Practical observations from an epidemiological investigation of a measles outbreak in a district of India

Abstract

Background:Measles is a major cause of childhood morbidity and mortality, accounting for nearly half of the morbidity associated with global vaccine preventable diseases. Regular outbreaks of Measles are reported in India, of which only a few are investigated. This study was conducted in the Shivpuri District of Madhya Pradesh (India) to investigate and asses various epidemiological factors associated with measles outbreak.Materials and Methods:A cross-sectional study was carried out in 30 randomly selected sub-centers in 8 blocks of the Shivpuri District of Madhya Pradesh, covering 212 villages, selected by cluster sampling. The villages, which had reported measles cases, were extensively investigated by the field teams through extensive house-to-house surveys during 12-19 May 2004.Results:A total of 1204 cases with 14 deaths were reported with an attack rate of 6.2% and a case fatality rate of 1.2%. In this study, 17.7% of the cases reported post-measles complications with diarrhea as the most common post measles complication. The routine measles vaccine and Vitamin A supplementation in the area was also less than 30%.Conclusions:The majority of the cases had occurred in the unvaccinated children and in under 5 year old population. There are repeated outbreaks and a long delay in reporting of the cases. The occurrence of cases, in a reasonable proportion of the vaccinated population, points toward the fact that there is a possibility of a vaccine failure in older children. This study calls for an improved surveillance system, an improvement in the cold chain, and enhancements for measles vaccination if India is to achieve the goal of measles elimination.

Measles outbreak investigation in Zaka, Masvingo Province, Zimbabwe, 2010

“…Low Vitamin A supplementation in Zaka may lead to increased risk of contracting measles and its complications. This is consistent with findings by Mishra et al, in a measles investigation outbreak in India where the Vitamin A supplementation coverage was less than 30% [10]. Vitamin A supplementation has been shown to increase measles specific antibody formation if it is administered simultaneously with the measles vaccine.…”

Epidemiology of measles in southern Iran: trends, challenges, and vaccination insights

“…In our current study, no deaths attributable to measles were reported. This contrasts with findings from other studies: Mishra and colleagues reported a single death in their study, Murhekar and colleagues reported six deaths, which constituted a 1.5% Case Fatality Rate (CFR), Pomerai and colleagues reported five deaths (4% CFR), and Mishra and colleagues recorded 14 deaths (6.2% CFR) 40 – 43 . The absence of fatalities in our study might be attributed to the immediate medical attention provided to the cases and the prophylactic administration of Vitamin A, which may have significantly influenced the outcome.…”

Assessment of Routine Measles Vaccine Effectiveness Among Children Referring to Tertiary Fever Hospital in Egypt

“…Measles is still a highly infectious disease in children leading to morbidity and mortality worldwide regardless of the availability of a relatively inexpensive, efficient, safe vaccine (1,2). The incidence differs along the years from 10% to 15%, with a noticeable increase to more than 50% during outbreaks (3,4). The factors predisposing people to the disease may include poverty, overcrowdedness, malnutrition, vitamin A deficiency, poor hygiene, improper immunization, and decreased immunity (5).…”