Page 1
Liberia Field Epidemiology Training Programme (LFETP)Liberia Field Epidemiology Training Programme (LFETP)
Miatta Kullie 1, 2, M. Amo-Addae2, T. Nagbe1, S.J.N. McNabb3, G.N. Farhat3, P.
Adewuyi2, J. Frimpong2, H. Kazoora4
1
Measles Outbreak, Duazon
Communities, Mamba Kaba District,
Margibi County, Liberia, 2015
1 Ministry of Health, Monrovia, Liberia2 Liberia Frontline FETP, Monrovia, Liberia3 Emory University, Atlanta, Georgia, USA4 AFENET, Kampala, Uganda
Page 2
Liberia Field Epidemiology Training Programme (LFETP)
Outline of Presentation
• Acknowledgement
• Introduction
• Objectives
• Methods
• Results
• Conclusion
• Pictures
2
Page 3
Liberia Field Epidemiology Training Programme (LFETP)
Acknowledgement
• Margibi County Health Team
• Liberia Ministry of Health
• Emory University
• CDC
• AFENET
• WHO
• FETP Frontline Mentors
3
Page 4
Liberia Field Epidemiology Training Programme (LFETP)
Introduction 1/2• Measles
– Viral disease, usually affects children aged 0 to 5
years
– Spreads through droplet infection and direct
contact
– Incubation period of about 7-14 days
– Vaccine is given at 9 months of age in Liberia
4
Page 5
Liberia Field Epidemiology Training Programme (LFETP)
Introduction 2/2
• 26th of December 2015:
– Suspected measles case from Duazon
community was reported to District
• 1st week January 2016:
– Field investigation began
5
Page 6
Liberia Field Epidemiology Training Programme (LFETP)
Objectives
• Confirm the outbreak
• Describe the outbreak by person, place and time
• Determine the source of the outbreak
• Control the outbreak
6
Page 7
Liberia Field Epidemiology Training Programme (LFETP)
Methods 1/2
• Duazon community,
Margibi County, Liberia
• Population: 3,684
• Active case search
• Case definition
– “any persons in Duazon
community with fever,
rashes, red eyes,
coryza from Dec. 26,
2015 to February 14,
2016”
7
Page 8
Liberia Field Epidemiology Training Programme (LFETP)
Methods 2/2
• Line-listed cases
– demographic data
– signs and symptoms
• Laboratory testing of blood samples for Measles
• We conducted a descriptive analysis of the data
8
Page 9
Liberia Field Epidemiology Training Programme (LFETP)
Results 1/2
9
• Twenty-nine cases were line-listed
– Fifteen (52%) were above 5years old
– Fifteen (52%) were male
– Median Age is 5years (Range: 6months-29years)
– 10 blood samples were positive for Measles• 3 were vaccinated
• 7 were not vaccinated
Page 10
Liberia Field Epidemiology Training Programme (LFETP)
Results 2/2
• Vaccination Status of the 29 cases:
– Vaccinated 4 (14%)
– Unvaccinated 22 (76%)
– Unknown 3 (10%)
• Index case
– 29 year old male
– No history of contact
– No relevant travel history
10
Page 11
Liberia Field Epidemiology Training Programme (LFETP)
Epicurve of Measles Outbreak, Duazon Communities, Mamba
Kaba, Margibi County, Liberia, Dec. 26, 2015 – Feb. 14, 2016
11
2015 20160
2
4
6
8
10
12
14
48 49 50 51 52 53 1 2 3 4 5 6 7 8
Nu
mb
er
of
Cas
es
Week of Onset
confirmed cases
Suspected Cases
Intervention
Mass vaccination
began
Page 12
Liberia Field Epidemiology Training Programme (LFETP)
Response
• Surveillance was maintained
• Cases were isolated and treated
• Intensive three-month vaccination outreach
was conducted
• Routine immunization was strengthened
12
Page 13
Liberia Field Epidemiology Training Programme (LFETP)
Conclusion 1/2
• Confirmed Measles outbreak in the Duazon
Community
• More than half of affected were aged >5years
• Most affected were unvaccinated (at least
76%)
13
Page 14
Liberia Field Epidemiology Training Programme (LFETP)
Conclusion 2/2
• Outbreak lasted 2months (Dec 2015 – Feb
2016)
• Source of the infection remains unknown
• Outbreak was controlled by public education,
mass vaccination, treatment and isolation of
cases
14
Page 15
Liberia Field Epidemiology Training Programme (LFETP)
Action Pictures
15
Miatta conducting an interviewInvestigation team preparation meeting