{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:01:54Z","timestamp":1788307314718,"version":"build-2803163510"},"reference-count":23,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,7,1]]},"abstract":"<jats:p>Measles is readily spread to susceptible individuals, but is no longer endemic in the United States. In March 2011, measles was confirmed in a Minnesota child without travel abroad. This was the first identified case-patient of an outbreak. An investigation was initiated to determine the source, prevent transmission, and examine measles-mumps-rubella (MMR) vaccine coverage in the affected community. Investigation and response included case-patient follow-up, post-exposure prophylaxis, voluntary isolation and quarantine, and early MMR vaccine for non-immune shelter residents &amp;gt;6 months and &amp;lt;12 months of age. Vaccine coverage was assessed by using immunization information system records. Outreach to the affected community included education and support from public health, health care, and community and spiritual leaders. Twenty-one measles cases were identified. The median age was 12 months (range, 4 months to 51 years) and 14 (67%) were hospitalized (range of stay, 2\u20137 days). The source was a 30-month-old US-born child of Somali descent infected while visiting Kenya. Measles spread in several settings, and over 3000 individuals were exposed. Sixteen case-patients were unvaccinated; 9 of the 16 were age-eligible: 7 of the 9 had safety concerns and 6 were of Somali descent. MMR vaccine coverage among Somali children declined significantly from 2004 through 2010 starting at 91.1% in 2004 and reaching 54.0% in 2010 (\u03c72 for linear trend 553.79; P &amp;lt; .001). This was the largest measles outbreak in Minnesota in 20 years, and aggressive response likely prevented additional transmission. Measles outbreaks can occur if undervaccinated subpopulations exist. Misunderstandings about vaccine safety must be effectively addressed.<\/jats:p>","DOI":"10.1542\/peds.2013-4260","type":"journal-article","created":{"date-parts":[[2014,6,10]],"date-time":"2014-06-10T03:53:17Z","timestamp":1402372397000},"page":"e220-e228","source":"Crossref","is-referenced-by-count":88,"title":["An Outbreak of Measles in an Undervaccinated Community"],"prefix":"10.1542","volume":"134","author":[{"given":"Pamala","family":"Gahr","sequence":"first","affiliation":[{"name":"Minnesota Department of Health, St Paul, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron S.","family":"DeVries","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health, St Paul, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Wallace","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Miller","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health, St Paul, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Kenyon","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health, St Paul, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Sweet","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health, St Paul, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Martin","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health, St Paul, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"White","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health, St Paul, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Bagstad","sequence":"additional","affiliation":[{"name":"Hennepin County Human Services and Public Health, Hopkins, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Hooker","sequence":"additional","affiliation":[{"name":"Hennepin County Human Services and Public Health, Hopkins, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gretchen","family":"Krawczynski","sequence":"additional","affiliation":[{"name":"Hennepin County Human Services and Public Health, Hopkins, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Boxrud","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health, St Paul, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gongping","family":"Liu","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health, St Paul, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Stinchfield","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital and Clinics of Minnesota, St Paul, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"LeBlanc","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital and Clinics of Minnesota, St Paul, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Hickman","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health, St Paul, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn","family":"Bahta","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health, St Paul, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Barskey","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Lynfield","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health, St Paul, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2014,7,1]]},"reference":[{"issue":"3","key":"2021121019374496400_B1","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1093\/infdis\/171.3.679","article-title":"An outbreak of measles at an international sporting event with airborne transmission in a domed stadium.","volume":"171","author":"Ehresmann","year":"1995","journal-title":"J Infect Dis"},{"key":"2021121019374496400_B2","doi-asserted-by":"crossref","unstructured":"Siegel JD, Rhinehart E, Jackson M, Chiarello L, and the Healthcare Infection Control Practices Advisory Committee. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. 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Anti-vaccine doctor meets with Somalis. Star Tribune. March 24, 2011. Available at: www.startribune.com\/lifestyle\/health\/118547569.html. Accessed July 10, 2013"},{"key":"2021121019374496400_B13","unstructured":"Perry S. Fear and frustration dominated Somali community forum on measles, vaccines, and autism. Minnpost. March 28, 2011. Available at: www.minnpost.com\/second-opinion\/2011\/03\/fear-and-frustration-dominated-somali-community-forum-measles-vaccines-and-au. 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