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Public Health Rep. 1988 Jan-Feb; 103(1): 49–54.
PMCID: PMC1477942

Measles outbreaks in religious groups exempt from immunization laws.


State immunization laws which exempt religious groups present difficult problems in disease control in measles epidemics. Two outbreaks are described, 136 cases in a college for Christian Scientists, and 51 cases associated with a camp attended by Christian Scientists. Control measures at the college included immunization and quarantine. An alternative strategy at the camp consisted of dispersal of exposed persons from the camp and their being quarantined in their home States. Three deaths (case-fatality ratio = 2.2 percent) were reported at the college; no serious complications were reported from the camp-associated epidemic. No transmission into the general community occurred in either epidemic. Public health officials are encouraged to be aware of the legal rights and obligations of religiously exempt groups so that outbreaks in these groups can be effectively controlled, even if standard immunization strategies are not possible. Early reporting and rapid case identification, investigation, and quarantine or vaccination procedures by public health workers are necessary for disease control in these settings.

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Selected References

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  • Bloch AB, Orenstein WA, Stetler HC, Wassilak SG, Amler RW, Bart KJ, Kirby CD, Hinman AR. Health impact of measles vaccination in the United States. Pediatrics. 1985 Oct;76(4):524–532. [PubMed]
  • Hinman AR, Brandling-Bennett AD, Nieburg PI. The opportunity and obligation to eliminate measles from the United States. JAMA. 1979 Sep 14;242(11):1157–1162. [PubMed]
  • Frank JA, Jr, Orenstein WA, Bart KJ, Bart SW, el-Tantawy N, Davis RM, Hinman AR. Major impediments to measles elimination. The modern epidemiology of an ancient disease. Am J Dis Child. 1985 Sep;139(9):881–888. [PubMed]

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