Outbreak of measles and rubella in refugee transit camps

Abstract

In 2004, concurrent measles and rubella outbreaks occurred in four camps hosting 2767 Liberian refugees in Côte d'Ivoire. Sixty rash and fever cases were identified. From 19 January to 23 February 2004 (weeks 8-13), measles IgM testing showed that 61.1% were positive. The highest incidence rate (18.5%) of measles was observed in children aged <9 months. Ninety-three percent of children aged between 6 months and 15 years received a measles vaccine during week 13, but the rash and fever cases continued to occur. This prompted a systematic test for both measles and rubella IgM antibodies. Rubella IgM testing revealed 74.0% positive cases between 14 February and 25 April (weeks 11-21). The highest incidence rate (3.88%) of rubella was found in children aged between 5 and 15 years. Supplemental immunization with a measles-mumps-rubella (MMR) vaccine was conducted during week 20. This study illustrates the importance of testing for both measles and rubella in outbreaks of rash and fever in refugee settings.

Infectious diseases following natural disasters: prevention and control measures

“…Measles immunization has been documented as one of the most cost-effective public health interventions in disaster and refugee settings [34]. Vaccination measures for sheltered populations after natural disaster can supplement normal public health vaccination programs.…”

“…Measles vaccinations should be conducted as soon as people start gathering in camps. Immunization should be done preferably using the combined measles-mumps-rubella vaccine especially in case of limited or inexistent laboratory facilities [34]. The target age groups for vaccination should be guided by surveillance data.…”

“…They can encourage early referral of patients as well as advise on preventive measures to be taken. Community leaders should contribute to mobilizing resources, and improving surveillance and vaccination activities [34].…”

Assessment of the Epidemiology and Burden of Measles in Southern Mozambique

“…[3][4][5] However, despite the remarkable reduction in mortality achieved, 4 measles epidemics continue to occur and affect both children and young adults, including vaccinated individuals. [6][7][8] Moreover, the sizable proportion of infants below vaccination age (i.e., < 9 months of age) who remain susceptible to the infection when their maternally derived antibodies wane [9][10][11] are prone to develop severe disease accompanied by a high case fatality; this is particularly true among human immunodeficiency virus (HIV)-infected subjects. 12,13 In Mozambique, a single dose of measles vaccine is administered at 9 months of age through the Expanded Program of Immunization (EPI).…”

Vaccine-preventable diseases in humanitarian emergencies among refugee and internally-displaced populations

“…6 We reviewed articles related to measles outbreaks among displaced populations in Tanzania, Ivory Coast, Darfur, Ethiopia, Somalia and Kenya. [8][9][10][11] Movement of new arrivals into a refugee camp may introduce measles transmission. For example, initial cases in concurrent measles outbreaks in the Dollo Ado refugee camp in Ethiopia and the Dadaab refugee camp in Kenya during 2010 and 2011 were likely new arrivals from Somalia, a country that was also experiencing an ongoing measles outbreak.…”