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MEASLES, YOUNG ADULTS - AFRICA: (LIBERIA), REQUEST FOR INFORMATION
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Date: Fri 28 Jan 2011
Source: The Inquirer [abbrev., edited]
<http://theinquirer.com.lr/story.php?record_id=3580⊂=14>


Measles Outbreak In Nimba
-------------------------
There has been a report of an outbreak of strange [i.e., strange in
the sense that unusually the illness is being observed in young adults
rather than children - Mod.CP] measles in Nimba County, a place that
is located in the northern part of Liberia and has experienced an
influx of refugees since the outbreak of the post-elections crisis in
neighboring Ivory Coast [Cote d'Ivoire].

However, the Minister of Health and Social Welfare, Walter T.
GwenIgale, has confirmed that indeed there is an outbreak of strange
measles in that county which [is currently affecting] young adults,
something that is [considered] strange. Also he added that the
outbreak had left one dead in the county. The Ministry has already
dispatched a team there to do all it could to bring the situation
under control.

Meanwhile, research done by this paper has shown that such outbreaks
have also happened in Australia involving predominantly young adults
in Victoria, which spread to South Australia between February and May
1999. And that in some countries where universal measles vaccination
has been introduced over an extended period of time, young adults are
emerging as the group most at risk of measles infection; approximately
85 percent of the 75 noticed cases confirmed with measles in that
outbreak were born between 1968 and 1981 (aged between 18 and 30
years). These young adults were most likely to be susceptible to
infection because of the timing of changes to measles vaccination
practices in Australia.

Prior to the introduction of vaccines, most people acquired immunity
through infection with wild measles virus in childhood. The reduction
in circulating wild measles virus and low vaccine coverage left a
cohort of young Australian adults with varying susceptibility to
infection.

[Byline: Rose M. Saulwas]

--
Communicated by:
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[The moderator's assumption that the term "strange" should be
interpreted as meaning "young adults" implies that the population
principally at risk of contracting measles virus infection (children)
has been well protected by comprehensive vaccination, leaving only
only a proportion of young adults still at risk of infection (as
discussed in the above press report). This interpretation needs to be
substantiated and, further information from Liberia would be welcomed.

Nimba is a county in the north-central portion of the West African
nation of Liberia. The location of Nimba is shown in the map at:
<http://en.wikipedia.org/wiki/Nimba_County>. The HealthMap/ProMED-mail
interactive map of Liberia can be accessed at:
<http://healthmap.org/r/0oWO>. - Mod.CP]

Pakistan - Masern
14.02.2011

Aus Punjab wird ein Ausbruch mit Hunderten Erkrankten gemeldet. Ende Januar wurde außerdem ein Ausbruch in Landikotal (NW) mit über 500 erkrankten Kindern im Alter von 0-7 Jahren gemeldet. Vielerorts fehlt es an medizinischer Hilfe. Impfschutz beachten. Bei fehlender zweiter Impfung kann diese jederzeit, auch anlässlich einer Reise, nachgeholt werden. / Quelle: crm

MEASLES - TURKEY
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Date: Wed 23 Feb 2011
Source: Daily News Economic Review [edited]
<http://www.hurriyetdailynews.com/n.php? ... 2011-02-23>


A previously unseen type of measles [see comment below] is spreading
in Istanbul, where 24 cases have been reported since the start of the
year [2011], the Istanbul Provincial Health Directorate has announced
in a warning issued to the public. According to the directorate, the
"foreign-origin virus [was] unseen in Turkey" and thus has been able
to spread very rapidly. In response to the new threat, the Health
Ministry has announced that it may vaccinate people born between 1975
and 1990 if they request inoculation. The number of measles cases in
Istanbul has increased from 2 to 24 over the last 3 months, according
to a report in the Radikal [newspaper].

Deputy Istanbul Health Director Serap Gencer said 2 of the
hospitalized people were released on Tuesday [22 Feb 2011], and the
remaining ones' were "generally in good condition." Gencer said all of
the ill are Turks. "The genetic analyses of the isolated viruses taken
from the samples point to a foreign origin." She said they could not
determine a direct origin but are sure this is a virus previously
unseen in Turkey. Gencer said the ill people, including 4 health
service employees and 4 infants, are either recovered or recovering,
and there is no risk of fatalities. There is no risk of an epidemic,
since vaccinations are standard at schools. "Since children of school
age have been vaccinated twice, there is no need for parents to
panic," she said.

Mustafa Sulku, a member of the Istanbul branch of the Practicing
Physicians Association who spoke at a press conference held in
Istanbul on Monday [21 Feb 2011] on the concerns of the "family
doctor" system, said although there are tendencies to present these
cases as coming from outside Istanbul, the 1st ones were detected in
residents living in Istanbul. Sulku said the most recently identified
cases belonged to people living in other Turkish cities. Sulku also
said the number one cause of the problem is "neglecting 1st-step
health services." Negligence caused this situation just as Istanbul
was about to eliminate measles for good.

Members of the Istanbul Medical Chamber attributed the failure to
identify and isolate measles cases in the city to the improper
functioning of the "family doctor" system and said that other worse
consequences could follow for people unless authorities do not address
this system's concerns properly.

Professor Nurhan Ince from Istanbul University's Public Health
Department said the Health Ministry implemented a program that
vaccinated 8.5 million in 2003 and 9 million people in 2004. She added
that it was too early to say whether the disease was caused by a
domestic virus or not, as the virus should be examined in
laboratories. Ince said the ministry already vaccinates people in 2
doses, 1st when they are one year old and then during the 1st year of
elementary school. Meanwhile, Minister of Health Recep Akdag announced
that they might vaccinate people born between 1975 and 1990 if they
request a vaccination.

--
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[Turkey has a commendable record in controlling measles virus
infection by vaccination, with 97 percent coverage of the population
by 2008, when no cases of measles were recorded.

Although measles virus is serologically monotypic, the genetic
characterization of wild-type viruses has identified 8 clades (A-H),
which have been divided into 22 genotypes and one proposed genotype.
Clades B, C, D, G and H each contain multiple genotypes (B1-3, C1-2,
D1-10, G1-3, H1-2) while clades A, E and F each contain a single
genotype (A, E, F) [1,2]. The sequences of the vaccine strains
indicate that the wild type viruses from which they were derived were
all members of genotype A (see: Review of the temporal and
geographical distribution of measles virus genotypes in the prevaccine
and postvaccine eras. Riddell et al. Virol J. 2005; 2: 87;
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1318492/>).

In 2005, genotype D6 was the genotype of measles virus present in
Turkey (Ceylan, A et al., Turk J Pediatr 2005 Oct-Dec;47(4):309-150).
It is presumed that measles virus of a different genotype is
responsible for the current outbreak in Turkey, and the suggestion is
that the virus has been introduced into Turkey from elsewhere.

The HealthMap/ProMED-mail interactive map of Turkey can be accessed
at: <http://healthmap.org/r/00ch>. - Mod.CP]

MEASLES - TURKEY (02)
*********************
A ProMED-mail post
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ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: 25 Feb 2011
From: Steven Berger
<mberger@post.tau.ac.il>


An ongoing outbreak in Istanbul reminds us that measles rates in
Turkey have decreased significantly only during the past 5 years, in
parallel with achievement of >90 percent vaccination coverage in the
country (WHO estimates) [1,2].

