The 2013 measles outbreak in XXXX Lanka: experience from a rural district and implications for measles elimination goals.

@entity1 @entity3329 @entity1910 @entity55 @entity294 @entity2024 @entity3595 @entity580 @entity2462
BACKGROUND: @entity3595 Lanka was the first country in the Southeast Asian region to achieve its measles elimination goal in 2011. In 2012, the measles immunization schedule changed from a measles vaccine at 9  months to a measles, mumps and @entity2462 vaccine at 12  months. However in 2013, @entity3595 Lanka reported its worst recent outbreak of measles. This study investigated a part of this outbreak in order to describe its epidemiology. METHODS: A prospective study was carried out at the university medical unit of the @entity580 ( @entity580 ), the third largest hospital in @entity3595 Lanka, from October 2013 until March 2014. An epidemiological profile of @entity1 was constructed, case confirmation was done on all suspected cases and the basic demographic details of these suspected cases were obtained from the available records. RESULTS: From January 2013 to March 2014, 101 measles suspects were admitted to the @entity580 . Until June 2013, all suspected cases were aged below 12  months of age. During the study period (15  months), the total number of @entity1 aged below 9  months, 9 to 12  months, 1 to 11  years, 12-29  years and over 29  years were 10 (9.9  %), 11 (10.9  %), 6 (5.9  %), 37 (36.6  %) and 36 (35.6  %), respectively (data missing-1). Out of the 33 @entity1 clinically suspected, 32 tested positive for measles. Common clinical features included: fever (n   =   33, 100  %), maculopapular @entity1910 (n   =   33), @entity2024 (n   =   31), posterior cervical @entity3329 (n   =   23) and Koplik's spots (n   =   8). Features suggestive of @entity55 were observed among 30 (90.9  %) @entity1 and 26 (78.8  %) had @entity294 . Two @entity1 (6.1  %) who developed severe @entity55 received care at an intensive care unit due to respiratory difficulties. Out of 33 @entity1 , 15 (45.5  %) had prior immunization for measles, two (6.1  %) reported that they never had a measles immunization and 16 (48.5  %) were unsure about their immunization status. Out of those who reported they were previously immunized, 11 (73.3  %) belonged to the age group of 12-29  years. CONCLUSION: Because the first cases of this outbreak were @entity1 , an increase in susceptible @entity1 due to the change in the vaccine schedule could partly explain the outbreak.
