Measles outbreak propagated by children congregating at water collection points in Mayuge District, eastern Uganda, July - October, 2016.
BMC Infect Dis
; 18(1): 412, 2018 Aug 20.
Article
em En
| MEDLINE
| ID: mdl-30126362
ABSTRACT
BACKGROUND:
On 12 October, 2016 a measles outbreak was reported in Mayuge District, eastern Uganda. We investigated the outbreak to determine its scope, identify risk factors for transmission, evaluate vaccination coverage and vaccine effectiveness, and recommend evidence-based control measures.METHODS:
We defined a probable case as onset of fever (≥3 days) and generalized rash, plus ≥1 of the following conjunctivitis, cough, and/or runny nose in a Mayuge District resident. A confirmed case was a probable case with measles-specific IgM (+) not explained by vaccination. We reviewed medical records and conducted active community case-finding. In a case-control investigation involving probable case-persons and controls matched by age and village, we evaluated risk factors for transmission for both cases and controls during the case-person's likely exposure period (i.e., 7-21 days prior to rash onset). We estimated vaccine effectiveness (VE) using the formula VE ≈ (1-ORprotective) × 100. We calculated vaccination coverage using the percentage of controls vaccinated.RESULTS:
We identified 62 probable case-persons (attack rate [AR] = 4.0/10,000), including 3 confirmed. Of all age groups, children < 5 years were the most affected (AR = 14/10,000). The epidemic curve showed a propagated outbreak. Thirty-two percent (13/41) of case-persons and 13% (21/161) of control-persons visited water-collection sites (by themselves or with parents) during the case-persons' likely exposure period (ORM-H = 5.0; 95% CI = 1.5-17). Among children aged 9-59 months, the effectiveness of the single-dose measles vaccine was 75% (95% CI = 25-92); vaccination coverage was 68% (95% CI = 61-76).CONCLUSIONS:
Low vaccine effectiveness, inadequate vaccination coverage and congregation at water collection points facilitated measles transmission in this outbreak. We recommended increasing measles vaccination coverage and restriction of children with signs and symptoms of measles from accessing public gatherings.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Abastecimento de Água
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Reservatórios de Doenças
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Comportamento Infantil
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Surtos de Doenças
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Sarampo
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
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Middle aged
País/Região como assunto:
Africa
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article