Measles- The Outbreak Case Study (Part 3)
This case study is based on an investigation by Philip Landrigan, EIS ’70. The investigation is described in: Landrigan PJ.
Epidemic measles in a divided city. JAMA 1972; 221: 567-570.
This case study was original developed by Philip Landrigan, Lyle Conrad and John Witte in 1971. The current version was
updated by Richard Dicker in 2001 and 2003.
Part III
Between June 1970 and January 1971, 633 cases of measles were reported from Texarkana. Dates of onset were
accurately determined for 535 cases. The epidemic curve is shown below.
Though infants, adolescents, and adults were involved in the epidemic, the majority of cases occurred in children 1 to 9
years of age. Measles cases were not evenly distributed within the two counties. Table 1 displays the number of measles
cases and population by age group for Bowie County, Texas and in Miller County, Arkansas.Table 1. Number of measles cases and population (1960 census) by age group and county, Texarkana
outbreak, 1970
Residence Urban/Rural Age Group # Cases Population Rate
Bowie Co, TX Rural 1-4 yr 47 2,452
5-9 178 3,242
1-9
Urban 1-4 195 2,481
5-9 73 3,010
1-9
Total 1-4 242 4,933
5-9 251 6.252
1-9
Miller Co, AK Total 1-4 19 2,671
5-9 6 3,345
1-9
Directions:
Measles is the theme of this Case Study. Please answer the questions listed for part 3 (below) using APA citation and
formatting in a 3-page paper after reading the material and using the resources provided. Use references as appropriate
to answer the questions fully. Remember to cite all sources. Please use professional references (not common websites),
cite the reference where used in the narrative, and use correct reference formatting.
Please answer the following questions with responses:
• Question 6: Discuss the key features of the epidemic that you can derive from the epidemic curve (epi curve).
Describe in terms of person, time, and place, where possible.
• Question 7: Calculate the totals and attack rates indicated in Table 1.
• Question 8: Discuss the differences in attack rates for the Texas and Arkansas counties, for rural versus urban children, and for preschool versus school-age children
