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ORIGINAL ARTICLE
Year : 2021  |  Volume : 65  |  Issue : 5  |  Page : 5-9

Measles outbreak among children ≤15 years old, Jaintia Hills District, Meghalaya, India, 2017


1 Epidemic Intelligence Service Officer, Integrated Disease Surveillance Programme, National Centre for Disease Control, Delhi, India
2 Deputy Director, Epidemiology Division, National Centre for Diseases Control, Delhi, India
3 Public Health Specialist, Division of Global Health Protection, Centers for Disease Control and Prevention, Delhi, India
4 Entomologist, Integrated Disease Surveillance Unit, Shillong, Meghalaya, India
5 Resident Advisor, Division of GLobal Health Protection, Centers for Disease Control and Prevention, Delhi, India
6 National Programme Officer, Integrated Disease Surveillance Programme, National Centre for Disease Control, Delhi, India

Correspondence Address:
Dipu Lowang
Room No. 6, Third Floor, Talo Apartment, Barapani Down Colony, Naharlagun, Papum Pare - 791 110, Arunachal Pradesh
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijph.IJPH_960_20

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Background: Of 1115 measles outbreaks during 2015 in India, 61,255 suspected measles cases were reported. In 2016, a measles outbreak was reported at East and West Jaintia Hills districts in Meghalaya State, India. Objectives: The outbreak was investigated to describe the epidemiology, estimate vaccination coverage and vaccine effectiveness (VE), determine risk factors for the disease, and recommend control and prevention measures. Methods: A measles case was defined as new-onset fever with maculopapular rash occurring between May 1, 2016, and January 21, 2017, in a resident of East and West Jaintia Hills. Cases were identified by active and passive surveillance. Serum and urine samples were collected from cases with laboratory diagnosis for confirmation. A retrospective cohort study was conducted to estimate vaccination coverage, VE, and risk factors for the disease. Results: We identified 382 cases (51% female). The attack rate was 24% with three deaths. The case fatality rate was <1%. The median age was 4 years (range: 3 months–12 years). Among children 12–60 months, 128 (56%) received measles-containing-vaccine first-dose (MCV1), 85 (37%) received measles-containing-vaccine second-dose (MCV2), and 80 (35%) received Vitamin A. VE for MCV1 was 78% and for MCV2 94%. Being unvaccinated for MCV1 (relative risk [RR] = 9.7, 95% confidence interval [CI] = 4.6–20.5) and MCV2 (RR = 17.4, 95% CI = 4.3–69.4) were both strongly associated with illness. Conclusions: Poor vaccination coverage led to the measles outbreak in East and West Jaintia Hills districts of Meghalaya. Strengthening the routine immunization systems and improving Vitamin A uptake is essential to prevent further outbreaks.


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