Outbreaks of measles in Rajasthan in 2014: a cross sectional epidemiological investigation

Abstract

Background: In India, although the measles vaccine is available across the country up to village level, but still India is struggling with mortality and morbidity associated with Measles and its outbreaks. Investigations in measles outbreak help to know the determinants behind it and thus prevent further outbreaks. The outbreaks of measles in Rajasthan were investigated in 2014 by analyzing various socio-demographic parameters. Objective: To assess the epidemiological profile of measles outbreak in Rajasthan in 2014.Methods: The data of the measles surveillance project of Rajasthan was used for analysis. This is an analytical, cross sectional study where 10 districts of Rajasthan having confirmed measles outbreak in 2014 were included. A total of 353 laboratory plus epidemiologically linked measles cases were considered. Statistical analysis: Percentages, proportions and Chi square test were applied. Results: Out of the 23 suspected measles outbreaks subjected for confirmatory laboratory investigation, majority i.e. 14 (60.8%) were found to be of measles. Out of these 14 outbreaks, 353 cases were of measles (Laboratory confirmed + epidemiologically confirmed). Maximum numbers (around 50%) of cases were from the age group 1-4 years. Only 108 (30.6%) cases were vaccinated for measles vaccine. Girl children contributed to about 60 % of the total measles cases. Almost 2/3rd (66.9%) cases were in Muslim families. Conclusions: There was clustering of measles cases in few of the districts adjacent to each other. Measles vaccination coverage in few pockets was poor in outbreak districts. There is a need to boost up measles vaccination coverage with special attention to high risks areas like urban slums etc.

Measles Outbreak among Nomadic Population with Low Herd Immunity in an Eastern District of Bhutan, 2016

“…The low vaccine coverage could have increased the susceptibility of children and adults for measles infection. Similar findings of low vaccine coverage being associated with measles outbreaks were observed in different parts of India 7,8 , Nepal 9 , Bangladesh 10,11 , Sri Lanka 12,13 , Thailand 14 and Lao PDR 14 .…”

A study on epidemiological and clinical characteristics of measles patients admitted to Sir Ronald Ross institute of tropical and communicable diseases, Hyderabad, India

“…This findings were similar to a study conducted by Singh et al where the incidence of disease was highest among unimmunized children followed by partially immunized followed by completely immunized. 10 In the present study, the most common complication was diarrhea (20.5%) followed by pneumonia (13.3%) and around 11.3% of them developed otitis media. The present study findings were similar to a study by Deepa et al and Rahima et al 7,8 This findings differed to a study by sultana et al, where pneumonia was the most common complication (63.6%).…”

“…7 The present study findings were different in comparison to a study conducted in Rajasthan where 60% of study subjects were females. 10 In the present study, almost half the cases (49.2%) were reported in the months of October-December (corresponding to winter season). The present study findings concurred with a study conducted by Babita et al where maximum cases were found in the months of September to December.…”

The impact of measles immunization campaigns in India using a nationally representative sample of 27,000 child deaths

“…The WHO estimated the coverage of first-dose vaccine in South-east Asia (which includes India) to be below the levels that would achieve herd immunity (85% in 2012) and stagnation of coverage in the past decade (Dabbagh et al, 2017; Moss, 2017). Documented measles outbreaks indicate that India remains endemic to measles given suboptimal coverage, with about 3 million infants not receiving first-dose measles vaccination in 2013 (Dabbagh et al, 2017; Jamir et al, 2016; Singh and Garg, 2017; Vaidya et al, 2016). India’s Integrated Disease Surveillance Program reported a decline in annual measles outbreaks during 2011–2013 but gradual increases since (Ministry of Health and Family Welfare, 2018).…”