Pathfinder
Editor, Senior Moderator
WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 6: 31 January – 6 February 2022
Data as reported by: 17:00; 6 February 2022
...
Measles Liberia
55 Suspected cases
2 Deaths
3.6% CFR
EVENT DESCRIPTION
On 13 December 2021, health authorities of the Commonwealth
district were notified of two suspected cases of measles from
the Iron Factory Community in Pepper Wulu Town, Johnsonville
in the Montserrado County. An additional eight suspects were
identified through active case finding. Laboratory specimens
were collected from the 10 suspected cases and shipped to the
National Public Health Reference Laboratory on 15 December
2021 for confirmation.
In a related event, a suspected case of measles was received
on 8 January 2022, three days after disease onset, in a health
facility in Zota District, Bong County, located approximately 200
kilometers away from the Commonwealth District that initially
reported measles suspected cases. More suspected cases were
identified in Zota District and specimens were collected and sent
to the laboratory for confirmation.
In total, the laboratory received 15 specimens coming from
Commonwealth (8) and Zota (7) Districts. A total of eight IgM
positive samples were identified from both sites, hence confirming
the outbreak in these districts in accordance with the Integrated
Disease Surveillance and Response Technical Guidelines.
Between weeks 1-4 of 2022, 55 suspected measles cases were
identified in the two districts: Commonwealth (30) and Zota (25).
Only 22 of the 55 suspected (40.0%) were vaccinated. A total of
22 suspected cases were epidemiologically-linked and 25 were
clinically compatible cases. Two deaths have been recorded in
children, one in each district, giving a case fatality ratio of 3.6%
(3.3% in Commonwealth and 4.0% in Zota). The ages of the
suspected cases ranged from 7 months to 52 years, with 33
(60.0%) of them aged between 9-59 months, and 29 of these
cases (52.7%) were females. Caregivers to both children who
died reported them to have been vaccinated against measles,
however the vaccination record was not observed for the
Commonwealth’s death.
Nationwide, a cumulative total of 92 suspected cases of measles
have been recorded from epi-week 1-4, 2022. Of these, 59.7%
(55 out of 92) of cases came from the two outbreak districts
during these weeks. Nearly all the counties (14/15, 93.3%)
across the country have notified at least one suspected case.
A total of 20 laboratory-confirmed cases have been recorded
since the beginning of the year from eight counties, seven (35%)
cases of whom were vaccinated and another seven (35%) with
unknown vaccination status. Compared to epi-week 1-3 of 2021
where 10 suspected cases were notified, a sharp increase has
been observed for the same period in 2022, with 59 suspected
cases reported across the country.
In 2021, two rounds of measles vaccination campaigns were
conducted and coverage rates in Commonwealth District were
71% and 28%, and 56% and 26% in Montserrado County. In the
Zota District, the coverage for the first round was 72%.
PUBLIC HEALTH ACTIONS
The National Epidemic Preparedness and Response
Committee, which is led by the Nation Public Health Institute
of Liberia, is coordinating outbreak preparedness and
response activities.
Active case finding along with contact isolation and tracing
have been initiated since the beginning of the outbreak
in the two affected districts and are still ongoing, with
a reinforcement in communities currently witnessing a
sustained outbreak.
An immunization campaign was conducted in the
Commonwealth District with 2 004 children aged below one
year vaccinated against measles. This is yet to be undertaken
in Zota District.
Suspected measles cases have been isolated in health care
facilities for management and caregivers have been educated
to keep suspected or confirmed cases away from others.
All cases have received appropriate care including
symptomatic treatment and a high dose of vitamin A.
Psychosocial support is being provided to patients and their
family members.
Risk communication and community engagement activities
have been carried out in the affected counties. Communities
have been educated on the earlier signs or symptoms of the
disease and to rapidly seek care in the nearest health care
facilities, and on the benefits of vaccination.
Local leaders have been committed to ensuring suspected
cases are brought to health care facilities.
SITUATION INTERPRETATION
This ongoing measles outbreak in the Commonwealth and
Zota Districts reflects the low vaccination coverage in the
affected districts. The 2021 first measles campaign (MCV1)
and MCV2 second campaign (MCV2) coverage rates were far
below the expected 90% coverage for collective community
protection against measles. It is therefore anticipated that
the situation may worsen in other districts/counties of the
country with low vaccination coverage.
PROPOSED ACTIONS
The national authorities are currently in need of financial
support to conduct immunization activities, especially in
Zota district. Besides, more human and logistical resources
should be dedicated to case investigation and contact tracing
activities.
Health care professionals should be trained to rapidly identify
and manage measles cases and precautionary measures
should be reinforced in health care facilities.
The delay in seeking health care should be addressed by
fully engaging administrative and traditional authorities of
the affected areas. Local media should play an appropriate
role, and education materials for measles should be widely
disseminated.
Preparedness activities should be initiated and/or intensified
in neighboring districts or in districts with a low vaccination
coverage against measles.
