The 2010 - 2011 measles outbreak in Zambia: Challenges and lessons learnt for future action

Abstract

Objective: The key objective of the report was to document response and epidemiological factors surrounding the 2010 to 2011 Measles outbreak in Zambia and to share the challenges and lessons learnt for control and prevention of future outbreaks.
Methods: Between January 2010 and September 2011, Measles line listed data, from 72 districts in Zambia was collected by the World Health Organisation /National Surveillance Officers (WHO/NSOs) through the Integrated Disease Surveillance Response (IDSR) system and aggregated at the Ministry of Health (MOH) headquarters. The response and epidemiological data was analysed and used for the report.
Results: A total of 37,582 cases of measles were captured in the IDSR system and 30,397 (80.9%) had almost complete data for the period 2010-2011. Of the total cases of measles, 17.1% (5,195/30,397) were below the immunisation age of 9 months, and 12.9% were females in the reproductive age group. Supplemental Immunisation Activity (SIA) as a response to measles outbreak in 2010 implemented 6 months into the epidemic had no significant impact on the disease progression as the outbreak remained sustained into 2011.
Conclusion: Resurgence outbreaks of measles following successful SIAs suggests that routine immunisation coverage has declined leading to the accumulation of a large pool of susceptible children in the communities. There is therefore an urgent need to strengthen and sustain high routine measles immunisation coverage which should include regular outreach services, supportive supervision and monitoring data for action. Measles SIAs should cover a wide age group, from 6 months to 15 years so that the adolescent females can enter the reproductive age group with high levels of measles antibodies to transfer to their newborns. As a matter of priority, immunisation outreach programmes should be reactivated by MOH and data collection in the IDSR system should be strengthened.

Key words: Measles outbreak, low immunisation coverage rate, late SIA implentation