In the attached graph, measles rates (green line) are contrasted with
vaccination coverage estimates:
<http://www.gideononline.com/wp/wp-conte ... easles.jpg>.

References:
1. Berger SA. Infectious Diseases of Turkey, 2011. 420 pp. Gideon
e-books,
<http://www.gideononline.com/ebooks/coun ... of-turkey/>.

2. Berger SA. Measles: Global Status, 2011. 386 pp. Gideon e-books,
<http://www.gideononline.com/ebooks/dise ... al-status/>.

--
Steve Berger
Geographic Medicine
Tel Aviv Medical Center
<mberger@post.tau.ac.il>

[ProMED-mail thanks Steven Berger for providing access to this
informative figure.

The HealthMap/ProMED-mail interactive map of Turkey can be accessed

at: <http://healthmap.org/r/00ch>. - Mod.CP]

MEASLES UPDATE 2011 (02)
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******
Zambia
Date: Mon 28 Feb 2011
Source: Zambia Daily Mail [edited]
<http://www.daily-mail.co.zm/media/news/ ... 1298927606>


Serenji measles contained
-------------------------
Serenji District Hospital has recorded a total of 371 cases of
measles which have been successfully treated since November last year
[2010]. And 30 patients are currently being treated at the measles
centre in Serenje district. Serenje District Medical Officer Tiza
Mfune disclosed to ZANIS that the 371 cases of measles do not include
those that were treated at rural health centres in the district.

Last month, the Serenje District Health Management Team (DHMT) had
carried out a government-sponsored measles mop-up immunisation
campaign in which thousands of children from the age of zero to 5
years were vaccinated.

The disease, which was 1st recorded on 25 Jan 2010, is believed to
have been introduced into the district by a resident of Lusaka's
Mandevu compound who visited the area and became sick while there.

Meanwhile, the number of people dying from measles in the district
has continued to reduce. Serenje District Commissioner Stanley
Chibwana said despite the epidemic spreading to most parts of the
district, there have been very few deaths. Mr Chibwana said this is
because Government has intensified efforts to curb the disease and
disclosed that over K200 million [USD 42 016.80]will be spent on the
fight against the epidemic.

--
Communicated by:
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[Until recently measles had been well contained in Zambia, but in
addition to the current outbreak in Serenji a serious outbreak was
recorded in Solwezi District in October 2010.

A map showing the location of Serenji (in the Central District) can
be accessed at
<http://mapsof.net/zambia/static-maps/pn ... -districts>.
The HealthMap/ProMED-mail interactive map of Zambia can be found at:
<http://healthmap.org/r/017q>. - Mod.CP]

MEASLES UPDATE (03)
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*****

Nigeria (Adamawa)
Date: Tue 8 Mar 2011
Source: Nigerian Compass [edited]
<http://www.compassnewspaper.com/index.p ... Itemid=607>


Measles outbreak hits Adamawa
-----------------------------
Barely a month after Adamawa State recorded a deadly incident of
Lassa fever, the state Ministry of Health has again announced an
outbreak of severe measles in at least 16 out of the 21 local
government areas of the state. [Recently another outbreak of Lassa
fever, occurring in Ebonyi state, was reported in ProMED-mail, see:
'Lassa fever - Nigeria: (EI) 20110223.0599'. - Mod.CP]

Confirming the development to newsmen in Yola, the state capital, the
head of the State Epidemiological Unit of the ministry, Dr Bwalki
Barem Dilli, said though the situation has been brought under control,
it would have been more devastating but for the recent integrated
campaign embarked upon in all the councils by the ministry.

Meanwhile, the commissioner for health, Dr Lawal Hamidu, while
speaking to newsmen on the development, confirmed that the 3 medical
doctors affected by the Lassa fever outbreak have since been taken to
the National Hospital, Abuja and Arowa Specialist Hospital in Edo
State for proper treatment.

Commenting on the role played by the Federal Ministry of Health at
curbing the spread of the diseases, Hamidu explained that the Federal
Ministry of Health had donated about 1000 doses of anti-virus drugs to
the state to combat and control the epidemic.

While denying knowledge of an outbreak of chickenpox as being
rumoured in some quarters, the commissioner said the ministry only
recorded an outbreak of measles, and that the state was lucky to have
towards the end of January [2011] embarked on integrated measles
campaign, which, according to him, was carried out in the entire
northern region to curtail the spread of the disease.

He recalled with dismay the damage done by an earlier outbreak in
2005, and applauded the efforts of the Federal Government for coming
up with the catch-up campaign, where children below 15 years were
immunised. He then advised communities, individuals to avoid sleeping
in crowded rooms, but to ensure that they keep their environment
clean, especially now that the state is experiencing hot and dry
weather.

[byline: Clement Ekong]

[Further information on the extent of the outbreak and the numbers of
cases would be appreciated. A map of Nigeria showing the location of
the state of Adamawa can be accessed at
<http://www.waado.org/nigerdelta/Maps/Ni ... tates.html>. - Mod.CP]

MEASLES UPDATE 2011 (05)
************************
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ProMED-mail is a program of the
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In this update:
[1] India (Uttar Pradesh)
[2] Niger
[3] Congo DR (Maniema)


******
[1] India (Uttar Pradesh)
Date: Mon 14 Mar 2011
Source: The Times of India (TOI), Times News Network (TNN) [edited]
<http://articles.timesofindia.indiatimes ... al-disease>


Childhood diseases increase in Allahabad
----------------------------------------
Hospitals [in Allahabad, Uttar Pradesh] have been flooded with over a
dozen fresh cases of measles and chickenpox every day. Health experts
are taking serious note of the prevailing situation and have asked
people to adopt precautions [for their own protection], and they have
issued some guidelines in this respect.

Senior medical officer for community health, Dr SAM Meesum, stated
that: "Measles is a highly contagious viral disease, which affects
mostly children.'' He said the 1st sign of measles is usually a high
fever, which begins about 10 to 12 days after exposure to the virus,
and lasts 4 to 7 days. "A runny nose, cough, red and watery eyes, and
small white spots inside the cheeks can develop in the initial stage.
After several days, a rash erupts, usually on the face and upper neck.
After 3 days, the rash spreads, eventually reaching the hands and
feet.''

There is no specific treatment for measles and most people recover
within 2-3 weeks. However, particularly in malnourished children and
people with reduced immunity, measles may even cause serious
complications, including blindness, encephalitis, severe diarrhoea,
ear infection, and pneumonia.

Measles can be prevented by immunisation, he said. Severe
complications from measles can be avoided though supportive care that
ensures good nutrition, adequate fluid intake, and treatment of
dehydration with WHO-recommended oral rehydration solution. This
solution replaces fluids and other essential elements that are lost
through diarrhoea or vomiting. Antibiotics should be prescribed to
treat eye and ear infections, and pneumonia, Dr Meesum said.

Chickenpox is a common illness among children. An itchy rash of spots
that look like blisters can appear all over the body and may be
accompanied by flu-like symptoms. Symptoms usually go away without
treatment, but because the infection is very contagious, an infected
child should stay at home and rest until the symptoms are gone, he
added.

--
Communicated by:
HealthMap Alerts via ProMED-mail
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[Measles and chickenpox are vaccine preventable mainly childhood
diseases. In India (at least until recently) only a single dose of
measles vaccine is administered at 9 months of age, rather than the 2
immunisations recommended elsewhere. Chickenpox virus vaccine is not
yet available In India.

