Epidemic measles in Shetland during 1977 and 1978.

During 1977 and 1978 an unusual epidemic of measles occurred in Shetland, affecting 1032 (5%) of the population. All age groups were represented, and 309 cases occurred in people over 15. Geographical distribution of notified cases ranged from 1% to over one-third of the population aged under 65. All the recognised complications occurred, with a significant excess of respiratory troubles (p less than 0 . 05). Complications were much less common in female patients (p less than 0 . 05). Only about 30% of children under 5 had been vaccinated against the disease, and, based on a sample population, vaccination was found to have had a protective effect of 92%. On cost effectiveness alone, uptake of vaccination by a community as susceptible as that of Shetland should clearly be encouraged and probably given high priority.