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For parents who are leery of immunization, a story to give pause

Here's a cautionary tale for you to relate to parents more frightened by rumors of mercury poisoning than by real risks posed by vaccine-preventable diseases.

Even though the Centers for Disease Control and Prevention (CDC) declared, in 2000, that transmission of the measles virus had ceased in the US, an outbreak of measles occurred in Indiana in the spring of 2005-the largest documented outbreak in 10 years. Thirty-four people, almost all children, were infected; three required hospitalization; no one died; the disease did not spread outside the counties where the outbreak originated; and the cost of containing the outbreak was estimated at $168,000 (N Engl J Med 2006;355:447).

How did that happen in a state where 98% of kindergarteners and nearly 100% of sixth graders have received the recommended two-dose coverage of measles vaccine? A review of the surrounding circumstances by a team of researchers from the Centers for Disease Control and Prevention revealed salient facts:

The lesson of the story? Childhood infectious diseases are still a menace. In a globalized world, diseases long vanquished here can reappear in the baggage of international travelers, and unvaccinated children are vulnerable to infection.