Question: In an attempt to understand the ongoing measles outbreak in Rockland County, New York, health officials have constructed the following plot of the number of new measles cases according to the date of symptom onset. At the time of publication, there were 242 confirmed cases of measles in Rockland County and neighboring counties.

1. Based on the distribution of cases over time, do you believe this outbreak is a point-source, continuous-source, or person-to-person epidemic? Briefly explain your selection.
2. Suppose the number of people at risk in this population is 10,000 people. What is the attack rate of this measles outbreak?
3. While no deaths have been reported in the current measles outbreak, approximately how many deaths would you expect if the case-fatality rate were 5%?
4. Suppose employees of the county’s Health Department conduct interviews with all 242 confirmed cases and find that 81% of cases are regular members of one of the county’s community groups. Express this percentage as a statement of probability and state whether it is a marginal, conditional, or joint probability.
5. The Health Department plans to release a statement informing the public that the basic reproductive number for measles is approximately 15. In one sentence, how would you explain the meaning of this number to someone with no public health training? (Be sure to interpret in the context of this problem).
6. Given your knowledge of how a basic reproductive number is calculated (i.e. , propose one strategy or intervention for each of the three factors (i.e. B, c, and D) that could be implemented to decrease the basic reproductive number of measles.
7. Assuming the measles vaccine is 100% effective and , what percent of the population would need to be immunized to achieve herd immunity against measles?

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