Uganda Public Health Fellowship Program, Kampala, Uganda.
Ministry of Health, Kampala, Uganda.
BMC Infect Dis. 2020 Jun 5;20(1):398. doi: 10.1186/s12879-020-05120-5.
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.
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.
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 (OR = 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.
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.
麻疹是一种高度传染性的病毒性疾病。2017 年 8 月，乌干达 Lyantonde 区向乌干达卫生部报告了麻疹疫情。我们对疫情进行了调查，以评估疫情范围、促进传播的因素，并提出控制措施。
我们将 Lyantonde、Lwengo 或 Rakai 区的居民在 2017 年 6 月 1 日至 9 月 30 日期间出现突发发热和全身性皮疹，并伴有以下至少 1 种症状：卡他症状、结膜炎或咳嗽，定义为疑似病例：麻疹特异性 IgM 血清阳性的疑似病例。我们进行了以邻里和年龄为匹配的病例对照研究，以确定暴露因素，并使用条件逻辑回归分析数据。我们估计了疫苗的有效性和接种率。
我们共发现 81 例病例（75 例疑似，6 例确诊），4 例（4.9%）患者死亡。在病例对照研究中，47%的病例患者和 2.3%的对照患者在病例患者发病前 7-21 天因非麻疹疾病在 Lyantonde 医院儿科住院（OR=34，95%CI：5.1-225）。估计疫苗的有效性为 95%（95%CI：75-99%），接种率为 76%（95%CI：68-82%）。在疫情期间，在普通儿科病房内设立了“隔离”病房，麻疹和非麻疹患者混合在一起。
此次疫情是由院内传播放大，并因低疫苗接种率而加剧。我们建议将隔离病房搬出建筑物外，进行补充接种，并在麻疹疫情期间为儿科患者接种疫苗。
