Science and
Technology Conference 2009, Huachiew Chalermprakiet University, Thailand;
10/2009
ABSTRACT
Background:
Since 2004, there have been increasing reports of rubella outbreaks in Nepal,
through the Vaccine Preventable Diseases (VPDs) surveillance network. This
report details an investigation of a suspected “measles-like illness” outbreak
in Mustang, a remote and hard to reach Himalayan district in the Western part
of Nepal.
Methods: The
Mustang District Rapid Response Team (RRT) investigated the outbreak in Chhonup
and Lomanthang villages in Mustang, beginning on the 17th of June 2008,
following the standard measles outbreak investigation guidelines. Blood samples
were collected from seven children within 4 to 28 days of rash onset. All the
samples were tested for both measles and rubella IgM antibodies in the National
Public Health Laboratory (NPHL) in Kathmandu, Nepal
Results:
Forty-eight cases were detected at the time of the investigation. There were
two waves in the outbreak. The first occurred at the beginning of April, and
the second from mid-May to mid-June. The primary attack rates were 1% and 4% in
Lomanthang and Chhonup respectively. The primary attack rates were highest in
the 1 – 9 year old population. No deaths in children with measles-like illness
were reported from either village during this investigation. All children found
with measles-like illness had been immunized against measles. All 7 serum
samples were confirmed to be IgM positive for anti-rubella. The remaining 41
cases with measles like illness were considered epidemiologically linked to
these laboratory-confirmed cases, and classified as rubella.
Conclusion:
Since there is no vaccination against rubella in Nepal, the number of rubella
susceptible individuals in the population has increased. Once the virus was
introduced into the community, it spread very quickly and affected many
susceptible individuals. It is highly recommended that rubella vaccinations be
included in the National Immunization Programme (NIP) of Nepal.
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| Chhonup Village |
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