The HealthMap/ProMED-mail interactive map of India is available at
<http://healthmap.org/r/0BZB>. A map of the states of India showing
the location of Uttar Pradesh can be accessed at
<http://www.mapsofindia.com/maps/india/i ... dunion.htm>.
Allahabad can be located in the map of Uttar Pradesh at
<http://www.mapsofindia.com/maps/uttarpr ... strict.htm>.
- Mod.CP]

******
[2] Niger
Date: Thu 10 Mar 2011
Source: Afrique en Ligne, Panafrican News Agency (PANA) report [in
French, trans., edited]
<http://www.afriquejet.com/afrique-de-l% ... 04380.html>


1630 cases of measles in Niamey
-------------------------------
As of 9 Mar 2011, 1630 cases of measles and one fatality have
occurred in Niger according to a report from the OCHA [UN Office for
the Coordination of Humanitarian Affairs] forwarded to PANA. According
to this report the most affected locality is Zinder region where there
have been 564 cases in Goure, 119 cases in Mirriah, 62 cases in
Tanout, and 62 cases in Magaria.

Last week [week of 1 Mar 2011], 94 cases of measles were registered
in comparison to 100 in the previous week according to the report. 289
cases have been recorded in Aguie in Maradi region, where the disease
still rages despite efforts during the past 3 weeks to contain the
outbreak. During the month of February [2011] a total of 403 cases
were registered, with 230 cases occurring in Aguie district.

--
Communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>

[Local reports suggest that widespread malnutrition is a contributory
factor in this outbreak. Maps of Niger can be accessed at
<http://healthmap.org/r/008b>,
<http://www.mapsofworld.com/niger/maps/niger-map.jpg>, and
<http://en.wikipedia.org/wiki/Departments_of_Niger>. - Mod.CP]

******
[3] Congo DR (Maniema)
Date Mon 14 Mar 2011
Source: UN OCHA, ReliefWeb, UN Stabilization Mission in the
Democratic Republic of the Congo (MONUSCO) [edited]
<http://www.reliefweb.int/rw/rwb.nsf/db9 ... 0&RSS20=FS>


Measles epidemic outbreak in southern Maniema
---------------------------------------------
More than 90 cases of measles were recently diagnosed in 3 health
centers in [southern] Maniema province. 3 people are reported to have
died from the epidemic. According to the Provincial Health Minister,
the territories so far affected are Kabambare, Kasongo, and Kibombo.
Medical personnel from different organizations have been meeting to
try and find ways to contain the disease. It has already reached
alarming proportions, according to Marie Claire Diwampovesa Nganzi, a
medical doctor specializing in epidemiology and Head of the World
Health Organisation (WHO) sub-office in Maniema. This, she said, can
now be described as a measles epidemic on a wide scale, and requiring
an immediate response from all relevant partners in the province.

The German Technical Cooperation Group (GTZ), through its support
project for the reinforcement of the health system -- known by the
acronym PARSS --, has already started providing care to affected
populations, while a team of the French NGO, Medecins sans Frontieres,
is busy assessing the exact extent of the epidemic.

A joint team from the UN Stabilization Mission in the DR Congo
(MONUSCO) regional office and UN agencies is preparing to visit the
affected area to help contain the epidemic.

[Byline: Matthieu Ilunga]

--
Communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>

[The HealthMap/ProMED-mail interactive map of Congo DR can be seen at
<http://healthmap.org/r/0BZC>. Maps showing the country's regions and
departments can be accessed at
<http://www.maplibrary.org/stacks/Africa ... /index.php>.
- Mod.CP]

MEASLES UPDATE 2011 (06)
************************
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******
Congo DR
Date: Sun 27 Mar 2011
Source: Relief Web, Medecins Sans Frontieres press release [edited]
<http://www.reliefweb.int/rw/rwb.nsf/db9 ... 0&RSS20=FS>


Over the past 6 months, a measles epidemic has been sweeping through
the Democratic Republic of Congo (DRC). Medecins Sans Frontieres (MSF)
is raising the alarm and calling for concerted action to halt the
spread of the disease. "The measles epidemic is spiraling out of
control," says Gael Hankenne, MSF Head of Mission in the DRC. "Since
September 2010, we have vaccinated more than 1.5 million children in
response to the crisis. But the disease is spreading like wildfire.
All parties involved in health in the DRC must now make this epidemic
a national priority. Since September 2010, we have counted more than
21 000 measles cases in the DRC," says Hankenne. "Concerted action
needs to happen right now."

The treatment and vaccination needs are huge, and the requirements in
terms of human resources, finances and logistical capacity mean that
MSF cannot be the only organisation providing a hands-on response
throughout the entire country. "We are asking the Ministry of Health
to launch a response immediately to outbreaks that occur in the other
provinces or in any new health zone that is affected," says Geza
Harzi, MSF Head of Mission in Katanga. "At the same time, we are
asking international donors and institutions, and health organisations
with activities in the DRC -- particularly UN agencies (such as the
WHO and UNICEF) and NGOs -- to take action immediately. We request
that they either release emergency funding or take hands-on action as
part of the epidemic response. If this international response not
rapid, it will be impossible to check the spread of measles in the
DRC."

MSF is expanding its emergency response in 3 provinces: Tshikapa in
Kasai Occidental province, at Fizi in South-Kivu province, and at
Kolwezi and Likasi in Katanga province. More than a million children
will be protected by these emergency vaccinations. Over the past
months, MSF has provided a complete emergency response (treatment,
vaccination and epidemiology) in Katanga, Kasai Occidental and
South-Kivu. New outbreaks have flared up in Bandundu, Kasai Oriental
and Maniema provinces. The epidemic is moving north fast.

Measles is an extremely contagious disease that can cause medical
complications such as pneumonia, malnutrition, severe dehydration, ear
infections and eye infections that can lead to blindness. Mortality
rates vary considerably depending on the context. When a population
has not been vaccinated, measles can kill between 1-15 percent of
afflicted children. Among vulnerable groups (such as people who have
been displaced or are malnourished), the mortality rate can rise to 25
percent if people have limited access to health care, as is the case
in many health zones in the DRC.

--
Communicated by:
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[The statistics contained in this press release demonstrate the
severity of measles virus infection, with mortalities up to 25 percent
in undernourished communities in the absence of protection by
vaccination. The tragedy is compounded by the fact that an effective
and secure vaccine is available for prevention of measles virus
infection.

The HealthMap/ProMED-mail interactive map of the Democratic Republic
of Congo can be accessed at: <http://healthmap.org/r/01Cl>. - Mod.CP]

MEASLES UPDATE 2011 (07)
************************
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ProMED-mail is a program of the
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In this update:

[1] Congo DR (Kinshasa)
[2] Africa (WHO Region Report)
[3] India (Hyderabad)

******
[1] Congo DR (Kinshasa)
Date: Tue 29 Mar 2011
Source: Metro, Associated Press report [edited]
<http://www.metronews.ca/calgary/world/a ... 6-children>


Health officials in Congo [that is, Democratic Republic of Congo] say
an outbreak of measles has left 106 children dead. Congolese officials
said Tuesday [29 Mar 2011] that 90 of the deaths have been in Katanga
province.

Aid group Medecins Sans Frontieres says there have been 21 000 cases
in 5 provinces in the giant Central African nation. The medical aid
group says it has given 1.5 million vaccinations since last year
[2010] but needs help to continue its efforts.

