scholarly journals Measles outbreak investigation in a highly vaccinated community in the Centre region of Cameroon

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Eposi C. Haddison ◽  
Randolph A. Ngwafor ◽  
Benjamin M. Kagina

Background: Measles remains a threat in many African settings due to sub-optimal routine immunisation and catchup campaigns. The Global Vaccine Action Plan goal to eliminate measles by 2020 remains unmet as several countries reported an increase in cases in 2019. In Cameroon, a measles-rubella vaccination campaign was organised in 2019 to reduce the cohort of susceptible children. However, in 2020, eleven suspected cases of measles were notified in the Sa’a Health District and five were confirmed. Objective: This report summarizes a measles outbreak investigation and contact tracing in a highly vaccinated community residing in the Sa’a Health District of Cameroon. Methods: Outbreak investigations were carried out in the Sa’a, Nlong-Onambele and Nkolmgbana health areas from 18 to 21 February 2020. A register review from December 2019 to February 2020 was carried out in all health facilities of the affected health areas. followed by contact tracing in the community. Results: Thirty households were visited in four neighbourhoods. Six missed Epidemiologically-linked cases were discovered in the community, bringing the total number of suspected and confirmed cases to 17. Thirty-five percent of the cases had not received any measles-containing vaccine; 35% of the cases were aged 5 years or older; 53% had history of travel. Community transmission only occurred in the Sa’a health area through a breakthrough case. Conclusions: This outbreak investigation portrayed the role that adequate vaccination coverage plays in preventing widespread outbreaks. Nonetheless, community sensitisation and routine immunisation require strengthening in order to erase pockets of susceptible children.

1994 ◽  
Vol 113 (2) ◽  
pp. 367-375 ◽  
Author(s):  
R. A. Lyons ◽  
H. I. Jones ◽  
R. L. Salmon

SUMMARYIn an outbreak of measles in North Wales centred on a secondary school in 1991, 74 cases occurred over a period of 51 days. Before the outbreak started, 27 % pupils did not have a history of measles or immunization and were considered susceptible. Active case rinding and identification and vaccination of susceptible contacts commenced after the fourth generation of cases and further reduced the pool of susceptible schoolchildren from 17%, at the onset of the vaccination campaign, to 8%. A fifth generation of cases did not occur. Delays in diagnosis (mean 2·8 days) and notification (mean 6·1 days) hampered control. There was no evidence of primary vaccine failure (observed vaccine efficacy 97%). Sixty-nine (93%) cases were considered preventable. Reasons for the apparent success of the intervention are discussed.


2019 ◽  
Vol 24 (17) ◽  
Author(s):  
Nicklas Sundell ◽  
Leif Dotevall ◽  
Martina Sansone ◽  
Maria Andersson ◽  
Magnus Lindh ◽  
...  

In an outbreak of measles in Gothenburg, Sweden, breakthrough infections (i.e. infections in individuals with a history of vaccination) were common. The objective of this study was to compare measles RNA levels between naïve (i.e. primary) and breakthrough infections. We also propose a fast provisional classification of breakthrough infections. Medical records were reviewed and real-time PCR-positive samples genotyped. Cases were classified as naïve, breakthrough or vaccine infections. We compared clinical symptoms and measles RNA cycle threshold (Ct) values between breakthrough and naïve infections. Sixteen of 28 confirmed cases of measles in this outbreak were breakthrough infections. A fast provisional classification, based on previous history of measles vaccination and detectable levels of measles IgG in acute serum, correctly identified 14 of the 16 breakthrough infections, confirmed by IgG avidity testing. Measles viral load was significantly lower in nasopharyngeal samples from individuals with breakthrough compared with naïve infections (median Ct-values: 32 and 19, respectively, p < 0.0001). No onward transmission from breakthrough infections was identified. Our results indicate that a high risk of onward transmission is limited to naïve infections. We propose a fast provisional classification of breakthrough measles that can guide contact tracing in outbreak settings.


Vaccines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 678
Author(s):  
Julio Jaramillo-Monge ◽  
Michael Obimpeh ◽  
Bernardo Vega ◽  
David Acurio ◽  
Annelies Boven ◽  
...  

We investigated the COVID-19 vaccination acceptance level in Azuay province, Ecuador through an online survey from 12th to 26th February (before the start of the COVID-19 vaccination campaign in Ecuador). Overall, 1219 respondents participated in the survey. The mean age was 32 ± 13 years; 693 participants (57%) were female. In total, 1109 (91%) of the participants indicated they were willing to be vaccinated with a COVID-19 vaccine, if the vaccine is at least 95% effective; 835 (68.5%) if it is 90% effective and 493 (40.5%) if it is 70% effective; 676 (55.5%) participants indicated they feared side effects and 237 (19.4%) thought the vaccine was not effective. Older age, having had a postgraduate education, a history of a negative COVID-19 test, a high level of worry of contracting COVID-19, believing that COVID-19 infection can be prevented with a vaccine and understanding there is currently an effective vaccine against COVID-19 were associated with higher vaccination acceptance. A vaccination education campaign will be needed to increase the knowledge of Ecuadorians about the COVID-19 vaccine and to increase their trust in the vaccine. People with a lower education level and living in rural areas may need to be targeted during such a campaign.


