Measles Outbreak Tham 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 Nurse Zone 2 First Case 19 YR Pregnant Zone 2

Initial Measures IsolationSupportive treatmentContact tracingActive case findingReport to MOPH

Contacts 18 yr Nurse Attend church service on day of onset Work at OPD and dressing room

Household contacts Church goers Neighbours Clinic staffs Total 109 Immediate measures “Immunisation” done on same day

11 May Rash Who is the source? 5 May Fever ~14 days 27 April

9 month Zone 1 More patients 40 yr Zone 1

9 month Zone 1 40 yr Zone 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

Our Control Plan Supplementary measles immunisation to “People at Risk ”

9 month - 20 years with Incomplete Immunisation

Students: 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 in community

Epidemiology

Weekly Epidemic Curve

Attack Rate by Age

Number by Age

Contact Tracing

Final Situation

Total 23 cases Last case 15 June

Lessons Learned

New Arrivals may introduce outbreaks children not covered by EPI are at risk Early detection is vital in outbreak control

Support and involvement of MOPH is important Prompt response and good coordination key to success

Thank You