Since 2008, funding cuts for vaccination campaigns have allowed
measles to spread again where previously it was close to being
eradicated. The number of cases has surged, with large outbreaks
reported in 30 African countries. The cost of vaccinating a child
against measles is less than USD 1.00.

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******
[2] WHO Africa Region report
Date: Fri 1 Apr 2011
Source: MMWR Weekly 60(12);374-378 [edited]
<http://www.cdc.gov/mmwr/preview/mmwrhtm ... ovdelivery>


Measles Outbreaks and Progress Toward Measles Pre-elimination:
African Region, 2009--2010
--------------------------------------

Introduction
------------
In 2008, the World Health Organization (WHO) African Region (AFR)
measles technical advisory group (TAG) recommended establishing a
measles pre-elimination goal, to be achieved by the end of 2012. The
goal sets the following targets for the 46 AFR countries: Greater than
or equal to 98 per cent reduction in estimated regional measles
mortality compared with 2000; measles incidence of under 5 cases per 1
million population per year nationally; over 90 per cent national
measles-containing vaccine (MCV) 1st dose (MCV1) coverage and over 80
per cent MCV1 coverage in all districts; and greater than or equal to
95 per cent MCV coverage by supplementary immunization activities
(SIAs) in all districts (1). The goal also sets surveillance
performance targets of greater than or equal to 2 cases of non-measles
febrile rash illness per 100 000 population, greater than or equal to
one suspected measles cases investigated with blood specimens in
greater than or equal to 80 per cent of districts, and routine
reporting from all districts (1). In addition, introduction of a
routine 2nd MCV dose (MCV2) was recommended for countries meeting
specific criteria for MCV1 coverage and measles surveillance (1,2).
This report updates progress toward the pre-elimination goal during
2009/2010 and summarizes measles outbreaks occurring in AFR countries
since 2008. Of the 46 AFR countries, 12 (26 per cent) reported measles
incidence of under 5 cases per one million population during 2010,
compared with 28 (61 per cent) in 2008. Furthermore, 28 (61 per cent)
countries reported a laboratory-confirmed measles outbreak during
2009/2010 (3). The recent measles outbreaks highlight the need for
renewed dedication by donors and governments to ensure that national
multiyear vaccination plans, national budgetary line items, and
financial commitments exist for routine immunization services and
measles control activities.

Measles vaccination coverage
----------------------------
The 46 AFR countries* report routine vaccination coverage to the WHO
Regional Office for Africa (AFRO) using the WHO and United Nations
Children's Fund (UNICEF) Joint Reporting Form (JRF) (4). In addition,
WHO and UNICEF publish MCV1 coverage estimates based on multiple data
sources, including JRF reports and demographic surveys (5). As of
2010, MCV1 was administered routinely at age 9 months** in 43
countries, and MCV2 was included in the routine immunization program
in 7 countries (Algeria, Cape Verde, Lesotho, Mauritius, Seychelles,
South Africa, and Swaziland).

During 2001--2008, reported MCV1 coverage increased from 55 per cent
to 79 per cent in the region (6). In 2009, AFR MCV1 administrative
coverage*** was 83 per cent, based on the most recent JRF data; the
WHO and UNICEF regional MCV1 coverage estimate was 69 per cent. In
2009, 4 (9 per cent) countries (Burkina Faso, Gambia, Mauritius, and
Sao Tome and Principe) reported over 80 per cent MCV1 coverage in all
districts. To interrupt endemic transmission of measles, mathematical
models indicate that 93 per cent -- 95 per cent population immunity is
needed (7). Since 1997, 41 (89 per cent) countries (all except
Algeria, Cape Verde, Mauritius, Sao Tome and Principe, and Seychelles)
have conducted an SIA targeting children aged 9 months to 14 years,
and 43 (93 per cent) countries (all except Algeria, Mauritius, and
Seychelles) have conducted at least one SIA targeting children aged 9
to 59 months. A nationwide SIA was conducted in 31 (67 per cent)
countries during 2009/2010; of these countries, 5 (16 per cent)
(Ethiopia, Ghana, Malawi, Zambia, and Zimbabwe) conducted post-SIA
vaccination coverage surveys.

Measles surveillance
--------------------
Data on suspected measles cases are tallied monthly at local health
facilities, reported to the district level, aggregated at the national
level, and annually reported to AFRO using the JRF (8 ). JRF data on
2010 suspected measles cases were not yet available; thus, 2010
measles case-based surveillance data reported to AFRO by 40 (87 per
cent) countries, in accordance with WHO AFRO measles surveillance
guidelines, are cited instead (8 ). During 2001/2008, reported measles
cases in AFR decreased by 93 per cent, and estimated measles-related
mortality declined 91 per cent (2). The number of reported measles
cases decreased from 520 102 in 2000 to 37 162 in 2008, then increased
to 83 464 in 2009 and to 172 824 in 2010. Of 172 824 reported cases,
23 842 (14 percent) were laboratory confirmed, and 109 570 (63 per
cent) were confirmed through epidemiologic link**** (3). During 2010,
25 (63 per cent) countries met the non-measles febrile rash illness
reporting target of greater than or equal to 2 cases per 100 000
population, and 29 (73 per cent) had greater than or equal to 80 per
cent of districts reporting greater than or equal to one suspected
cases with blood specimen. The overall confirmed measles incidence for
the region in 2010 was 17.2 per 100 000 population, and 12 (30 per
cent) countries reported measles incidence of under 5 cases per one
million population.

During 2009 and 2010, B3 measles virus was detected in all 25
countries with genotype information and was the predominant genotype
in the region. In addition to the B3 outbreak strain, Angola and
Namibia reported transmission of the B2 genotype, and South Africa
reported 2 additional genotypes: a D4 from a single case imported
during the World Cup games in June 2010 and a D8 from a single case in
2009.

Major outbreaks and response activities
---------------------------------------
During 2009/2010, a total of 28 (61 per cent) of the 46 AFR countries
had laboratory-confirmed measles outbreaks with over 100 reported
measles cases, including 13 countries in 2009 and 15 additional
countries in 2010, compared with 9 (20 per cent) countries in 2008. Of
these 28 countries, 10 reported greater than or equal to 90 per cent
MCV1 coverage in 2009, 15 had a follow-up SIA within 24 months before
the outbreak, and all reported greater than or equal to 90 per cent
SIA administrative coverage in the most recent measles SIA. Of the 28
countries with reported outbreaks, 20 conducted an outbreak
investigation, and 14 implemented an outbreak response immunization
(ORI) campaign or a nationwide SIA following the start of the
outbreak.

In some AFRO countries, frequent outbreaks continued, suggesting that
children [had been] missed by routine vaccinations and by SIAs in
recent years. Measles outbreaks in which the majority of cases
involved children aged under 5 years occurred in Angola, Democratic
Republic of Congo, Ethiopia, Nigeria, and Sierra Leone. Ethiopia, for
example, reported that MCV1 coverage increased from 59 per cent in
2005 to 75 per cent in 2009. The last nationwide measles SIA,
conducted in 3 phases during 2007/2009, targeted children aged 9 to 59
months, with reported coverage of 98 per cent, 92 per cent, and 93 per
cent, respectively.