2020 ◽  
Vol 41 (S1) ◽  
pp. s318-s318
Author(s):  
Lisa Stancill ◽  
Lauren DiBiase ◽  
Emily Sickbert-Bennett

Background: A critical step during outbreak investigations is actively screening for additional cases to assess ongoing transmission. In the healthcare setting, one widely used method is point-prevalence screening on the whole unit where a positive patient is housed. Although this point-prevalence approach captures the “place,” it can miss the “person” and “time” elements that define the population-at-risk. Methods: At University of North Carolina (UNC) Hospitals, we used business intelligence tools to build a query that harnesses the admission, discharge, and transfer (ADT) data from the electronic medical record (EMR). Using this data identifies every patient who overlapped in time and space with a positive patient. An additional query identifies currently admitted overlap patients and their current location. During an outbreak investigation, an analyst executes these queries in the mornings when surveillance screens are scheduled. The queries generate a list of patients to screen that are prioritized on the number of days they were in the same unit with the positive patient. This overlap methodology successfully captures the person, place, and time associated with possible disease transmission. We implemented the overlap method for the last 3 months following 1 year of point-prevalence approach screening during a novel disease outbreak at UNC Hospitals. Results: In total, 4,385 unique patients overlapped with previously identified infected or colonized patients, of which 781 (17.8%) from 40 departments were screened over 15 months. During a subsequent, currently ongoing, outbreak, we are utilizing the overlap method and in 6 weeks have already screened 161 of the 1,234 overlapping patients (13%). After 3 rounds of overlap screening, we have already been able to identify 1 additional positive patient. This patient was on the same unit as patient zero 4 months prior but was readmitted to a unit that would not have received a point-prevalence screen using the standard approach. Conclusions: Surveillance screening is a time-consuming, resource-intensive effort that requires collaboration between infection prevention, clinical staff, patients, and the laboratory. By harnessing EMR ADT data, we can better target the population at risk and more efficiently utilize resources during outbreak investigations. In addition, the overlap method fills a gap in the current CDC guidelines by focusing on patients who were on the same unit with any positive patient, including those who discharged and readmitted. Most importantly, we identified an additional positive patient that would not have been detected through a point-prevalence screen, helping us prevent further disease transmission.Funding: NoneDisclosures: None


2020 ◽  
Vol 101 ◽  
pp. 313
Author(s):  
M.N. Nanga Dampand ◽  
A.V. Kouatchouang ◽  
T. Djikeussi ◽  
J. Lontsi ◽  
S. Billong

2001 ◽  
Vol 119 (4) ◽  
pp. 142-145 ◽  
Author(s):  
Páris Ali Ramadan ◽  
Francisco Barreto de Araújo ◽  
Mario Ferreira Junior

CONTEXT: Routine immunization of groups at high risk for influenza has been progressively implemented as a matter of Brazilian public health policy. Although the benefits of the vaccination for healthy young adults are still controversial, it has been offered yearly to hundreds of thousands of Brazilian workers, generally as part of wellness initiatives in the workplace. OBJECTIVE: To study the characteristics of subjects that accepted or refused to be vaccinated against influenza and to report on respiratory symptoms in both groups, one year after the campaign date. DESIGN: A prospective observational study. SETTING: Workers at a subsidiary of an international bank in São Paulo, Brazil. PARTICIPANTS: 124 persons that did not accept and 145 that voluntarily accepted the vaccine completed 12 months of follow-up. MAIN MEASUREMENTS: Data concerning gender, age, tobacco use, and any history of chronic respiratory illness such as asthma, bronchitis, rhinitis, and repetitive upper-respiratory infections, were recorded at the time of vaccination. After that, workers were asked monthly by questionnaire or telephone about respiratory symptoms, days of work lost and medical consultations. RESULTS: The results showed statistically significant differences regarding age (P = 0.004) with the vaccinated group (V) being younger than the non-vaccinated (NV) one, and with reference to previous repetitive upper-respiratory infections being higher among the V group (P < 0.0001). During the follow-up, the V group reported more occurrences of upper respiratory symptoms (P < 0.0001), due to both non-influenza (P < 0.0001) and influenza-like illness (P = 0.045). Differences were also found between V and NV groups concerning days off work and number of medical consultations due to upper-respiratory symptoms and non-influenza illness. Gender and history of repetitive upper-respiratory infections were the best predictors of influenza-like illness-related events. CONCLUSIONS: The making of previous reference to repetitive upper-respiratory infections was a major difference between those who accepted or rejected the vaccine. The vaccination itself was not sufficient to reduce the number of occurrences of respiratory symptoms and related absenteeism to levels similar to those found among non-vaccinated people.


