MEASLES — HORN OF AFRICA, 2010–2011

Thursday, 3rd of January 2013

[source]Morbidity and Mortality Weekly Report (MMWR)[|source]

Abstract below; full text, with tables and figures, is at 

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6134a4.htm?s_cid=mm6134a4_w

Severe drought, famine, war, large-scale population movements, and overcrowded refugee camps led to a complex emergency in the Horn of Africa during 2010–2011. In Somalia, low MCV coverage in areas where immunization services could not be provided for nearly 2 years led to a massive measles outbreak, primarily among children aged <5 years. Population movements, including large influxes of refugees from southern and central areas of Somalia into camps in Kenya and Ethiopia near the Somalia borders led to measles virus transmission among refugees and to outbreaks in Ethiopia and Kenya. After Outbreak response immunization activities, the number of cases decreased in the refugee camps; the decrease coincided with a decrease in the number of arriving refugees. However, large outbreaks continued in Kenya and Somalia.

To prevent large measles outbreaks and ultimately reach measles elimination goals in Eastern Mediteranean Region by 2015 and in African Region by 2020, vaccination strategies must be implemented to achieve and maintain uniformly high 2-dose MCV coverage to reach the 93%–95% population immunity threshold that can provide herd immunity in all countries. In refugee settings, Sphere minimum standards for humanitarian response should highlight the need to provide 1) 2 MCV doses to every child, 2) close monitoring of 2-dose MCV coverage, and 3) inclusion of informal settlements and host communities in vaccination plans. Outbreak preparedness should be maintained to ensure high-quality surveillance for measles cases, appropriate case management, and rapid Outbreak response immunization strategies that reach susceptible populations, based on the age distribution of infected persons in a particular outbreak