Work

Outbreak of measles in Dakshinlaogaon, Nagaon District, Assam, India, 2016

Year: 2020

Type: article

Abstract: Background: An estimated 2–3 million measles cases and 100–200 thousand measles deaths occur annually in India. About 50% of these measles cases are children <5 years indicating insufficient routine measles immunization. On January 20, 2016, the District Surveillance Unit Nagaon reported 37 children <9years with fever and rash from Dakshinlaogaon village. We investigated the suspected measles outbreak to confirm and describe the outbreak and propose recommendation for control. Methods and materials: We defined a case of measles as fever and rash with cough, coryza, or conjunctivitis in Dakshinlaogaon village from October 19, 2015 to February 14, 2016.We included all children 7 months to 9 years. We interviewed mothers of children and reviewed vaccination cards and immunization registers at health care facilities to assess vaccination coverage and vaccine effectiveness. We reviewed the use of vitamin A for case management. We tested five serum samples for IgM antibodies for measles towards the end of the outbreak. Results: We identified 78 measles cases with an attack rate of 13% and median age of 36 months (7–110 months). Attack rate was 29% (20/78) among 10–24 months and 4% (3/78) among 7-9 months. Males were more affected 63% (49/78). Among cases, 55% (43/78) had cough, 41% (32/78) had coryza, 26% (20/78) had conjunctivitis, 6% (5/78) had diarrhoea and 5% (4/78) had ear discharge. Among children 7 months to 9 years, vaccination coverage for first dose measles-containing vaccine was 23% (113/496) and Vaccine effectiveness of measles-containing vaccine was 57% (95% CI = 8.5–79.5). There were four hospitalization with case fatality rate of 2.5% (2/78). Nine cases received vitamin A. Four out of five serum samples were positive for IgM antibodies for measles and one was equivocal. Conclusion: This measles outbreak was caused by low vaccination coverage in Dakshinlaogaon and low vaccine effectiveness. We recommended strengthening routine immunization in the area by increasing community awareness about the importance of vaccines and by increasing outreach vaccination services. We also recommended annual trainings of staff involved in vaccine service delivery and vaccine management and emphasize on vitamin A supplementation during outbreaks.

Source: International Journal of Infectious Diseases

DOI: 10.1016/j.ijid.2020.09.924

Authors: T. Jamir, S. Laskar, A. Sibarini, M. Malakar

Institution: Nagaland University

Language: English

Topic: Virology and Viral Diseases

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,750