2015 ◽  
Vol 13 (3/4) ◽  
pp. 346-360 ◽  
Author(s):  
Simon Rogerson

Purpose – The purpose of this paper is to review the world of information and communications technology (ICT) from its early days to the near future. The aim is to consider how successfully academia, industry and government have worked together in delivering ethically acceptable ICT which is accessible to those who might benefit from such advances. The paper concludes with suggestions of a fresh approach for the future. Design/methodology/approach – The paper draws upon evidence from the history of computers, funded research projects, professional bodies in the field, the ETHICOMP conference series and reported ICT disasters. The author uses his experience as both an ICT practitioner and an academic in the ICT ethics field to synthesise the evidence so providing a foundation on which to build an outline global action plan. Findings – The paper lays out the findings that there has been much detailed observation and analysis of the ethical challenges surrounding ICT but the transformation of this into widespread practical positive action remains elusive. It explores why progress has been difficult. Originality/value – This review of the interconnecting landscapes of practical ICT, funded research and the ICT ethics community is new. The attempt to demonstrate what progress has been made and to identify the underlying factors which influence progress are valuable to future generations working in this area. The concluding suggestions for action offer a starting point for entering the next phase of ICT ethics.


2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Craig M. Hales ◽  
Eliaser Johnson ◽  
Louisa Helgenberger ◽  
Mark J. Papania ◽  
Maribeth Larzelere ◽  
...  

Abstract Background.  A measles outbreak in Pohnpei State, Federated States of Micronesia in 2014 affected many persons who had received ≥1 dose of measles-containing vaccine (MCV). A mass vaccination campaign targeted persons aged 6 months to 49 years, regardless of prior vaccination. Methods.  We evaluated vaccine effectiveness (VE) of MCV by comparing secondary attack rates among vaccinated and unvaccinated contacts after household exposure to measles. Results.  Among 318 contacts, VE for precampaign MCV was 23.1% (95% confidence interval [CI], −425 to 87.3) for 1 dose, 63.4% (95% CI, −103 to 90.6) for 2 doses, and 95.9% (95% CI, 45.0 to 100) for 3 doses. Vaccine effectiveness was 78.7% (95% CI, 10.1 to 97.7) for campaign doses received ≥5 days before rash onset in the primary case and 50.4% (95% CI, −52.1 to 87.9) for doses received 4 days before to 3 days after rash onset in the primary case. Vaccine effectiveness for most recent doses received before 2010 ranged from 51% to 57%, but it increased to 84% for second doses received in 2010 or later. Conclusions.  Low VE was a major source of measles susceptibility in this outbreak; potential reasons include historical cold chain inadequacies or waning of immunity. Vaccine effectiveness of campaign doses supports rapid implementation of vaccination campaigns in outbreak settings.


2020 ◽  
Vol 11 ◽  
Author(s):  
Raghuram Nagarathna ◽  
Parul Bali ◽  
Akshay Anand ◽  
Vinod Srivastava ◽  
Suchitra Patil ◽  
...  

BackgroundThe young Indian population, which constitutes 65% of the country, is fast adapting to a new lifestyle, which was not known earlier. They are at a high risk of the increasing burden of diabetes and associated complications. The new evolving lifestyle is not only affecting people’s health but also mounting the monetary burden on a developing country such as India.AimWe aimed to collect information regarding the prevalence of risk of diabetes in young adults (&lt;35 years) in the 29 most populous states and union territories (7 zones) of India, using a validated questionnaire.MethodsA user-friendly questionnaire-based survey using a mobile application was conducted on all adults in the 29 most populous states/union territories of India, after obtaining ethical clearance for the study. Here, we report the estimation of the prevalence of the risk of diabetes and self-reported diabetes on 58,821 young individuals below the age of 35 years. Risk for diabetes was assessed using a standardized instrument, the Indian diabetes risk score (IDRS), that has 4 factors (age, family history of diabetes, waist circumference, and physical activity). Spearman’s correlation coefficient was used to check the correlations.ResultsThe prevalence of high (IDRS score &gt; 60), moderate (IDRS score 30–50), and low (IDRS &lt; 30) diabetes risk in young adults (&lt;35 years) was 10.2%, 33.1%, and 56.7%, respectively. Those with high-risk scores were highest (14.4%) in the Jammu zone and lowest (4.1%) in the central zone. The prevalence of self-reported diabetes was 1.8% with a small difference between men (1.7%) and women (1.9%), and the highest (8.4%) in those with a parental history of diabetes. The south zone had the highest (2.5%), and the north west zone had the lowest (4.4%) prevalence.ConclusionsIndian youth are at high risk for diabetes, which calls for an urgent action plan through intensive efforts to promote lifestyle behavior modifications during the pandemics of both communicable and noncommunicable diseases.


Sign in / Sign up

Export Citation Format

Share Document