American Journal of Epidemiology

Badara Cisse, Peter Aaby, François Simondon, Badara Samb, Masserigne Soumaré, Hilton Whittle

doi: aje;149/4/295pmid: N/A

Patterns of measles transmission at school and at home were studied in 1995 in a rural area of Senegal with a high level of vaccination coverage. Among 209 case children with a median age of 8 years, there were no deaths, although the case fatality ratio has previously been 6–7% in this area. Forty percent of the case children had been vaccinated against measles; the proportion of vaccinated children was higher among secondary cases (47%) than among index cases (33%) (prevalence ratio = 1.36, 95% confidence interval (CI) 1.04–1.76). Vaccinated index cases may have been less infectious than unvaccinated index cases, since they produced fewer clinical cases among exposed children (relative risk = 0.55, 95% CI 0.29–1.04). The secondary attack rate was lower in the schools than in the homes (relative risk = 0.31, 95% CI 0.20–0.49). The school outbreaks were protracted, with 4–5 generations of cases being seen in the two larger schools. Vaccine efficacy was found to be 57% (95% CI −23 to 85) in the schools and 74% (95% CI 62–82) in the residential compounds. Measles infection resulted in a mean of 3.8 days of absenteeism per case, though this did not appear to have an impact on the children's grades. Among the index cases, 56% of children were probably infected by neighbors in the community, and 7% were probably infected at health centers, 13% outside the community, and 24% in one of the three schools which had outbreaks during the epidemic. However, most of the school-related cases occurred at the beginning and therefore contributed to the general propagation of the epidemic. To prevent school outbreaks, it may be necessary to require vaccination prior to school entry and to revaccinate children in individual schools upon detection of cases of measles. Multidose measles vaccination schedules will be necessary to control measles in developing countries. Am J Epidemiol 1999; 149: 295–301. Key words developing countries disease outbreaks disease transmission measles measles vaccine schools vaccination © 1999 by The Johns Hopkins University School of Hygiene and Public Health « Previous | Next Article » Table of Contents This Article Am. J. Epidemiol. (1999) 149 (4): 295-301. » Abstract Free Full Text (PDF) Free Classifications Original Contribution Services Article metrics Alert me when cited Alert me if corrected Find similar articles Similar articles in Web of Science Similar articles in PubMed Add to my archive Download citation Request Permissions Disclaimer Citing Articles Load citing article information Citing articles via CrossRef Citing articles via Scopus Citing articles via Web of Science Citing articles via Google Scholar Google Scholar Articles by Cisse, B. Articles by Whittle, H. Search for related content PubMed PubMed citation Articles by Cisse, B. Articles by Aaby, P. Articles by Simondon, F. Articles by Samb, B. Articles by Soumaré, M. Articles by Whittle, H. Related Content Load related web page information Share Email this article CiteULike Delicious Facebook Google+ Mendeley Twitter What's this? Search this journal: Advanced » Current Issue November 1, 2015 182 (9) Alert me to new issues The Journal About this journal Publishers' Books for Review Rights & Permissions Dispatch date of the next issue This journal is a member of the Committee on Publication Ethics (COPE) We are mobile - find out more Journals Career Network Published on behalf of The Johns Hopkins Bloomberg School of Public Health In association with The Society for Epidemiologic Research (SER) Impact factor: 5.230 5-Yr impact factor: 5.632 Editor-in-Chief Moyses Szklo, MD, DrPH View full editorial board For Authors Instructions to authors Author Self Archiving Policy Online Submission Submit a manuscript Open access options for authors - visit Oxford Open This journal enables compliance with the NIH Public Access Policies Policy Epidemiologic Reviews 2016 Call for Papers With questions or concerns, please contact the Editorial Office at (410) 223-1649 or via [email protected] . Alerting Services Email table of contents Email Advance Access CiteTrack XML RSS feed Corporate Services Advertising sales Reprints Supplements Classified Advertising Sales Widget Get a widget

Cisse, Badara; Aaby, Peter; Simondon, François; Samb, Badara; Soumaré, Masserigne; Whittle, Hilton

doi: N/Apmid: N/A

Patterns of measles transmission at school and at home were studied in 1995 in a rural area of Senegal with a high level of vaccination coverage. Among 209 case children with a median age of 8 years, there were no deaths, although the case fatality ratio has previously been 6–7% in this area. Forty percent of the case children had been vaccinated against measles; the proportion of vaccinated children was higher among secondary cases (47%) than among index cases (33%) (prevalence ratio = 1.36, 95% confidence interval (CI) 1.04–1.76). Vaccinated index cases may have been less infectious than unvaccinated index cases, since they produced fewer clinical cases among exposed children (relative risk = 0.55, 95% CI 0.29–1.04). The secondary attack rate was lower in the schools than in the homes (relative risk = 0.31, 95% CI 0.20–0.49). The school outbreaks were protracted, with 4–5 generations of cases being seen in the two larger schools. Vaccine efficacy was found to be 57% (95% CI −23 to 85) in the schools and 74% (95% CI 62–82) in the residential compounds. Measles infection resulted in a mean of 3.8 days of absenteeism per case, though this did not appear to have an impact on the children's grades. Among the index cases, 56% of children were probably infected by neighbors in the community, and 7% were probably infected at health centers, 13% outside the community, and 24% in one of the three schools which had outbreaks during the epidemic. However, most of the school-related cases occurred at the beginning and therefore contributed to the general propagation of the epidemic. To prevent school outbreaks, it may be necessary to require vaccination prior to school entry and to revaccinate children in individual schools upon detection of cases of measles. Multidose measles vaccination schedules will be necessary to control measles in developing countries. Am J Epidemiol 1999; 149: 295–301.

