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A Mixed Outbreak of Rubeola-Rubella in District Kangra of Northern India

Surender N Gupta1, Naveen Gupta2, Shivani Gupta3

  • 1District Program Officer, Chief Medical officer office, Dharamshala at Kangra cum Epidemiologist-in-Charge, district Chamba; Department of Health and Family Welfare, Government of Himachal Pradesh, India.

Journal of Family Medicine and Primary Care
|December 15, 2015
PubMed
Abstract

Insights

A mixed measles and rubella outbreak occurred in Kangra. Vaccination significantly reduced measles risk, with an 83% vaccine efficacy, highlighting the need for widespread immunization.

Area of Science:

  • Epidemiology
  • Public Health
  • Infectious Disease Control

Background:

  • A sudden increase in fever and rash cases was reported in five villages in Kangra district, India.
  • An investigation was initiated to confirm the diagnosis and implement control measures for the suspected outbreak.

Purpose of the Study:

  • To investigate a suspected outbreak of fever and rash in Kangra district.
  • To confirm the diagnosis, determine the causative agent, and assess vaccine efficacy.
  • To recommend preventive and control strategies.

Main Methods:

  • A case definition was established for rubeola (measles) and rubella.
  • Data on demographics, symptoms, vaccination status, and treatment were collected.
  • A retrospective cohort study was conducted to calculate vaccine efficacy (VE).
  • Clinical, epidemiological, and serological methods were used for confirmation.

Main Results:

  • Sixty cases of rubeola and rubella were identified across five villages.
  • The overall attack rate was 9%, with higher rates in unvaccinated children (25.8% vs. 4.5%).
  • Measles vaccine efficacy was estimated at 83% overall and 84% for males.
  • Rubeola virus genotype D4 was identified; serological confirmation was obtained for eight cases.

Conclusions:

  • A mixed outbreak of rubeola and rubella was confirmed.
  • Measles and rubella (MR) vaccination is recommended at 18-24 months.
  • Enhanced Information, Education, and Communication (IEC) activities are crucial to improve healthcare-seeking behaviors.
Keywords:
D4-genotypeKangrahighly immunized villagesimmunoglobin M (IgM) antibodiesrubeola-rubella outbreak

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