The 2009 non-measles febrile rash illness rate was 2.4 per 100 000
population, and 87 per cent of districts reported greater than or
equal to one suspected cases with blood specimen. In 2009, 1176
suspected cases were reported, compared with 8261 cases in 2010 in 93
of 96 administrative zones. Of the cases reported in 2010, a total of
4182 (51 per cent) were confirmed by either laboratory testing or
epidemiologic link. Of the confirmed cases, 3142 (75 per cent) were
among children aged under 5 years, and 3877 (93 per cent) were among
unvaccinated persons. In 2010, an ORI campaign was conducted in 54
districts of 5 zones, targeting children aged 6 to 59 months, with
reported coverage over 100 per cent [?].

In AFRO countries with higher, but still suboptimal, MCV1 coverage
and SIA implementation, the age distribution of measles cases shifted
to include older children and young adults. A measles outbreak pattern
in which the age distribution of measles cases included older children
and young adults occurred in Burkina Faso, Malawi, Namibia, South
Africa, and Zambia. In Malawi, for example, reported MCV1 coverage
increased from 82 per cent in 2005 to 92 per cent in 2009; a
nationwide SIA targeting children aged 9 to 59 months was implemented
in both 2005 and 2008, each with over 95 per cent reported coverage.

In 2009, the non-measles febrile rash illness rate was 3.8 per 100
000, and 96 per cent of districts reported greater than or equal to
one suspected case with blood specimen. In 2010, 73 727 suspected
measles cases were reported from 24 of 28 districts in Malawi. Among
35 366 patients reported during 24 Oct 2009 to 17 Jul 2010, a total of
14 627 (41 per cent) were aged under 5 years, 11 391 (32 per cent)
were aged 5 to 14 years, and 9348 (26 per cent) were aged 15 years or
over. An initial ORI campaign was conducted 3 months after the start
of the outbreak in 3 districts targeting children aged 9 to 59 months.
A 2nd ORI campaign was conducted 5 to 6 months after the outbreak
started in 8 districts targeting children aged 6 months to 14 years in
affected schools and prisons with clusters of patients. In 2010, a
nationwide SIA was implemented targeting children aged 6 months to 14
years with over 95 per cent administrative coverage in 26 of 28
districts.

Reasons for non-vaccination identified through outbreak
investigations during 2009/2010 included vaccine unavailability;
strict adherence to the WHO open vial policy, leading to batching of
children into infrequent vaccination sessions; and exclusion of
children aged over 12 months, who were considered ineligible for MCV1.
In addition, unwillingness to receive vaccination was identified among
certain religious groups in Zimbabwe, Botswana, Malawi, and South
Africa.

MMWR editorial note
-------------------
During 2001/2008, AFR countries made remarkable progress in reducing
measles mortality and morbidity by increasing MCV1 coverage and
periodic SIAs (2). However, since reaching an historic low of 32 278
reported cases in 2008, a resurgence of measles led to multiple large
outbreaks during 2009/2010, despite increases in reported MCV1
coverage, indicating the fragility of the progress. Suboptimal routine
and SIA vaccination coverage led to an increasing number of
susceptible persons over a prolonged period of low incidence, allowing
some children to remain susceptible as they grew older. Outbreak cases
occurring among older children and young adults suggest some progress
in reducing measles incidence together with long-standing gaps in
vaccination activities. In countries with large outbreaks occurring
primarily among children aged under 5 years, substantial numbers of
children were missed by both routine vaccination and SIAs in recent
years. In these countries, estimated MCV1 coverage remains suboptimal,
and reviews of vaccination services are needed to identify
programmatic reasons for non-vaccination (9). Detailed outbreak
investigations are recommended to describe the epidemiology of an
outbreak, guide rapid ORI, and determine the likely cause of the
outbreak (such as failure to vaccinate) (1).

The findings in this report are subject to at least 2 limitations.
1st, underreporting of measles cases and low sensitivity of measles
case-based surveillance in some countries likely led to underestimates
of measles incidence. 2nd, SIA administrative coverage over 100
percent suggests inaccurate and inflated reported coverage (9).

Although post-SIA coverage surveys are recommended, only 5 of 31
countries implemented a post-SIA coverage survey during 2009/2010.
Estimates of vaccination coverage from population-based coverage
surveys are key inputs to determine the susceptibility profile of a
population. In addition, reliable coverage estimates can help identify
areas of low coverage so that program managers can better prioritize
and more efficiently use resources. Even though AFR reported MCV
coverage has increased continuously and the quality of measles
surveillance has improved, subsequent measles outbreaks raise doubts
concerning the accuracy and reliability of reported coverage and
surveillance data. WHO-recommended methods for improving the accuracy
of monitoring measles vaccination programs and post-SIA surveys to
estimate coverage should be implemented routinely (1).

The 2009/2010 outbreaks highlight the need for full implementation of
regional strategies, with an emphasis on improving vaccination
coverage through routine immunization services and SIAs in every
district, and introduction of MCV2 into routine immunization services
in eligible countries (1). National immunization program policies and
delivery systems should be reviewed to ensure access to the
recommended 2 doses of MCV by all eligible children. Communication
strategies should be identified to ensure vaccination acceptance and
demand among all segments of the population. Renewed dedication by
donors and governments is needed to ensure that national multiyear
plans, budgetary line items, and financial commitments exist for
routine immunization services and measles control activities.

--
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[Interested readers should access the original text via the URL in
the heading to view the tabulated and graphical presentation of data
and the literature references cited in the text.

After a long period of success in reducing the incidence of measles
virus infection in the AFR, there has been a regrettable reversal of
success in the recent past in part due to the factors outlined above
and due to financial constraints.

During 2001/2008, reported measles-containing vaccine 1st dose (MCV1)
coverage increased from 55 per cent to 79 per cent in 46 African
countries, reported measles cases decreased by 93 per cent, and
estimated measles-related mortality decreased 91 per cent. By 2008, 40
of the 46 countries had established case-based surveillance in
accordance with WHO guidelines, and 28 reported measles incidence
under 5 cases per one million population per year.

In 2009, reported MCV1 coverage among the 46 African countries was 83
per cent; 12 (26 per cent) countries had measles incidence of under 5
cases per one million population in 2010, and 28 (61 per cent)
reported laboratory-confirmed measles outbreaks. Despite this
substantial progress toward reducing measles mortality and morbidity,
multiple outbreaks during 2009/2010 showed the gains were fragile, and
epidemiologic investigations of some outbreaks showed a failure to
vaccinate. The reasons for non-vaccination and corrective solutions
need to be determined, the quality of reported data should be
verified, and measles surveillance should be strengthened.

The African Region countries are: Algeria, Angola, Benin, Botswana,
Burkina Faso, Burundi, Cameroon, Cape Verde, Central African Republic,
Chad, Comoros, Congo, Cote d'Ivoire, Democratic Republic of Congo,
Equatorial Guinea, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea,
Guinea-Bissau, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali,
Mauritania, Mauritius, Mozambique, Namibia, Niger, Nigeria, Rwanda,
Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, South
Africa, Swaziland, Togo, Uganda, United Republic of Tanzania, Zambia,
and Zimbabwe.

Many African governments are not allocating enough funds from their
annual budgets to health, says a study by WHO. Without additional
resources, vital health goals will not be achieved, it says.

