017-04-17T00:00:00Z","timestamp":1492387200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n                  <jats:p>As endemic measles is eliminated through immunization, countries must determine the risk factors for the importation of measles into highly immunized populations to target control measures. Despite eliminating endemic measles, New Zealand suffers from outbreaks after introductions from abroad, enabling us to use it as a model for measles introduction risk. We used a generalized linear model to analyze risk factors for 1137 measles cases from 2007 to June 2014, provide estimates of national immunity levels, and model measles importation risk. People of European ethnicity made up the majority of measles cases. Age is a positive risk factor, particularly 0\u20132-year-olds and 5\u201317-year-old Europeans, along with increased wealth. Pacific islanders were also at greater risk, but due to 0\u20132-year-old cases. Despite recent high measles, mumps, and rubella vaccine immunization coverage, overall population immunity against measles remains ~90% and is lower in people born between 1982 and 2005. Greatest measles importation risk is during December, and countries predicted to be sources have historical connections and highest travel rates (Australia and UK), followed by Asian countries with high travel rates and higher measles incidences. Our results suggest measles importation due to travel is seeding measles outbreaks, and immunization levels are insufficient to continue to prevent outbreaks because of heterogeneous immunity in the population, leaving particular age groups at risk.<\/jats:p>","DOI":"10.1017\/s0950268817000723","type":"journal-article","created":{"date-parts":[[2017,4,17]],"date-time":"2017-04-17T05:48:28Z","timestamp":1492408108000},"page":"1875-1885","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":13,"title":["Global importation and population risk factors for measles in New Zealand: a case study for highly immunized populations"],"prefix":"10.1017","volume":"145","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0087-3015","authenticated-orcid":false,"given":"D. T. S.","family":"HAYMAN","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. C.","family":"MARSHALL","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. P.","family":"FRENCH","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. E.","family":"CARPENTER","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2693-5093","authenticated-orcid":false,"given":"M. G.","family":"ROBERTS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"KIEDRZYNSKI","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2017,4,17]]},"reference":[{"key":"S0950268817000723_ref29","unstructured":"New Zealand Ministry of Health. National and DHB immunisation data, 2016. http:\/\/www.health.govt.nz\/our-work\/preventative-health-wellness\/immunisation\/immunisation-coverage\/national-and-dhb-immunisation-data."},{"key":"S0950268817000723_ref28","first-page":"15","article-title":"Childhood immunisations in Northland, New Zealand: declining care and the journey through the immunisation pathway","volume":"129","author":"Rumball-Smith","year":"2016","journal-title":"The New Zealand Medical Journal"},{"key":"S0950268817000723_ref16","unstructured":"Statistics New Zealand. Statistics New Zealand, 2014 http:\/\/nzdotstat.stats.govt.nz\/."},{"key":"S0950268817000723_ref35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2013.11.008"},{"key":"S0950268817000723_ref11","doi-asserted-by":"publisher","DOI":"10.1017\/S095026880100601X"},{"key":"S0950268817000723_ref7","volume-title":"Field Guidelines for Measles Elimination","year":"2005"},{"key":"S0950268817000723_ref32","doi-asserted-by":"publisher","DOI":"10.1016\/0264-410X(95)00098-L"},{"key":"S0950268817000723_ref14","volume-title":"EpiSurv, Public Health Surveillance","year":"2016"},{"key":"S0950268817000723_ref19","unstructured":"Statistics New Zealand. Population data, 2013 http:\/\/www.stats.govt.nz\/."},{"key":"S0950268817000723_ref3","unstructured":"Pan American Health Organization. Region of the Americas is declared free of measles: World Health Organisation, 2016 http:\/\/www.paho.org\/hq\/index.php?option=com_content&view=article&id=12528%3Aregion-americas-declared-free-measles."},{"key":"S0950268817000723_ref30","unstructured":"World Health Organization. The immunological basis for immunization series: module 7: measles \u2013 Update 2009. Geneva, Switzerland: World Health Organization, 2009, pp. 10\u201333. http:\/\/apps.who.int\/iris\/bitstream\/10665\/44038\/1\/9789241597555_eng.pdf."