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Lessons and challenges for measles control from unexpected large outbreak, Malawi

By Andrea Minetti, Matthew Kagoli, Agnes Katsulukuta, Helena Huerga, Amber Featherstone, Hazel Chiotcha, Delphine Noel, Cameron Bopp, Laurent Sury, Renzo Fricke, Marta Iscla, Northan Hurtado, Tanya Ducomble, Sarala Nicholas, Storn Kabuluzi, Rebecca F Grais and Francisco J Luquero

Abstract

Despite high reported coverage for routine and supplementary immunization, in 2010 in Malawi, a large measles outbreak occurred that comprised 134,000 cases and 304 deaths. Although the highest attack rates were for young children (2.3%, 7.6%, and 4.5% for children <6, 6-8, and 9-11 months, respectively), persons >15 years of age were highly affected (1.0% and 0.4% for persons 15-19 and >19 years, respectively; 28% of all cases). A survey in 8 districts showed routine coverage of 95.0% for children 12-23 months; 57.9% for children 9-11 months; and 60.7% for children covered during the last supplementary immunization activities in 2008. Vaccine effectiveness was 83.9% for 1 dose and 90.5% for 2 doses. A continuous accumulation of susceptible persons during the past decade probably accounts for this outbreak. Countries en route to measles elimination, such as Malawi, should improve outbreak preparedness. Timeliness and the population chosen are crucial elements for reactive campaigns

Publisher: Center for Disease Control and Prevention
Year: 2013
DOI identifier: 10.3201/eid1902.120301
OAI identifier: oai:fieldresearch.msf.org:10144/270740
Provided by: MSF Field Research
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