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Risk Factors for Measles Outbreak in Pune City: A Case-Control Study

A S Ajinsha1, Malangori Abdulgani Parande2, Ashish Bharati3

  • 1Junior Resident II, Department of Community Medicine, B. J. Government Medical College, Pune, Maharashtra, India.

Indian Journal of Public Health
|September 18, 2025
PubMed
Abstract

Insights

Low measles-rubella (MR) vaccination rates, particularly during the COVID-19 lockdown, fueled a significant measles outbreak in Pune. Maintaining high immunization coverage is crucial to prevent future outbreaks.

Area of Science:

  • Epidemiology
  • Public Health
  • Immunization Practices

Background:

  • A measles outbreak in Pune, reported from November 14, 2022, resulted in 266 cases within the Pune Municipal Corporation (PMC).
  • Understanding the specific risk factors driving this outbreak is essential for public health interventions.

Purpose of the Study:

  • To identify key risk factors associated with measles infection during the Pune outbreak.
  • To inform targeted strategies for controlling and preventing future measles transmission.

Main Methods:

  • A 1:1 unmatched case-control study was conducted in PMC from February to September 2023.
  • Laboratory-confirmed measles cases (immunoglobulin M-positive) were compared with controls (children without rash).
  • Data on sociodemographics, immunization history, and Vitamin A supplementation were collected via face-to-face interviews (n=200).

Main Results:

  • Unimmunized children had a significantly higher odds of measles infection (OR=3.093) compared to fully immunized children.
  • Partially immunized children (1 dose MR vaccine) also showed increased odds (OR=2.027).
  • Factors like parental education, Vitamin A supplementation, and measles-rubella (MR) vaccination status were statistically significant.

Conclusions:

  • Under-immunization was identified as the primary driver of the measles outbreak in Pune.
  • Maintaining high under-5 immunization rates, even during emergencies like the COVID-19 lockdown, is critical.
  • Strengthening routine immunization programs is vital to prevent future measles outbreaks.
Keywords:
ImmunizationPune Municipal Corporationmeaslesoutbreak

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