Texarkana: Epidemic Measles in a Divided City

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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.
Date published
Jan, 2003
Last updated
31 Jan 2020


Measles outbreak in a community on the border of two states — the Arkansas side with required school immunization and high immunization rates, the Texas side without required immunization and low immunized rates, 1970.


  • Discuss the advantages and disadvantages of using a sensitive and/or specific case definition in an epidemic investigation;
  • Calculate vaccine efficacy and discuss its interpretation; and
  • Discuss the advantages and limitations of selecting a specific age as the recommended target date for administering vaccinations.