In the 10 years since heads of state of African Union countries met
in Abuja, Nigeria and pledged to set a target of allocating "at least
15 per cent" of their annual budget to improve the health sector, only
Rwanda and South Africa have reached the objective, says WHO. -
Mod.CP]

******
[3] India (Hyderabad)
Date: Mon 4 Apr 2011
Source: The Times of India [edited]
<http://timesofindia.indiatimes.com/city ... 859830.cms>


The city has witnessed a major measles outbreak in the last 3 months,
pushing the total number of cases to an alarming 345 against 279 last
year [2010]. What's more, several children who were vaccinated against
the infection figure in this measles headcount. Surprisingly, the
itchy rash did not spare even 40 and 50 year olds.

District health officials said that outbreak investigations carried
out twice during February and mid-March 2011 all over Hyderabad turned
out to be positive. "There was a spurt in the number of cases during
January, February, and mid March [2011]. A total of 15 cases were
reported last week (21-27 Mar 2011). However, the numbers have shown a
decline since the onset of summer," said Dr B L Veena Kumari, district
medical and health officer.

Authorities at the Fever Hospital said that they have seen 5-6 cases
a day in the last couple of months as against the normal 1-2 cases.
"Around 95 per cent of the cases are of children," said Dr G Vinod,
assistant professor, Fever Hospital.

Doctors at private hospitals who also saw an unusual flow of such
cases said this outbreak was unexpected. "Measles is not common among
adults, but last month [March 2011], we have come across around 8-10
cases," said Dr Aftab Ahmed, physician, Apollo Hospital,
Secunderabad.

Doctors said that measles symptoms include cough, running nose and
itchy eyes similar to the flu, with increased eye irritation. These
symptoms will last several days and are followed by a rash starting on
the head and progressing down the body.

On an average, 9200 children at the age of 9 months are being
vaccinated against measles under the National Immunisation Programme
every month in the city. Most of the children who got the infection
this year [2011] were in the age group of 5-12 years, said officials.
Now, authorities say that a study is being conducted in Andhra Pradesh
to find out why measles is occurring among vaccinated children and
elders as well. "After the study, we will send a report to the central
government requesting that a 2nd dose be given to children at the age
of 18 months," said Dr G Srinivasulu, district immunisation officer.

--
communicated by:
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[Hyderabad is the capital of the state of Andhra Pradesh. The
population of the metropolitan area is in excess of 6.5 million.

Hyderabad can be located in the map at
<http://en.wikipedia.org/wiki/Hyderabad, ... mographics>. It may
be that the measles vaccination policy in India of a single dose of
vaccine at 9 months will have to be replaced by a 2-dose schedule as
practised in most other countries. - Mod.CP]

MEASLES UPDATE 2011 (08 )
************************
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ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
[1] Pakistan (Federally Administered Tribal Areas)
[2] Somalia


******
[1] Pakistan (Federally Administered Tribal Areas)
Date: Wed 6 Apr 2011
Source: Dunya News Network [edited]
<http://dunyanews.tv/index.php?key=Q2F0S ... Q9MjM0NzI=>


According to official sources, 5 children of ages between 2 and 5
years have died of measles and several others affected by the disease
have been admitted to Miranshah District Headquarters.

The epidemic has been spreading in North Waziristan [Federally
Administered Tribal Areas] and other adjoining areas. People have
demanded the government provide treatment facilities at the hospital.

--
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[A map showing the location of North Waziristan, part of the
Federally Administered Tribal Areas of Pakistan, can be accessed at
<http://en.wikipedia.org/wiki/North_Waziristan>. - Mod.CP]

******
[2] Somalia
Date: Wed 7 Apr 2011
Source: UN Integrated Regional Information Networks (IRIN) News
[edited]
<http://www.irinnews.org/Report.aspx?ReportID=92408>


Somalia: vaccine fears fuel measles outbreak
--------------------------------------------
The cause of a measles outbreak in Somalia has yet to be determined
but doctors say initial suspicions point to "unfounded rumours" that
the vaccine could cause HIV/AIDS in children and interfere with their
reproductive abilities.

"There are false rumours creating fear among parents that the
vaccination causes HIV/AIDS and can affect a child's reproductive
system," said Ismail Isse Roble, head of the Bari Medical Association
in Bosasso, capital of Somalia's semi-autonomous region of Puntland.
Roble said most of the children brought to his clinic had not been
vaccinated.

"The irony is that most of the affected children are those whose
parents can afford medical care," he said. "Children in IDP
[internally displaced persons] camps [in Bosasso] are least affected
because they took advantage of the free vaccinations provided."

According to the UN World Health Organization (WHO) Somalia, 83
cases, including 5 deaths, were reported in Mogadishu in the past 5
weeks. Some 127 cases were reported in Puntland, WHO said.

The agency said the UN Children's Fund (UNICEF), WHO and their
partners conducted outbreak response campaigns in the last week of
March [2011], vaccinating more than 75 000 children.

Although measles cannot be treated, WHO said, "it can easily be
prevented by taking the measles vaccine that is provided in all MCH
[mother-child health] facilities in Somalia daily for free." Lul
Mahamud Mohamed, head of the pediatric department at Benadir Hospital
in Mogadishu, told IRIN she had been seeing more and more cases in the
past 3 months. "In February [2011], we had 53 cases with 3 deaths; in
March [2011], there were 81 cases with 6 deaths," she said. "In the
1st week of April [2011], we already had 17 cases and 2 deaths. The
increasing numbers point to an upward trend," said Mohamed. She said
90 percent of the patients were younger than 2. Since February, 151
cases of measles have been reported in Benadir hospital alone.

"Already, there are response campaigns going on in the affected areas
but they are being hampered by lack of access to certain areas,"
Mohamed told IRIN. Mohamed said overcrowding in parts of Mogadishu and
in the IDP camps in the Afgoye corridor facilitated the spread of the
virus.

She said vaccines were available but parents had to be convinced to
take their children to be immunized. "We need to mount an awareness
campaign to fight these false rumours and lies that the vaccine will
harm the child." Mohamed appealed to parents with children aged
between 9 months and 5 years who had never received the measles
vaccination to take their children to the nearest immunizing health
facility.

Roble in Bosasso said religious scholars should also inform the
people about the safety of the vaccines. "They are the ones that
ordinary Somalis will listen to; it is sad that in this day and age
our children must die because of ignorance and lies," Roble said.

--
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MEASLES UPDATE 2011 (13)
************************
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In this update:

[1] India (Uttar Pradesh)
[2] Congo DR (MSF)
[3] Zambia (Eastern province)

******
[1] India (Uttar Pradesh)
Date: Sun 15 May 2011
Source: Yahoo News India [edited]
<http://in.news.yahoo.com/2-children-die ... 00385.html>


A brother and sister died of measles, while 3 others were admitted
for treatment in Jiyanpur area of the district, officials said today
[Sun 15 May 2011].

The 2 3-year-old children died due to measles this morning [15 May
2011] in Gangepur Varzala village, family members said. Teams of
doctors have been rushed to the village, and they were trying to
ascertain the reason for the death, Chief Medical Officer BB Singh
said.

