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Updated: Dec 19, 2025
Remote Laboratory Management: Respiratory Virus Diagnostics
Published on: April 6, 2019
Measles outbreak amplified in a pediatric ward: Lyantonde District, Uganda, August 2017
Claire Biribawa1, Joselyn Annet Atuhairwe2, Lilian Bulage2
1Uganda Public Health Fellowship Program, Kampala, Uganda. biribawaclaire@musph.ac.ug.
Background:
Measles is a highly infectious viral disease. In August 2017, Lyantonde District, Uganda reported a measles outbreak to Uganda Ministry of Health. We investigated the outbreak to assess the scope, factors facilitating transmission, and recommend control measures.
Methods:
We defined a probable case as sudden onset of fever and generalized rash in a resident of Lyantonde, Lwengo, or Rakai Districts from 1 June-30 September 2017, plus ≥1 of the following: coryza, conjunctivitis, or cough. A confirmed case was a probable case with serum positivity of measles-specific IgM. We conducted a neighborhood- and age-matched case-control study to identified exposure factors, and used conditional logistic regression to analyze the data. We estimated vaccine effectiveness and vaccination coverage.
Results:
We identified 81 cases (75 probable, 6 confirmed); 4 patients (4.9%) died. In the case-control study, 47% of case-patients and 2.3% of controls were hospitalized at Lyantonde Hospital pediatric department for non-measles conditions 7-21 days before case-patient's onset (ORadj = 34, 95%CI: 5.1-225). Estimated vaccine effectiveness was 95% (95%CI: 75-99%) and vaccination coverage was 76% (95%CI: 68-82%). During the outbreak, an "isolation" ward was established inside the general pediatric ward where there was mixing of both measles and non-measles patients.
Conclusions:
This outbreak was amplified by nosocomial transmission and facilitated by low vaccination coverage. We recommended moving the isolation ward outside of the building, supplemental vaccination, and vaccinating pediatric patients during measles outbreaks.
Insights
Nosocomial transmission amplified a measles outbreak in Uganda, driven by low vaccination coverage. Recommendations include improved isolation practices and supplemental vaccination to prevent future outbreaks.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Measles is a highly contagious viral illness.
- An outbreak was reported in Uganda's Lyantonde District in August 2017.
- An investigation was launched to understand the outbreak's scope and transmission dynamics.
Purpose of the Study:
- To investigate the 2017 measles outbreak in Uganda.
- To identify factors contributing to measles transmission.
- To recommend effective control and prevention strategies.
Main Methods:
- A case definition was established for probable and confirmed measles cases.
- A neighborhood- and age-matched case-control study was conducted.
- Logistic regression analyzed exposure factors; vaccine effectiveness and coverage were estimated.
Main Results:
- 81 measles cases were identified, with 4 deaths (4.9%).
- Hospitalization for non-measles conditions prior to onset was a significant risk factor (aOR=34).
- Vaccine effectiveness was 95%, with 76% vaccination coverage; nosocomial transmission occurred in the pediatric ward.
Conclusions:
- The outbreak was exacerbated by hospital-acquired infections and insufficient vaccination rates.
- Recommendations include relocating isolation wards, implementing supplemental vaccination campaigns, and vaccinating pediatric patients during outbreaks.
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