measles outbreak, duazon communities, mamba kaba...

Liberia Field Epidemiology Training Programme (LFETP)Liberia Field Epidemiology Training Programme (LFETP)

Miatta Kullie 1, 2, M. Amo-Addae2, T. Nagbe1, S.J.N. McNabb3, G.N. Farhat3, P.

Adewuyi2, J. Frimpong2, H. Kazoora4

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Measles Outbreak, Duazon

Communities, Mamba Kaba District,

Margibi County, Liberia, 2015

1 Ministry of Health, Monrovia, Liberia2 Liberia Frontline FETP, Monrovia, Liberia3 Emory University, Atlanta, Georgia, USA4 AFENET, Kampala, Uganda

Liberia Field Epidemiology Training Programme (LFETP)

Outline of Presentation

• Acknowledgement

• Introduction

• Objectives

• Methods

• Results

• Conclusion

• Pictures

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Liberia Field Epidemiology Training Programme (LFETP)

Acknowledgement

• Margibi County Health Team

• Liberia Ministry of Health

• Emory University

• CDC

• AFENET

• WHO

• FETP Frontline Mentors

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Liberia Field Epidemiology Training Programme (LFETP)

Introduction 1/2• Measles

– Viral disease, usually affects children aged 0 to 5

years

– Spreads through droplet infection and direct

contact

– Incubation period of about 7-14 days

– Vaccine is given at 9 months of age in Liberia

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Liberia Field Epidemiology Training Programme (LFETP)

Introduction 2/2

• 26th of December 2015:

– Suspected measles case from Duazon

community was reported to District

• 1st week January 2016:

– Field investigation began

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Liberia Field Epidemiology Training Programme (LFETP)

Objectives

• Confirm the outbreak

• Describe the outbreak by person, place and time

• Determine the source of the outbreak

• Control the outbreak

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Liberia Field Epidemiology Training Programme (LFETP)

Methods 1/2

• Duazon community,

Margibi County, Liberia

• Population: 3,684

• Active case search

• Case definition

– “any persons in Duazon

community with fever,

rashes, red eyes,

coryza from Dec. 26,

2015 to February 14,

2016”

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Liberia Field Epidemiology Training Programme (LFETP)

Methods 2/2

• Line-listed cases

– demographic data

– signs and symptoms

• Laboratory testing of blood samples for Measles

• We conducted a descriptive analysis of the data

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Liberia Field Epidemiology Training Programme (LFETP)

Results 1/2

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• Twenty-nine cases were line-listed

– Fifteen (52%) were above 5years old

– Fifteen (52%) were male

– Median Age is 5years (Range: 6months-29years)

– 10 blood samples were positive for Measles• 3 were vaccinated

• 7 were not vaccinated

Liberia Field Epidemiology Training Programme (LFETP)

Results 2/2

• Vaccination Status of the 29 cases:

– Vaccinated 4 (14%)

– Unvaccinated 22 (76%)

– Unknown 3 (10%)

• Index case

– 29 year old male

– No history of contact

– No relevant travel history

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Liberia Field Epidemiology Training Programme (LFETP)

Epicurve of Measles Outbreak, Duazon Communities, Mamba

Kaba, Margibi County, Liberia, Dec. 26, 2015 – Feb. 14, 2016

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2015 20160

2

4

6

8

10

12

14

48 49 50 51 52 53 1 2 3 4 5 6 7 8

Nu

mb

er

of

Cas

es

Week of Onset

confirmed cases

Suspected Cases

Intervention

Mass vaccination

began

Liberia Field Epidemiology Training Programme (LFETP)

Response

• Surveillance was maintained

• Cases were isolated and treated

• Intensive three-month vaccination outreach

was conducted

• Routine immunization was strengthened

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Liberia Field Epidemiology Training Programme (LFETP)

Conclusion 1/2

• Confirmed Measles outbreak in the Duazon

Community

• More than half of affected were aged >5years

• Most affected were unvaccinated (at least

76%)

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Liberia Field Epidemiology Training Programme (LFETP)

Conclusion 2/2

• Outbreak lasted 2months (Dec 2015 – Feb

2016)

• Source of the infection remains unknown

• Outbreak was controlled by public education,

mass vaccination, treatment and isolation of

cases

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Liberia Field Epidemiology Training Programme (LFETP)

Action Pictures

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Miatta conducting an interviewInvestigation team preparation meeting