--
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[Azamgarh is a town in the northern Indian state of Uttar Pradesh. It
is headquarters of Azamgarh district and of Azamgarh Division. Its
location can be found in the map at:
<http://en.wikipedia.org/wiki/Azamgarh>. - Mod.CP]

******
[2] Congo DR (MSF)
Date: Fri 13 May 2011
Source: Afrique en ligne [in French, trans. & edited]
<http://www.afriquejet.com/actualites/sa ... 11726.html>


More than 16 000 suspected cases of measles have been recorded
throughout the Democratic Republic of Congo (Congo DR), with 107
deaths, according to the non-governmental organisation (NGO) Medecins
sans Frontieres (MSF) in a statement sent to PANA (Pan African News
Agency) on Wed 11 May 2011. "For 6 months, a measles epidemic has been
spreading across the Congo DR. The situation is out of control. MSF
reported that they had vaccinated more than 1.5 million children since
September 2010, but the disease is spreading like wildfire," stated
MSF, urging the Congolese Ministry of Health to "ensure rapid response
to outbreaks in new areas as they become infected.

MSF is also asking the World Health Organization and UNICEF (the
United Nations Children's Fund) to intervene immediately by releasing
emergency funding. "If the reaction of these official organisations is
not forthcoming, it will be impossible to stem the epidemic of measles
in the DRC," warns MSF.

--
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******
[3] Zambia (Eastern Province)
Date: Tue 10 May 2011
Source: Lusaka Times [abridged & edited]
<http://www.lusakatimes.com/2011/05/10/z ... s-measles/>


The Ministry of Health says it has so far recorded 1076 cases [of
measles], with the majority of the cases in Lundazi, Chipata, and
Chadiza districts of Eastern Province. Dr. Mbewe noted that the
provincial health office is coordinating awareness campaigns on the
importance of ensuring that children are immunized. Dr. Mbewe said
both static and outreach immunization services have been intensified
in all districts. He explained that active surveillance for cases is
ongoing to minimize cases in the community from spreading and to
identify cases.

A health spokesperson said in Lusaka today [10 May 2011] during a
press briefing that the ministry will also be conducting mass
immunization in affected areas and further advised parents in the
country to take their children for immunization against measles. "As
you know, last year [2010], the Ministry of Health conducted a
nationwide measles campaign. We are still in discussion with our
partners as to whether they can [continue] supporting us in conducting
a measles vaccination campaign for selected districts in Eastern
Province."

--
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[A map showing the location of the Eastern Province of Zambia can be
accessed at:
<http://www.mapsofworld.com/zambia/zambi ... l-map.html>.

Viewing the geographical extent of the global outbreak of measles
revealed by these reports, with case numbers ranging from one to 16
000, the WHO revised target of the year 2015 for the final eradication
of measles virus infection, notwithstanding the existence of a cheap
and secure vaccine, seems overly optimistic. - Mod.CP]

MEASLES UPDATE 2011 (14)
************************
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*****
Congo DR
Date: Wed 18 May 2011
Source: allAfrica.com [abridged, edited]
<http://allafrica.com/stories/201105180615.html>


More than 3000 cases of measles have been recorded in the past 3
months in 2 districts of Maniema Province, in the eastern part of the
Democratic Republic of Congo [Congo DR]. Provincial statistics seen by
IPS [Inter Press Service] for the districts of Kibombo and Kindu show
that since mid-April 2011, a measles epidemic has caused more than 15
deaths at health facilities, and 3 or 4 times as many have died at
home, in cases where families did not take stricken children to
medical centres. "The villages further upstream along the Congo River
are the worst affected by measles," says Dr Theo Katako, interim head
of the Provincial Inspectorate of the Ministry of Public Health.

"Meanwhile, the province was only able to organize a vaccination
campaign against polio, for lack of resources to take on these 2
epidemics at once. The total number dying of measles at home in April
2011 could have been more than 60 for lack of a way for these families
to bring these patients to the hospital because of the distance to
health facilities," says Germain Musombo, a member of civil society in
Maniema. "The fear is even greater because the measles vaccination
campaign, planned for last week, did not take place for reasons no one
has explained," Musombo said.

Julie Bibi Bin Kito is a small trader and mother of a 6-year-old who
died of measles last week. She told IPS it would take more than 4
hours to walk to the nearest hospital to her home. She has no access
to a car, and that hospital requires patients to pay to open a medical
file before they can receive care. Neither she nor her husband had any
money on the evening their child died.

"The question of poverty is critical throughout the province of
Maniema," says Musombo.

"A large majority of the population lives on rice and cassava leaves
grown in small gardens near the family home. There is also the fact
that the province is landlocked and doesn't benefit from commerce with
the rest of the country. The province is generally underdeveloped,
with few people enjoying access to clean drinking water and just 52
000 of the provinces' estimated population of 2 million having access
to electricity. With the population living under these conditions,
there is cause for concern," says Martin Bila Omari, who is
responsible for epidemiology at the provincial inspectorate of the
health ministry.

"The provincial authorities have outlined a plan to end the epidemic
and prevent new cases," says Bila Omari, "which will cost USD 180 000.
But there is an acute shortage of financial resources to carry it out.
The modest provincial budget will not allow for an urgent response."

[Byline: Emmanuel Chaco]

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[Maniema is a province of the Democratic Republic of Congo. Its
provincial capital is Kindu. It borders Kasai-Oriental to the west,
Orientale to the north, Nord-Kivu and Sud-Kivu to the east, and
Katanga to the south. Its location is shown in the map at:
<http://en.wikipedia.org/wiki/Maniema>.

The seriousness of this situation is compounded by the fact that the
funds available for vaccination have been diverted to contain an
outbreak of poliomyelitis in the region (see: Poliomyelitis -
worldwide (07): update 20110512.1462). - Mod.CP]

MEASLES UPDATE 2011 (15)
************************
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In this update:
Africa
[1] Nigeria
[2] Somalia


******
[1] Nigeria
Date: 23 May 2011
Source: All Africa [edited]
<http://allafrica.com/stories/201105230763.html>


41 persons have died as a result of cerebrospinal meningitis and
measles in Yobe tate in the past 18 months. This was contained in a
report by the state's Epidemiological Department in Damaturu yesterday
[22 May 2011].

According to the report, Yobe state recorded 322 cases of
cerebrospinal meningitis across the 17 local government areas of the
state last year [2010], and 22 persons died from the disease. It added
that 4 persons died out of the 51 cases that were reported between
January and May this year [2011]. It further stated that 7 persons
died in 2010 out of the 464 cases of measles recorded in the state,
while 8 persons died out of the 3022 cases of the disease recorded
this year.

Reacting to the report, the Director General of the Yobe State Health
Care Management Board, Alhaji Lawal Ibrahim, said the board had
procured preposition drugs on measles, meningitis and other related
diseases and that they had already been distributed to the 6
epidemiological zonal offices in the state. He said that government
has also embarked on a campaign against overcrowding and personal and
environmental hygiene, saying that those were preventive measures
against a disease outbreak in the state. He added that the board in
collaboration with donor agencies, WHO, UNICEF, etc. were working on
what he described as pre-attack programmes to prevent cholera and
malaria in the state.

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*****
[2] Somalia
Date: 25 May 2011
Source: All Africa [edited]
<http://allafrica.com/stories/201105250151.html>


At least 4 kids died of the disease measles in parts of southern
Somalia, local residents said Wednesday [25 May 2011]. The deadly
disease is said to have disseminated in the villages of Bay-Amow and
Dhoba-Ade in Gedo region.

One of the residents in Gedo region told Shabelle Media Network that
all who died or who are suffering from the disease are children whose
ages are under 5. Most of the children who have come down with the
disease were taken to a hospital in Bardhere town in Gedo region where
Al Shabaab has tight control. People said that diseases spread when
Somalia receives rain.

