Measles outbreak investigation in Dwarahat block of District Almora, Uttarakhand

We report an assessment of measles outbreak during the months of February 2014 to April 2014 in Dwarahat block of district Almora and the response mounted to it.

An intensive door-to-door search to six measles affected villages in Dwarahat block of district Almora, covering a population of 2,408 was carried out to identify the cases of measles by a rapid response team (RRT). A total of ten blood samples were randomly collected for detecting IgM antibody against measles. For all cases, information on personal details, place of residence, time of onset and status of immunization were obtained.

Overall attack rate (AR) was 2.8%. AR among the population of age-group 0-16 was 7.2%. Statistically significant higher AR (16.26%) was seen for the age-group of 0-5 years as compare to 6-10 and 11-16 years of age (AR-8.71, relative risk-0.53, 95% confidence interval-0.32-0.88, P value-0.012 and AR-0.57%, relative risk-0.035, 95% confidence interval-0.00-0.14, P value-0.000, respectively). Males were affected more often than females 35 [59.2%] vs. 24 [40.8%]. Measles-related complications were seen in three children. No death was reported. Of the 10 samples, nine were positive for measles IgM antibodies by enzyme-linked immunosorbent assay (ELISA).

The recognition of early warning signals, timely investigation and application of specific control measures can contain the outbreak. The unvaccinated or partially protected human beings serve as the reservoir of measles virus. Hence, there is a need for sero surveillance for measles in Uttarakhand and one catch up measles immunisation campaign to prevent future outbreak.