Responding to measles outbreak: closing the immunity gap in children of Timor-Leste

ABSTRACT

Background: An outbreak of measles was reported in Timor-Leste during 2011. A concertedresponse at national level utilized this opportunity to improve measles immunization coveragerates.Methods: Health Management Information System and Surveillance System data were utilized todescribe the outbreak. Attack rates and case fatality rates (CFR) were calculated using standardmethods. Evaluation surveys were used to access immunization coverage. Proceedings of weeklymeetings of the National Committee for Control of Disease Outbreaks were reviewed.Results: A total of 739 cases and 8 deaths were reported to the Surveillance Unit. Most (>82%)of the measles cases were reported from Dili and Ermera districts. The attack rate was 1.3 per1000 population and CFR was 1.1%. The response was coordinated by the National Committee forControl of Disease Outbreaks, which included case management, active and passive surveillance,communication and measles immunization among six-month to 14-year old children. Immunizationactivity targeted 495 000 children, i.e. almost one-half of the Timor-Leste population and achievedhigh coverage (85%).Conclusions: The outbreak highlighted gaps in the immunity against measles. The NationalCommittee for Control of Disease Outbreaks ensured a coordinated response which led to preventionof deaths from measles due to early case management with vitamin A supplementation, and highmeasles immunization coverage