Measles OutbreakTham Hin Temporary Shelter

May - June 2012

Background

Situated in Ratchaburi Province

Home to 8,000+ refugees

High number of visitors and new arrivals

Last measles outbreak in 2007

18 YR Nurse18 YR NurseZone 2Zone 2

First Case

19 YR 19 YR PregnantPregnantZone 2Zone 2

Initial Measures

IsolationSupportive treatment

Contact tracing

Active case findingReport to MOPH

Contacts

18 yr 18 yr NurseNurse

Attend Attend church church

service on service on day of onsetday of onset

Work at Work at OPD and OPD and dressing dressing

roomroom

Household contacts

Church goers

Neighbours

Clinic staffs

Total 109Total 109

Immediate measures “Immunisation”

done on done on same daysame day

11 May

Rash

Who is the source?

5 May

Fever

~14 days

27 April

9 month9 monthZone 1Zone 1

More patients

40 yr40 yrZone 1Zone 1

9 month9 monthZone 1Zone 1

40 yr40 yrZone 1Zone 1

?

We found her!

7 year old girl

Visitor from Myanmar

Onset on 26 April

Visited OPD with ILI

We found her!

Rash seen on follow up on 2 May

Measles was not suspected

Next follow up 4 May, but not show up

Already went back to Myanmar

MOPH Involvement

MOPH Involvement

Our Control Plan• Supplementary measles

immunisation

• to

“People at Risk”

“People at Risk”

9 month - 20 yearswith

Incomplete Immunisation

Students: 5 - 20 years

In KG & Grade 1 with no or one previous measles vaccination

Any grade with no or unverified measles vaccination

Day 1

In Community: 9 month - 20 years

with NO or Unverified measles vaccination status

Day 2

MOPH provided

All vaccines

Human resources

Technical support

Vaccination at School

Vaccination at School

Vaccination at School

Vaccination in community

Epidemiology

Weekly Epidemic Curve

Attack Rate by Age

Number by Age

Contact Tracing

Final Situation

Total 23 Total 23 casescases

Last caseLast case15 June15 June

Lessons Learned

New Arrivals may New Arrivals may introduce outbreaksintroduce outbreaks

children not covered children not covered by EPI are at riskby EPI are at risk

Early detection is Early detection is vital in outbreak vital in outbreak

controlcontrol

Support and Support and involvement of MOPH involvement of MOPH

is importantis important

Prompt response and Prompt response and good coordination good coordination

key to successkey to success

Thank You