...
https://apps.who.int/iris/bitstream...OEW06-310106022022.pdf?sequence=1&isAllowed=y
AND OTHER EMERGENCIES
Week 6: 31 January – 6 February 2022
Data as reported by: 17:00; 6 February 2022
...
Measles Liberia
55 Suspected cases
2 Deaths
3.6% CFR
EVENT DESCRIPTION
On 13 December 2021, health authorities of the Commonwealth
district were notified of two suspected cases of measles from
the Iron Factory Community in Pepper Wulu Town, Johnsonville
in the Montserrado County. An additional eight suspects were
identified through active case finding. Laboratory specimens
were collected from the 10 suspected cases and shipped to the
National Public Health Reference Laboratory on 15 December
2021 for confirmation.
In a related event, a suspected case of measles was received
on 8 January 2022, three days after disease onset, in a health
facility in Zota District, Bong County, located approximately 200
kilometers away from the Commonwealth District that initially
reported measles suspected cases. More suspected cases were
identified in Zota District and specimens were collected and sent
to the laboratory for confirmation.
In total, the laboratory received 15 specimens coming from
Commonwealth (8) and Zota (7) Districts. A total of eight IgM
positive samples were identified from both sites, hence confirming
the outbreak in these districts in accordance with the Integrated
Disease Surveillance and Response Technical Guidelines.
Between weeks 1-4 of 2022, 55 suspected measles cases were
identified in the two districts: Commonwealth (30) and Zota (25).
Only 22 of the 55 suspected (40.0%) were vaccinated. A total of
22 suspected cases were epidemiologically-linked and 25 were
clinically compatible cases. Two deaths have been recorded in
children, one in each district, giving a case fatality ratio of 3.6%
(3.3% in Commonwealth and 4.0% in Zota). The ages of the
suspected cases ranged from 7 months to 52 years, with 33
(60.0%) of them aged between 9-59 months, and 29 of these
cases (52.7%) were females. Caregivers to both children who
died reported them to have been vaccinated against measles,
however the vaccination record was not observed for the
Commonwealth’s death.
Nationwide, a cumulative total of 92 suspected cases of measles
have been recorded from epi-week 1-4, 2022. Of these, 59.7%
(55 out of 92) of cases came from the two outbreak districts
during these weeks. Nearly all the counties (14/15, 93.3%)
across the country have notified at least one suspected case.
A total of 20 laboratory-confirmed cases have been recorded
since the beginning of the year from eight counties, seven (35%)
cases of whom were vaccinated and another seven (35%) with
unknown vaccination status. Compared to epi-week 1-3 of 2021
where 10 suspected cases were notified, a sharp increase has
been observed for the same period in 2022, with 59 suspected
cases reported across the country.
In 2021, two rounds of measles vaccination campaigns were
conducted and coverage rates in Commonwealth District were
71% and 28%, and 56% and 26% in Montserrado County. In the
Zota District, the coverage for the first round was 72%.
PUBLIC HEALTH ACTIONS
The National Epidemic Preparedness and Response
Committee, which is led by the Nation Public Health Institute
of Liberia, is coordinating outbreak preparedness and
response activities.
Active case finding along with contact isolation and tracing
have been initiated since the beginning of the outbreak
in the two affected districts and are still ongoing, with
a reinforcement in communities currently witnessing a
sustained outbreak.
An immunization campaign was conducted in the
Commonwealth District with 2 004 children aged below one
year vaccinated against measles. This is yet to be undertaken
in Zota District.
Suspected measles cases have been isolated in health care
facilities for management and caregivers have been educated
to keep suspected or confirmed cases away from others.
All cases have received appropriate care including
symptomatic treatment and a high dose of vitamin A.
Psychosocial support is being provided to patients and their
family members.
Risk communication and community engagement activities
have been carried out in the affected counties. Communities
have been educated on the earlier signs or symptoms of the
disease and to rapidly seek care in the nearest health care
facilities, and on the benefits of vaccination.
Local leaders have been committed to ensuring suspected
cases are brought to health care facilities.
SITUATION INTERPRETATION
This ongoing measles outbreak in the Commonwealth and
Zota Districts reflects the low vaccination coverage in the
affected districts. The 2021 first measles campaign (MCV1)
and MCV2 second campaign (MCV2) coverage rates were far
below the expected 90% coverage for collective community
protection against measles. It is therefore anticipated that
the situation may worsen in other districts/counties of the
country with low vaccination coverage.
PROPOSED ACTIONS
The national authorities are currently in need of financial
support to conduct immunization activities, especially in
Zota district. Besides, more human and logistical resources
should be dedicated to case investigation and contact tracing
activities.
Health care professionals should be trained to rapidly identify
and manage measles cases and precautionary measures
should be reinforced in health care facilities.
The delay in seeking health care should be addressed by
fully engaging administrative and traditional authorities of
the affected areas. Local media should play an appropriate
role, and education materials for measles should be widely
disseminated.
Preparedness activities should be initiated and/or intensified
in neighboring districts or in districts with a low vaccination
coverage against measles.
...
https://apps.who.int/iris/bitstream...OEW06-310106022022.pdf?sequence=1&isAllowed=y
DF