Evaluation of Measles Outbreak During 2010/2011 in Skopje, Macedonia

Background Due to low rates of vaccination coverage, in mostly rural in Skopje and as a result of military conflict in 2001, lead to spillover of the measles from neighboring countries, where outbreak of measles was already declared. Methods and materials: Measles reporting is mandatory in Macedonia. Cases analyzed had to meet the national case definition. Case-series investigation were conducted, surveys of rates of vaccination coverage. Results From 07.09.2010 to 22.07.2011, we have registered 596 cases of measles. Of these 596, twenty five case after getting a negative result from laboratory testing were discarded, so the number of cases of measles in the area of Skopje was 572 (Mb = 97.0/100.000). The first case was during a 13 months of age unvaccinated child. Out of 572 cases of measles 235 (41.0%) were hospitalized, mostly with severe clinical symptoms. According to the patients vaccination status the conclusion was that: 517 (90.4%) persons were vaccinated, of which 59 not subject to the vaccination, 19 (3.3%) persons no data, 36 (6.3%) persons were vaccinated, of which a portion of MMR are 30 and 6 with two doses. During the outbreak, laboratory confirmed 84 cases out of 103 taken materials, were positive. Conclusions The high rate of vaccine coverage in most municipalities in Skopje, unvaccinated children with a first dose and absence of the second dose in the first grade in elementary school, mostly in rural areas affected by the military conflict in 2001, were the cause of measles in epidemic form