Sitaula S, Awasthi G R, Thapa J B, Joshi K P, Ramaiya A
xenoMED Foundation, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2010 Oct-Dec;50(180):273-6.
Measles outbreak occurs when there are three or more laboratory confirmed measles cases in a village in a period of one month. Integrated surveillance system has helped to identify the measles outbreak, to characterize its epidemiology and to timely respond it.
This is a descriptive study of measles outbreak that occurred in Bajura district in February to March 2010. The epidemiological characteristics of the outbreak are described. The outbreak was investigated from 4-8 March 2010 with necessary epidemiological information and biological specimen collection. One month follow up was done to determine the clinical outcome of the measles cases.
A total of 36 people had measles; 97% of them were under 15 years of age and 89% had not been immunized with measles vaccine. Attack rate and vaccine efficacy was 23% and 50% amongst children less than 15 years of age and case fatality rate (CFR) was 3%. Biological samples were collected from 11 patients; all of which tested IgM positive for measles and genotype D8 was isolated.
CFR of this outbreak is higher than the national CFR. Vaccine efficacy of 50% points towards the need for investigation of vaccine logistics and cold chain system. Moreover, this laboratory test confirmed an outbreak showing that the measles virus could be imported from an endemic region and rapidly spread through a susceptible population who were previously not immunized.
当一个村庄在一个月内出现三例或更多实验室确诊的麻疹病例时，就会发生麻疹疫情。综合监测系统有助于识别麻疹疫情，描述其流行病学特征并及时做出应对。
这是一项对2010年2月至3月在巴久拉地区发生的麻疹疫情的描述性研究。描述了疫情的流行病学特征。于2010年3月4日至8日对疫情进行了调查，收集了必要的流行病学信息并采集了生物样本。进行了为期一个月的随访，以确定麻疹病例的临床结局。
共有36人感染麻疹；其中97%为15岁以下儿童，89%未接种麻疹疫苗。15岁以下儿童的发病率和疫苗效力分别为23%和50%，病死率为3%。从11名患者身上采集了生物样本；所有样本的麻疹IgM检测均为阳性，并分离出D8基因型。
此次疫情的病死率高于国家病死率。50%的疫苗效力表明需要对疫苗物流和冷链系统进行调查。此外，该实验室检测证实了疫情，表明麻疹病毒可能从流行地区传入，并在以前未接种疫苗的易感人群中迅速传播。