},{"key":"S0950268817000723_ref9","first-page":"1","volume-title":"A Mathematical Model for Measles Vaccination","author":"Roberts","year":"2004"},{"key":"S0950268817000723_ref10","first-page":"1","volume-title":"Predicting and Preventing Measles Epidemics in New Zealand: Application of a Mathematical Model","author":"Tobias","year":"1998"},{"key":"S0950268817000723_ref24","unstructured":"World Health Organization. Measles factsheet, 2016 http:\/\/who.int\/mediacentre\/factsheets\/fs286\/en\/."},{"key":"S0950268817000723_ref21","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jit143"},{"key":"S0950268817000723_ref6","volume-title":"Public Health Surveillance","year":"2016"},{"key":"S0950268817000723_ref27","unstructured":"Public Health England. Measles, mumps, rubella (MMR): use of combined vaccine instead of single vaccines, 2016 https:\/\/www.gov.uk\/government\/publications\/mmr-vaccine-dispelling-myths\/measles-mumps-rubella-mmr-maintaining-uptake-of-vaccine."},{"key":"S0950268817000723_ref22","unstructured":"New Zealand Statistics. Research and Statistics, 2016 https:\/\/www.immigration.govt.nz\/about-us\/research-and-statistics."},{"key":"S0950268817000723_ref8","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268899003556"},{"key":"S0950268817000723_ref4","unstructured":"World Health Organization Regional Office for the Western Pacific. Fourth Annual Meeting of the Regional Verification Commission for Measles Elimination in the Western Pacific: World Health Organization Regional Office for the Western Pacific, 2015."},{"key":"S0950268817000723_ref17","volume-title":"R: A Language and Environment for Statistical Computing","year":"2013"},{"key":"S0950268817000723_ref33","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040297"},{"key":"S0950268817000723_ref18","doi-asserted-by":"publisher","DOI":"10.1002\/9781118448908"},{"key":"S0950268817000723_ref12","unstructured":"Ministry of Health New Zealand. Measles: Ministry of Health, 2017 http:\/\/www.health.govt.nz\/your-health\/conditions-and-treatments\/diseases-and-illnesses\/measles."},{"key":"S0950268817000723_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68770-9"},{"key":"S0950268817000723_ref20","volume-title":"National Serosurvey of Vaccine Preventable Diseases","author":"Weir","year":"2009"},{"key":"S0950268817000723_ref34","unstructured":"New Zealand Statistics. Childhood immunisation, 2016. http:\/\/www.stats.govt.nz\/browse_for_stats\/snapshots-of-nz\/nz-social-indicators\/Home\/Health\/childhood-immunisation.aspx."},{"key":"S0950268817000723_ref31","doi-asserted-by":"publisher","DOI":"10.1016\/0264-410X(94)00086-3"},{"key":"S0950268817000723_ref13","first-page":"53","article-title":"Analysis of the Auckland 2014 measles outbreak indicates that adolescents and young adults could benefit from catch-up vaccination","volume":"128","author":"Reynolds","year":"2014","journal-title":"The New Zealand Medical Journal"},{"key":"S0950268817000723_ref26","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268815002599"},{"key":"S0950268817000723_ref15","volume-title":"Socioeconomic Deprivation Indexes: NZDep and NZiDep, Department of Public Health","year":"2016"},{"key":"S0950268817000723_ref5","first-page":"467","article-title":"A measles epidemic controlled by immunisation","volume":"111","author":"Mansoor","year":"1998","journal-title":"The New Zealand Medical Journal"},{"key":"S0950268817000723_ref23","unstructured":"World Health Organization. Immunization, Vaccines and Biologicals: Measles, 2016 http:\/\/www.who.int\/immunization\/diseases\/measles\/en\/."},{"key":"S0950268817000723_ref1","first-page":"1034","article-title":"Progress toward regional measles elimination-worldwide, 2000\u20132013","volume":"63","author":"Perry","year":"2014","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"S0950268817000723_ref25","unstructured":"World Health Organization. Measles monthly data, 2016 http:\/\/www.who.int\/immunization\/monitoring_surveillance\/burden\/vpd\/surveillance_type\/active\/measles_monthlydata\/en\/."}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268817000723","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,17]],"date-time":"2019-04-17T16:48:31Z","timestamp":1555519711000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268817000723\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4,17]]},"references-count":35,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["S0950268817000723"],"URL":"https:\/\/doi.org\/10.1017\/s0950268817000723","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,4,17]]},"assertion":[{"value":"Copyright \u00a9 Cambridge University Press 2017\u00a0","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}