1. Infection control: Responding to measles outbreak Atoifi Hospital  Christopher Jimuru, RN, PHC Coordinator  James Asugeni, RN,  Ronald Oleka, RN  Mike Puia, RNA  John Maomatekwa, RN

2.  Atoifi Hospital serves the population of East Kwaio. Aprproximately 10,00 people including inpatient, outpatient and outreach  Measles is a very infectious viral illness that causes rash and fever. Complications include ear infection, pneumonia and encephalitis. Rash from measles on face

3.  Outbreak first reported in Honiara in June 2014  First case was a 21 year old female acquired infection in Papua New Guinea (PNG)  People from East Kwaio area often go to Honiara  First case in area was a 1 year old from a village south of Atoifi on 28/7/2014.  Outbreak response commenced (Measles Taskforce Team).

4. Background  Routine immunisation is provided by PHC- outreach and clinic  Immunisation coverage for catchment area is about 48% for measles in 1 year olds for 2014

5. Method  Epidemiological review of the measles outbreak 2014:  Case definition  Epi- curve  Demographics  Vaccination status of cases  Hospitalisation

6. Case definition used  Case definition- clinical -fever, rash, plus cough, conjunctivitis or koplick spot  No Lab confirmation available

7. Epi-curve

8. Age-groups

9. Gender and Hospitalisations  Hospitalisation:  71/123 (57.7%) were hospitalised, at a rate of 746/100,000 population for catchment  In New South Wales Australia the hospitalisation rate was 0.20 per 100,000 population over a 10 year period to 2012

10. Location  Vaccination status cases is unknown because data were not collected

11. Outbreak response – 1 st step  Photo staff being vaccinated

12. Vaccines given during the response  Staff and families – 264 doses given  Community – 1734 doses given, over 2 weeks

13. Outbreak response  Outbreak response include: -organise a measles response team - Immunize high risk 6mnth-5years, OPD staff, ward staff and kids - Immunize immediate family members of suspected cases - Mass immunization first to the villages of suspected cases and to the whole catchment -establish two isolation ward to admit measles cases -conduct health awareness talk on measles to schools and surrounding communities - Develop guide lines, case definitions, form for reporting cases during outbreak - Use of pineapple juice as home remedy to help recovery

14. Infection control  Infection control - Measles is very infectious - Increased hand washing, staff wearing mask, isolation of the case, separate entrance, restrict visitors and vaccinate family members. - But best infection control is immunisation beforehand - Measles vaccine twice gives 98% of people protection

15. Conclusion  Immunisation at very high levels is essential because measles is very infectious. Outreach clinics need to occur to achieve this. This is an area for further research.  Data collection during outbreak to be improved e.g. vaccination status  Use an Excel spread sheet daily to enter data  Infection control is best done by infection prevention. Immunise!

16.  Thank you