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Published on: September 12, 2016
Outbreak of measles and rubella in refugee transit camps
I K Kouadio1, A K Koffi, H Attoh-Toure
1Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Abstract:
In 2004, concurrent measles and rubella outbreaks occurred in four camps hosting 2767 Liberian refugees in Côte d'Ivoire. Sixty rash and fever cases were identified. From 19 January to 23 February 2004 (weeks 8-13), measles IgM testing showed that 61.1% were positive. The highest incidence rate (18.5%) of measles was observed in children aged <9 months. Ninety-three percent of children aged between 6 months and 15 years received a measles vaccine during week 13, but the rash and fever cases continued to occur. This prompted a systematic test for both measles and rubella IgM antibodies. Rubella IgM testing revealed 74.0% positive cases between 14 February and 25 April (weeks 11-21). The highest incidence rate (3.88%) of rubella was found in children aged between 5 and 15 years. Supplemental immunization with a measles-mumps-rubella (MMR) vaccine was conducted during week 20. This study illustrates the importance of testing for both measles and rubella in outbreaks of rash and fever in refugee settings.
Insights
Concurrent measles and rubella outbreaks in Liberian refugee camps highlighted diagnostic challenges. Testing for both measles and rubella IgM antibodies is crucial for accurate diagnosis in outbreak settings.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Concurrent outbreaks of measles and rubella occurred in Liberian refugee camps in Côte d'Ivoire in 2004.
- Sixty cases of rash and fever were identified among 2767 refugees.
Purpose of the Study:
- To investigate concurrent measles and rubella outbreaks in a refugee population.
- To assess the diagnostic utility of testing for both measles and rubella IgM antibodies during outbreaks.
Main Methods:
- Retrospective analysis of rash and fever cases in refugee camps.
- Serological testing for measles and rubella IgM antibodies.
- Calculation of incidence rates by age group.
- Description of vaccination campaigns.
Main Results:
- Measles IgM testing was positive in 61.1% of cases during weeks 8-13, with the highest incidence in children under 9 months (18.5%).
- Despite measles vaccination, rash and fever cases continued, prompting rubella IgM testing.
- Rubella IgM testing revealed 74.0% positive cases between weeks 11-21, with the highest incidence in children aged 5-15 years (3.88%).
- Supplemental immunization with measles-mumps-rubella (MMR) vaccine was conducted.
Conclusions:
- Outbreaks of rash and fever in refugee settings may involve multiple viral agents, including measles and rubella.
- Simultaneous testing for both measles and rubella IgM antibodies is essential for accurate diagnosis and effective outbreak response.
- Vaccination strategies must consider the potential for concurrent outbreaks and the need for broad-spectrum immunization.
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