Læknablaðið - 01.04.2014, Side 16

216 LÆKNAblaðið 2014/100
Þessar niðurstöður minna okkur á mikilvægi hjarðónæmis og
þá miklu hættu sem stafar af mislingum ef ekki næst að halda
því nægilega háu. Nánari skoðun á fjölskyldutengslum og skyld-
leika væri afar áhugaverð með aðferðum sem áður hefur verið
lýst í rannsóknum á spönsku veikinni. Upplýsingar sem leynast
í gömlum íslenskum kirkjubókum gefa okkur kost á því að svara
grundvallarspurningum um þessa skæðu mislingafaraldra, meira
en 130 árum síðar.
Þakkir
Jón Torfason skjalavörður á Þjóðskjalasafni Íslands fær þakkir
fyrir aðstoð við öflun gagna.
Heimildir
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R A N N S Ó K N
ENGLISH SUMMARY
introduction: Measles have increased in incidence in some parts of
the developed world in the past 10-15 years. They can be fatal and lead
to severe sequelae.Measles were infrequently introduced to Iceland in
the 19th century and consequently, epidemics were few but associated
with an extremely high mortality. The availability of 19th century church
registries enables studies on the impact of measles on mortality.
Materials and methods: Historical accounts mention two major meas-
les epidemics, starting mid-year 1846 and 1882. We analysed these two
epidemics using contemporary historical sources, mainly original church
registries.
Results: In the 1846 epidemic the data show a clear increase in morta-
lity in june and reach a peak in july of 741 fatal cases total, a four-fold
increase from expected baseline rate. The epidemic subsided in the
ensuing five months. A cluster of measles was described in the eastern
region of Iceland in 1869 but did not spread further. The epidemic of
1882 reached its peak in july, when 1084 individuals died, a five-fold
increase from the expected rate. Excess mortality was highest in N-Isa-
fjardarsysla county, 4,7 %, and none in A-Skaftafellssysla county where
the illness was described 13 years previously. The highest numbers of
fatal cases in the 1882 epidemic (64,6%) was among 0-4 year old child-
ren. The number of fatalities among women of child-bearing age was
more than two-fold compared to men; the number of births 7-9 months
following the 1882 peak dropped significantly by 50%.
Conclusions: This study highlights the consequences of measles fol-
lowing introduction into a largely susceptible population and also docu-
ments the importance of herd immunity. Information can be identified on
most individual fatalities during the 1846 and 1882 measles epidemics
in Iceland.
key words: Measles, mortality, epidemic, historical sources, pregnancy.
Correspondence: Magnús Gottfreðsson magnusgo@landspitali.is
1Faculty of medicine, university of Iceland, 2Directorate of Health, 3Landspítali university Hospital
Extent and impact of the measles epidemics of 1846 and 1882 in iceland
Sandra Gunnarsdottir1, Haraldur Briem1,2, Magnús Gottfredsson1,3
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