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MEASLES UPDATE 2011 (18)
************************
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In this update:

Africa
------
[1] Algeria (M'sila)
[2] Mozambigue
[3] Sudan (West Darfur)

*****

[1] Algeria (M'sila)
Date: Thu 9 Jun 2011
Source: Afrique Hebdo (In French, machine translation, edited]
<http://afriquehebdo.com/090621764-alger ... s-recenses>


Algeria: Outbreak of measles in M'sila -- 417 cases reported
------------------------------------------------------------
A measles outbreak which began in January [2011] in a score of
Communes in Southern Wilaya M'sila [district], affected 417 people (28
seriously) by May, the Director of Health and Population reported on
Wednesday [8 Jun 2011]. The age of those affected by the outbreak of
measles are 0 to 4 years (212 cases) and 20 to 44 years (126 cases),
according to the official, adding that the outbreak has been contained
by the efforts of the department's hospital in the Boussaada region,
home to more than half of the registered cases.

Immunisation of patients and their contacts was carried out involving
a total of 1626 people of whom 1346 were adults. Besides taking care
of patients, an epidemiologic investigation was initiated to determine
the cause of this high frequency of cases, together with a catch-up
vaccination programme against measles, especially in schools.

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[M'Sila is the capital of M'Sila Province, Algeria, and is
co-extensive with M'Sila District. It has a population of over 100
000. It can be located in the map at:
<http://en.wikipedia.org/wiki/M%27Sila>. - Mod.CP]

******
[2] Mozambique
Date: Wed 8 Jun 2011
Source: Club of Mozambique, via AIM News [edited]
<http://www.clubofmozambique.com/solutio ... 1&tipo=one>


Drop in cases of measles in Mozambique
--------------------------------------
Mozambican health authorities have reported in the 1st 5 months of
this year 137 suspected cases of measles across the country, of which
55 were declared positive, down from 188 reported in the same period
in 2010.

According to the spokesperson of the Health Ministry, Leonardo
Chavana, measles was reported in several provinces. However, the
central province of Manica is a major concern for the government
because members of a local religious sect refuse to support the
vaccination programmes. Chavana explained that the Health Ministry has
decided to deploy a team to that province to sensitise the members of
the sect to the importance of their participation in vaccination
programmes, "as a means not to compromise the growth of their
children. It is wrong for a parent to endanger the life of his/her
children because of a lack of a vaccination. The Health Ministry
respects any social, ideological, religious or cultural belief, but
will never respect decisions that endanger the lives of children,"
stressed Chavana.

Manica [province] shares a long border with Zimbabwe, a country
where, according to international media reports, there are thousands
of measles cases each year which result in death of hundreds of
children.

Official statistics indicate that during the 1st 5 months of 2010
there were 405 suspected measles cases investigated in Mozambique. The
health authorities collected 397 samples for laboratory tests,
resulting in 188 confirmed cases. The overall rate of measles was 5.4
cases per 100 000 inhabitants, which was higher than the recommended
rate set by the World Health Organization (WHO) of 2 cases per 100 000
inhabitants. In the provinces where no major outbreaks of measles were
reported, namely Gaza, Inhambane and the capital Maputo, all in the
southern region of Mozambique, the rate of detection was 1.7 per 100
000 inhabitants during the period under review.

Currently, the Health Ministry is making efforts to increase the rate
of vaccination against measles and remains on alert due to outbreaks
of measles recently reported in neighbouring countries, particularly
South Africa, Zimbabwe and Malawi.

--
Communicated by:
HealthMap alerts via ProMED-mail
<promed@promedmail.org>

[Mozambique has been making commendable progress in the control of
measles in comparison with its African neighbors. The
HealthMap/ProMED-mail interactive map of Mozambique can be accessed
at:
<http://healthmap.org/r/00Ps>. - Mod.CP]

******
[3] Sudan (West Darfur)
Date: Wed 8 Jun 2011
Source: Radio Dabanga [edited]
<http://www.radiodabanga.org/node/14938>


Measles infection kills 2 children in camp near El Geneina
----------------------------------------------------------
Measles infection led to the death of 2 children in the camp of Abuz
near the city of El Geneina in West Darfur during the 2 days 5 and 6
Jun 2011. A sheikh from the camp told Radio Dabanga that they are
afraid that the very contagious disease would spread, especially in
the light of lack of any effort to prevent or contain the disease. He
also stated that the ANC [African National Congress] medical
organization which was working in the camp announced that it has ended
its work in the camp. The camp lacks any other medical organization.

The sheikh said that they have held a meeting with the Minister of
Health who informed them that the Ministry does not have any
medication [vaccine?] for the disease. Dr. Wali Eldeen Elfaki, a
pediatric specialist, called on to the citizens to avoid crowded
places to avoid getting infected by the disease, which he said is
transmitted through breathing.

--
Communicated by:
HealthMap alerts via ProMED-mail
<promed@promedmail.org>

[The HealthMap/ProMED-mail interactive map of West Darfur can be
accessed at:
<http://healthmap.org/r/0YDC>. - Mod.CP]

MEASLES UPDATE 2011 (19)
************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>


******
[1] Republic of Congo
Date: Fri 17 Jun 2011
Source: AlertNet [abridged, edited]
<http://www.trust.org/alertnet/news/meas ... lic-report>


A measles epidemic in the Republic of Congo has infected 800 people
and killed 32 in Pointe-Noire, the country's economic hub, a newspaper
reported on Friday [17 Jun 2011]. "This is really disturbing given
that a vaccination campaign (against measles) could only begin on 22
Jun 2011," said Alexis Elira Dokekias, the director general of health
services in the Central African country.

Measles is a highly infectious disease that mostly affects children.
It is characterised by a rash, runny nose and high fever. It reduces
children's resistance to illness and makes them more likely to die
when they are malnourished and suffering from other diseases. The
disease can be prevented through vaccination. The World Health
Organization (WHO) says recent immunisation efforts have resulted in a
74 per cent reduction in measles deaths globally.

However, Dokekias said there has been poor vaccination coverage in
the Pointe Noire Kouilou region in southern Congo, which explains the
current outbreak, according to the report in the Les Depeches de
Brazzaville.

The measles outbreak comes at a time when the country's health
services are trying to deal with an epidemic of chikungunya fever
which has infected more than 4000 people in the southern districts of
the capital Brazzaville.

[byline: George Fominyen]

--
communicated by:
HealthMap alerts via ProMED-mail
<promed@promedmail.org>

[A map of the Republic of Congo, showing the location of
Pointe-Noire, can be accessed at <http://healthmap.org/r/01x0>. -
Mod.CP]

******
[2] Kyrgyzstan
Date: Fri 10 Jun 2011
Source: KABAR [edited]
<http://eng.kabar.kg/index.php?option=co ... 8&Itemid=1>


83 cases of measles have been registered in Kyrgyzstan as of 9 Jun
2011 according to the press service of the Ministry of Health. A total
of 66 of the cases have been registered in Osh oblast, 16 in Bishkek
and one in Naryn oblast.

Specialists on immunization intend to appeal to WHO representation in
Kyrgyzstan with the suggestion to initiate measles vaccination of
children at 6 or 9 months of age, the reason being that infants are
now more often appearing among those affected.

--
communicated by:
ProMED-mail <promed@promedmail.org>