Cisse, Badara;Aaby, Peter;Simondon, François;Samb, Badara;Soumaré, Masserigne;Whittle, Hilton

doi: 10.1093/oxfordjournals.aje.a009811pmid: 10025469

Abstract Patterns of measles transmission at school and at home were studied in 1995 in a rural area of Senegal with a high level of vaccination coverage. Among 209 case children with a median age of 8 years, there were no deaths, although the case fatality ratio has previously been 6–7% in this area. Forty percent of the case children had been vaccinated against measles; the proportion of vaccinated children was higher among secondary cases (47%) than among index cases (33%) (prevalence ratio = 1.36, 95% confidence interval (CI) 1.04–1.76). Vaccinated index cases may have been less infectious than unvaccinated index cases, since they produced fewer clinical cases among exposed children (relative risk = 0.55, 95% CI 0.29–1.04). The secondary attack rate was lower in the schools than in the homes (relative risk = 0.31, 95% CI 0.20–0.49). The school outbreaks were protracted, with 4–5 generations of cases being seen in the two larger schools. Vaccine efficacy was found to be 57% (95% CI −23 to 85) in the schools and 74% (95% CI 62–82) in the residential compounds. Measles infection resulted in a mean of 3.8 days of absenteeism per case, though this did not appear to have an impact on the children's grades. Among the index cases, 56% of children were probably infected by neighbors in the community, and 7% were probably infected at health centers, 13% outside the community, and 24% in one of the three schools which had outbreaks during the epidemic. However, most of the school-related cases occurred at the beginning and therefore contributed to the general propagation of the epidemic. To prevent school outbreaks, it may be necessary to require vaccination prior to school entry and to revaccinate children in individual schools upon detection of cases of measles. Multidose measles vaccination schedules will be necessary to control measles in developing countries. Am J Epidemiol 1999; 149: 295–301. developing countries, disease outbreaks, disease transmission, measles, measles vaccine, schools, vaccination © 1999 by The Johns Hopkins University School of Hygiene and Public Health

Strebel,, Peter;Guris,, Dalya;Papania,, Mark;Cochi,, Stephen

doi: 10.1093/oxfordjournals.aje.a009812pmid: 10025470

Article PDF first page preview Close This content is only available as a PDF. © 1999 by The Johns Hopkins University School of Hygiene and Public Health

Strebel, Peter; Guris, Dalya; Papania, Mark; Cochi, Stephen

doi: N/Apmid: N/A

Aaby,, Peter;Cisse,, Badara;Simondon,, François;Samb,, Badara;Soumaré,, Masserigne;Whittle,, Hilton

doi: 10.1093/oxfordjournals.aje.a009813pmid: 10025471

Article PDF first page preview Close This content is only available as a PDF. © 1999 by The Johns Hopkins University School of Hygiene and Public Health

Aaby, Peter; Cisse, Badara; Simondon, François; Samb, Badara; Soumaré, Masserigne; Whittle, Hilton

doi: N/Apmid: N/A

Grievink, Linda;Zijlstra, Aletta G.;Ke, Xiaodong;Brunekreef, Bert

doi: 10.1093/oxfordjournals.aje.a009814pmid: 10025472

Abstract The aim of this study was to investigate whether the acute effects of ozone on lung function could be modulated by antioxidant vitamin supplementation in a placebo-controlled study. Lung function was measured in Dutch bicyclists (n = 38) before and after each training session on a number of occasions (n = 380) during the summer of 1996. The vitamin group (n = 20) received 100 mg of vitamin E and 500 mg of vitamin C daily for 15 weeks. The average ozone concentration during exercise was 77 μg/m3 (range, 14–186 μg/m3). After exclusion of subjects with insufficient compliance from the analysis, a difference in ozone exposure of 100 μg/m3 decreased forced expiratory volume in 1 second (FEV1) 95 ml (95% confidence interval (CI) −265 to −53) in the placebo group and 1 ml (95% CI −94 to 132) in the vitamin group; for forced vital capacity, the change was −125 ml (95% CI −384 to −36) in the placebo group and −42 ml (95% CI −130 to 35) in the vitamin group. The differences in ozone effect on lung function between the groups were statistically significant. The results suggest that supplementation with the antioxidant vitamins C and E confers partial protection against the acute effects of ozone on FEV1 and forced vital capacity in cyclists. Am J Epidemiol 1999;149:306–14. antioxidants, bicycling, ozone, spirometry, vitamins © 1999 by The Johns Hopkins University School of Hygiene and Public Health

