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Measles Outbreak in a Fully Immunized Secondary-School Population

Abstract An outbreak of measles occurred among adolescents in Corpus Christi, Texas, in the spring of 1985, even though vaccination requirements for school attendance had been thoroughly enforced. Serum samples from 1806 students at two secondary schools were obtained eight days after the onset of the first case. Only 4.1 percent of these students (74 of 1806) lacked detectable antibody to measles according to enzymelinked immunosorbent assay, and more than 99 percent had records of vaccination with live measles vaccine. Stratified analysis showed that the number of doses of vaccine received was the most important predictor of antibody response. Ninety-five percent confidence intervals of seronegative rates were 0 to 3.3 percent for students who had received two prior doses of vaccine, as compared with 3.6 to 6.8 percent for students who had received only a single dose. After the survey, none of the 1732 seropositive students contracted measles. Fourteen of 74 seronegative students, all of whom had been v...

Public health information infrastructure

The public health infrastructure is a set of agencies and organizations whose mission is to create the environment in which we can be healthy. This broadest of definitions includes state and local health departments, selected federal agencies, and a wide range of other governmental, nonprofit, and for-profit agencies and organizations. This report will limit itself to state and local health departments and the federal Centers for Disease Control and Prevention (CDC), the nations foremost public health agency. With numerous exceptions, this public health infrastructure is in a state of crisis, incapable of meeting our collective needs for public health protections and services, and likely to get worse in the near-term future.

Who needs health care? Health care may be an oxymoron.

EDITOR—Before decrying preventive medicine in her article “Who needs health care—the well or the sick?” Heath should have defined the term.1 The best of preventive medicine has saved more lives and reduced more suffering at far less cost than all medical interventions, whether in the shape of immunisation, improved sanitation, or better diet. Prevention is about …

The Biomedical Sciences

The biomedical sciences—anatomy, physiology, biochemistry, pathology, microbiology, and pharmacology —are presently taught in the first phase of medical school.