Measles outbreak amplified in a pediatric ward: Lyantonde District, Uganda, August 2017

BMC Infectious Diseases

Bao-Ping Zhu¹  Benon Kwesiga²  Lilian Bulage²  Denis Othuba Okethwangu²  Claire Biribawa²  Joselyn Annet Atuhairwe²  Alex Riolexus Ario² 

[1] US Centers for Disease Control and Prevention;Uganda Public Health Fellowship Program;

关键词: Pediatric measles outbreak;    Nosocomial infection;    Global health security;    Vaccine-effectiveness;    Vaccination-coverage;   

DOI  :  10.1186/s12879-020-05120-5

来源: DOAJ

【 摘 要 】

Abstract 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.

【 授权许可】

Unknown