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Liberia Field Epidemiology Training Programme (LFETP)Liberia Field Epidemiology Training Programme (LFETP)

Miatta Kullie 1, 2, M. Amo-Addae2, T. Nagbe1, S.J.N. McNabb3, G.N. Farhat3, P.

Adewuyi2, J. Frimpong2, H. Kazoora4

1

Measles Outbreak, Duazon

Communities, Mamba Kaba District,

Margibi County, Liberia, 2015

1 Ministry of Health, Monrovia, Liberia2 Liberia Frontline FETP, Monrovia, Liberia3 Emory University, Atlanta, Georgia, USA4 AFENET, Kampala, Uganda

Liberia Field Epidemiology Training Programme (LFETP)

Outline of Presentation

• Acknowledgement

• Introduction

• Objectives

• Methods

• Results

• Conclusion

• Pictures

2


Acknowledgement

• Margibi County Health Team

• Liberia Ministry of Health

• Emory University

• CDC

• AFENET

• WHO

• FETP Frontline Mentors

3


Introduction 1/2• Measles

– Viral disease, usually affects children aged 0 to 5

years

– Spreads through droplet infection and direct

contact

– Incubation period of about 7-14 days

– Vaccine is given at 9 months of age in Liberia

4


Introduction 2/2

• 26th of December 2015:

– Suspected measles case from Duazon

community was reported to District

• 1st week January 2016:

– Field investigation began

5


Objectives

• Confirm the outbreak

• Describe the outbreak by person, place and time

• Determine the source of the outbreak

• Control the outbreak

6


Methods 1/2

• Duazon community,

Margibi County, Liberia

• Population: 3,684

• Active case search

• Case definition

– “any persons in Duazon

community with fever,

rashes, red eyes,

coryza from Dec. 26,

2015 to February 14,

2016”

7


Methods 2/2

• Line-listed cases

– demographic data

– signs and symptoms

• Laboratory testing of blood samples for Measles

• We conducted a descriptive analysis of the data

8


Results 1/2

9

• Twenty-nine cases were line-listed

– Fifteen (52%) were above 5years old

– Fifteen (52%) were male

– Median Age is 5years (Range: 6months-29years)

– 10 blood samples were positive for Measles• 3 were vaccinated

• 7 were not vaccinated


Results 2/2

• Vaccination Status of the 29 cases:

– Vaccinated 4 (14%)

– Unvaccinated 22 (76%)

– Unknown 3 (10%)

• Index case

– 29 year old male

– No history of contact

– No relevant travel history

10


Epicurve of Measles Outbreak, Duazon Communities, Mamba

Kaba, Margibi County, Liberia, Dec. 26, 2015 – Feb. 14, 2016

11

2015 20160

2

4

6

8

10

12

14

48 49 50 51 52 53 1 2 3 4 5 6 7 8

Nu

mb

er

of

Cas

es

Week of Onset

confirmed cases

Suspected Cases

Intervention

Mass vaccination

began


Response

• Surveillance was maintained

• Cases were isolated and treated

• Intensive three-month vaccination outreach

was conducted

• Routine immunization was strengthened

12


Conclusion 1/2

• Confirmed Measles outbreak in the Duazon

Community

• More than half of affected were aged >5years

• Most affected were unvaccinated (at least

76%)

13


Conclusion 2/2

• Outbreak lasted 2months (Dec 2015 – Feb

2016)

• Source of the infection remains unknown

• Outbreak was controlled by public education,

mass vaccination, treatment and isolation of

cases

14


Action Pictures

15

Miatta conducting an interviewInvestigation team preparation meeting

Documents

Measles Outbreak, Duazon Communities, Mamba Kaba …liberiafetp.com/wp-content/uploads/Miatta_Measles-Outbreak-Duazon... · Measles Outbreak, Duazon Communities, Mamba Kaba District,