India Epidemic Intelligence Service Officer, National Centre for Disease Control, Delhi, India.
Joint Director, Epidemiology Division, National Centre for Disease Control, Delhi, India.
Indian J Public Health. 2021 Jan;65(Supplement):S23-S28. doi: 10.4103/ijph.IJPH_1067_20.
On May 23, 2017, the health authorities in Longding district, Arunachal Pradesh, India, reported four suspected measles-related deaths in Konsa village, a remote village on the Indo-Myanmar border.
We investigated to describe the epidemiology of the outbreak and identify associated risk factors.
We defined a measles case as fever and maculopapular rash with cough, coryza, or conjunctivitis in a village of Longding district resident from March 1 to June 18, 2017. In Konsa village, we conducted a retrospective cohort study of children ≤5 years. We calculated attack rate (AR), case fatality rate (CFR), measles-containing vaccine first dose (MCV1) and Vitamin A coverage, risk ratio (RR), and vaccine efficacy. We collected samples for laboratory confirmation. We conducted a routine immunization system evaluation at multiple levels of Longding district.
We identified 75 suspected cases (56% females) for a Konsa village-specific AR of 86% (75/87) among children ≤5 years; the median age was 36 months; CFR was 7% (5/75); all deaths unvaccinated; none received Vitamin A. Coverage for MCV1 was 9.2% (6/65) and Vitamin A 4.6% (3/65). No MCV1 (RR = 7.3, 95% confidence interval [CI] = 1.3-53) and participation in a recent local festival (RR = 5.3, 95% CI = 1.5-18.5) were associated with illness. MCV vaccine efficacy was 100%. Of 17 cases, 13 tested positive for measles. The local health facility had neither staff nor immunization microplans.
This outbreak was likely due to low MCV1 and Vitamin A coverage due to poor health-care access. The investigation led to a district measles catch-up campaign and resumption of regular immunization.
2017 年 5 月 23 日，印度阿鲁纳恰尔邦隆丁区卫生当局报告称，在印度-缅甸边境偏远村庄孔萨村发生了四起疑似与麻疹有关的死亡事件。
我们对该疫情的流行病学进行调查并确定相关的危险因素。
我们将 2017 年 3 月 1 日至 6 月 18 日期间居住在隆丁区的村庄中出现发热、斑丘疹并伴有咳嗽、流涕或结膜炎的患者定义为麻疹病例。在孔萨村，我们对 5 岁以下的儿童进行了回顾性队列研究。我们计算了发病率（AR）、病死率（CFR）、麻疹疫苗初免（MCV1）和维生素 A 覆盖率、风险比（RR）和疫苗效力。我们采集了样本以进行实验室确认。我们对隆丁区的多个层面进行了常规免疫系统评估。
我们共发现 75 例疑似病例（56%为女性），孔萨村 5 岁以下儿童的特定 AR 为 86%（75/87）；中位数年龄为 36 个月；CFR 为 7%（5/75）；所有死亡病例均未接种疫苗；均未接受维生素 A 治疗。MCV1 覆盖率为 9.2%（6/65），维生素 A 覆盖率为 4.6%（3/65）。未接种 MCV1（RR = 7.3，95%置信区间 [CI] = 1.3-53）和近期参加当地节日（RR = 5.3，95% CI = 1.5-18.5）与发病有关。MCV 疫苗效力为 100%。17 例病例中有 13 例检测出麻疹阳性。当地卫生机构既没有工作人员，也没有免疫计划。
此次疫情可能是由于医疗服务获取机会有限，导致 MCV1 和维生素 A 覆盖率较低所致。调查促使开展了全区麻疹补种运动和常规免疫恢复。