Linda Grievink, Aletta G. Zijlstra, Xiaodong Ke, Bert Brunekreef

doi: aje;149/4/306pmid: N/A

The aim of this study was to investigate whether the acute effects of ozone on lung function could be modulated by antioxidant vitamin supplementation in a placebo-controlled study. Lung function was measured in Dutch bicyclists ( n = 38) before and after each training session on a number of occasions ( n = 380) during the summer of 1996. The vitamin group ( n = 20) received 100 mg of vitamin E and 500 mg of vitamin C daily for 15 weeks. The average ozone concentration during exercise was 77 μg/m 3 (range, 14–186 μg/m 3 ). After exclusion of subjects with insufficient compliance from the analysis, a difference in ozone exposure of 100 μg/m 3 decreased forced expiratory volume in 1 second (FEV 1 ) 95 ml (95% confidence interval (CI) −265 to −53) in the placebo group and 1 ml (95% CI −94 to 132) in the vitamin group; for forced vital capacity, the change was −125 ml (95% CI −384 to −36) in the placebo group and −42 ml (95% CI −130 to 35) in the vitamin group. The differences in ozone effect on lung function between the groups were statistically significant. The results suggest that supplementation with the antioxidant vitamins C and E confers partial protection against the acute effects of ozone on FEV 1 and forced vital capacity in cyclists. Am J Epidemiol 1999;149:306–14. Key words antioxidants bicycling ozone spirometry vitamins © 1999 by The Johns Hopkins University School of Hygiene and Public Health « Previous | Next Article » Table of Contents This Article Am. J. Epidemiol. (1999) 149 (4): 306-314. » Abstract Free Full Text (PDF) Free Classifications Original Contribution Services Article metrics Alert me when cited Alert me if corrected Find similar articles Similar articles in Web of Science Similar articles in PubMed Add to my archive Download citation Request Permissions Disclaimer Citing Articles Load citing article information Citing articles via CrossRef Citing articles via Scopus Citing articles via Web of Science Citing articles via Google Scholar Google Scholar Articles by Grievink, L. Articles by Brunekreef, B. Search for related content PubMed PubMed citation Articles by Grievink, L. Articles by Zijlstra, A. G. Articles by Ke, X. Articles by Brunekreef, B. Related Content Load related web page information Share Email this article CiteULike Delicious Facebook Google+ Mendeley Twitter What's this? Search this journal: Advanced » Current Issue November 1, 2015 182 (9) Alert me to new issues The Journal About this journal Publishers' Books for Review Rights & Permissions Dispatch date of the next issue This journal is a member of the Committee on Publication Ethics (COPE) We are mobile - find out more Journals Career Network Published on behalf of The Johns Hopkins Bloomberg School of Public Health In association with The Society for Epidemiologic Research (SER) Impact factor: 5.230 5-Yr impact factor: 5.632 Editor-in-Chief Moyses Szklo, MD, DrPH View full editorial board For Authors Instructions to authors Author Self Archiving Policy Online Submission Submit a manuscript Open access options for authors - visit Oxford Open This journal enables compliance with the NIH Public Access Policies Policy Epidemiologic Reviews 2016 Call for Papers With questions or concerns, please contact the Editorial Office at (410) 223-1649 or via [email protected] . Alerting Services Email table of contents Email Advance Access CiteTrack XML RSS feed Corporate Services Advertising sales Reprints Supplements Classified Advertising Sales Widget Get a widget

Grievink, Linda; Zijlstra, Aletta G.; Ke, Xiaodong; Brunekreef, Bert

doi: N/Apmid: N/A

The aim of this study was to investigate whether the acute effects of ozone on lung function could be modulated by antioxidant vitamin supplementation in a placebo-controlled study. Lung function was measured in Dutch bicyclists (n = 38) before and after each training session on a number of occasions (n = 380) during the summer of 1996. The vitamin group (n = 20) received 100 mg of vitamin E and 500 mg of vitamin C daily for 15 weeks. The average ozone concentration during exercise was 77 μg/m3 (range, 14–186 μg/m3). After exclusion of subjects with insufficient compliance from the analysis, a difference in ozone exposure of 100 μg/m3 decreased forced expiratory volume in 1 second (FEV1) 95 ml (95% confidence interval (CI) −265 to −53) in the placebo group and 1 ml (95% CI −94 to 132) in the vitamin group; for forced vital capacity, the change was −125 ml (95% CI −384 to −36) in the placebo group and −42 ml (95% CI −130 to 35) in the vitamin group. The differences in ozone effect on lung function between the groups were statistically significant. The results suggest that supplementation with the antioxidant vitamins C and E confers partial protection against the acute effects of ozone on FEV1 and forced vital capacity in cyclists. Am J Epidemiol 1999;149:306–14.