Measles in a hilly hamlet of northern India

To ascertain the epidemiological links and risk factors responsible for the epidemic of measles in the village Astani in Himachal Pradesh.

All the children less than twelve years who were present on 27th July 1997 were evaluated. A questionnaire requesting data on vaccination history and symptoms of measles was administered and complete physical examination including anthropometry was recorded in each child by the authors. The data also included complications (including that of death) secondary to measles infection.

A total of 48 children less than 12 years, present in the hamlet on 27th July 1997, were examined, out of which 28 (58%) were affected and 20 (42%) were unaffected. The immunization coverage in the affected children was 33% in contrast to 70% coverage in the unaffected group. Vaccine efficacy in the present epidemic was 51%. The complication rate was 59%, which included one death. The anthropometric data showed that 92% of the affected children were malnourished. All the children were given age appropriate dose of Vitamin A and children of the nearby villages were vaccinated against measles as a part of outbreak control.

This study clearly highlights the need to achieve and sustain high immunization coverage along with strengthening of the routine surveillance systems in remote village of India.