WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 41: 4 - 10 October 2021
Data as reported by: 17:00; 10 October 2021
...
Measles Cameroon
380 Cases
8 Death
2.1% CFR
EVENT DESCRIPTION
A measles outbreak has been ongoing in Cameroon since the
beginning of 2021. The affected health districts are from seven
regions of Adamaoua, Centre, East, Far-North, Littoral, Northwest
and West. The regions hosting refugee camps and internally
displaced persons (IDPs) have the highest number of affected
health districts: eight health districts in the Far-North region; five
health districts in East region and three health districts in Adamawa
region.
A total of 380 measles cases including 214 confirmed positive for
IgM, 158 clinically compatible and eight deaths (Case Fatality Ratio
(CFR) = 2.1%) were reported from week 1 to week 38 (ending 26
September 2021) 2021. The overall attack rate is 1.4 per 100.000
population. A total of 23 health districts are currently experiencing a
measles outbreak, including 21 with a confirmed outbreak and two
with a suspected outbreak.
The peak of the reported cases was reached at week 12 (ending 28
March 2021). The last death among cases was registered in week 18
(ending 9 May 2021). Most of the cases, (73.4%) 279 are between 9
months and 9 years old followed by the age group under 9 months
with 40 cases (10.5%). The most affected region is the East region
with an attack rate of 7.3 per 100.000 population followed by the
regions of Adamaoua 5.3 per 100.000 population and Far-North
region 1.6 per 100.000 population.
Among the affected districts, 73.9% (15/23) carried out an in-depth
investigation of the notified cases. Of the 23 health districts with
an ongoing outbreak, only four (17.4%) have reached at least 80%
of their targeted children (9-59 months old) vaccinated against
measles from January to August 2021. Eight of the 23 (34.8%)
health districts with an outbreak have less than 50% of routine
immunization coverage rate for measles first dose, while (69.6%)
16 out of 23 health districts in outbreak have less than 50% of
routine immunization coverage rate for the measles second dose.
Thus far, only five affected health districts (21.7%) have organized
tangible response activities.
PUBLIC HEALTH ACTIONS
Close follow up from the central level of the MoH for activities
carried out in the affected health districts is ongoing as well as
encouraging all affected health districts to carry out in-depth
case investigations
Local response carried out in five affected health districts of
Bankim, Ngaoundal, Batouri, Lomié and Moloundou
Monitoring and training of the affected health districts on
outbreak reporting and microplanning for the response is
ongoing
Regular updates of the measles databases and dashboards for
effective monitoring of the affected health districts continues
The preparations for outbreak response in the affected health
districts that have not yet organized any response is underway.
SITUATION INTERPRETATION
The frequent measles outbreaks in Cameroon could be attributed
to the low immunization coverage against the disease. Among all
the currently affected health districts, none of them has achieved
the target coverage rate for complete routine immunization against
measles as recommended by the national immunization program
(≥ 80%). More to that, the delays in case investigations as well
as response activities in the affected health districts are also
affecting the overall capacity to control this outbreak. The regions
hosting refugees and IDP camps have recorded higher attack rates
compared to other affected regions. In addition, the Covid-19
pandemic has impacted health systems of most African countries
including Cameroon.
PROPOSED ACTIONS
Routine measles immunization for children, combined with
reactive mass immunization campaigns, are key public health
strategies to reduce the measles cases and deaths. It is
therefore essential to improve vaccination coverage to reduce
the risk of future outbreaks. The required resources and efforts
should be deployed to achieve the goals of the national measles
immunization program.
Weaknesses already identified around case investigation,
response and epidemiological surveillance for measles need
to be addressed.
More attention should be given to health districts hosting
refugees and IDP camps the living conditions in these settings
is a significant factor of the rapid spread of measles.
https://apps.who.int/iris/bitstream/handle/10665/346225/OEW41-0410102021.pdf