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Measles epidemics in Kerman City, Iran
M Janghorbani1, M H Daie Parizi, K Ghorbani
1Department of Community Medicine, Kerman University of Medical Sciences, Iran.
Abstract:
In early 1990 an outbreak of measles occurred in Kerman City (population 257,284), Iran. Overall 745 cases were identified, four of whom died (case fatality ratio was 5.4 per thousand). Illness was limited, primarily, to children below 15 years of age: 166 (22.3%) cases were in children under five years, 573 (77%) in those aged between five and 14 years and six (0.8%) were above 15 years of age. The age of the cases ranged from 5 months to 35 years. The age-specific attack rates were 3.9, 1.8, 7.3 and 2.8 per 1,000 for children under 1, 1-4, 5-9 and 10-14 years of age respectively. Overall 14 (1.9%) children with measles were hospitalized for severe complications which consisted mainly of pneumonia, otitis and gastroenteritis. Based on 745 cases with available immunization records, vaccine efficacy was calculated at 88% indicating a slight problem with the cold chain or vaccine. The outbreak was primarily related to low immunization coverage during the last 10 years and indicates the need to improve vaccine coverage with the AIK-C existing vaccine. It also highlights the urgent need for an effective single-dose measles vaccine (Edmondson-Zagreb) for children below nine months of age.
Insights
A 1990 measles outbreak in Kerman City affected primarily children, with low vaccine efficacy suggesting cold chain issues. Improving immunization coverage is crucial, alongside developing a single-dose vaccine for infants under nine months.
Area of Science:
- Epidemiology
- Public Health
- Vaccinology
Background:
- Measles outbreaks pose significant public health risks, particularly in populations with suboptimal immunization coverage.
- Understanding disease transmission dynamics and vaccine effectiveness is critical for outbreak control.
Purpose of the Study:
- To investigate the epidemiology of a measles outbreak in Kerman City, Iran, in early 1990.
- To assess measles-related morbidity, mortality, and vaccine efficacy during the outbreak.
- To identify factors contributing to the outbreak and inform future prevention strategies.
Main Methods:
- Retrospective case identification and analysis of 745 measles cases in Kerman City.
- Calculation of age-specific attack rates and case fatality ratio.
- Assessment of vaccine efficacy using available immunization records.
Main Results:
- The outbreak primarily affected children under 15 years, with 745 cases and a case fatality ratio of 5.4 per thousand.
- Severe complications included pneumonia, otitis, and gastroenteritis, leading to hospitalization in 1.9% of cases.
- Calculated vaccine efficacy was 88%, suggesting potential issues with the cold chain or vaccine quality.
Conclusions:
- The outbreak was linked to low immunization coverage over the preceding decade.
- There is a need to enhance vaccine coverage with existing vaccines.
- An effective single-dose measles vaccine for infants under nine months is urgently required.