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year in 199 I I 998 (3)・ Thoughthefrequency of large.Outbreaks has lately been seen to decrease, measles remainsanlmPOrtant EPI target disease in Japan. Fromthe end of November to the end of December 1998, an outbreak or measles occumd in a Junior high school in Tokyo・ Among 630 students enrolled in the school, 28 were diagnosed as having measles. The measles vims was isolated from four patients byusing B95a cells (4). Among 476 students who responded our questionnaire, 345 (72.4%) had received measles vaccineand 61 (12.8%) had past-histories of measles. Among the 345 vaccinees, only two students were affected by the present measles outbreak (0.6%). On the other hand, among 59 non-vaccinees without past-histories of measles, 22 students were affected (37.3%), indicating that the present outbreak affected mainly non-vaccinees. The number of measles patients among vaccinees was 2 in 345 (2.6%) (Table 1). The two students with histories of measles vaccination had measles in the present outbreak. It was not clear whether this was due to a pnmary vaccine failure or secondary vaccine failure (5). We measuredthe HI antibody titers of 174 students by HI test (6) three months after the outbreak. The average HI titer in the group with histories of natural infection was 82, while that in the vaccinees was 32. It was evident that the vaccination could not elevate the antibody liter to the level obtained by naturalinfection・ The distribution of serum HI titers of 169 students who escaped the outbreak is shown in Figure I ・ Among l30 vaccinees in this group, 19 (15%) had no detectable HI antibody and 74 (56.9%) had only low levels of the antibody (X8-16). Namely, 72% of the vaccinees had no or showed only low levels of measles antibody・ It was suggested that an outbreak of this size had no txnster effect onthe herd immunity, producing a condition for secondary vaccine failure・ This may be related to the recent increase of measles cases among the adults (7).

Measles Outbreak in a Junior High School in November-December 1998