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Measles outbreak response among adolescent and adult Somali refugees displaced by famine in Kenya and Ethiopia, 2011.
J Infect Dis 2014; 210(12):1863-70JI

Abstract

BACKGROUND

The refugee complexes of Dadaab, Kenya, and Dollo-Ado, Ethiopia, experienced measles outbreaks during June-November 2011, following a large influx of refugees from Somalia.

METHODS

Line-lists from health facilities were used to describe the outbreak in terms of age, sex, vaccination status, arrival date, attack rates (ARs), and case fatality ratios (CFRs) for each camp. Vaccination data and coverage surveys were reviewed.

RESULTS

In Dadaab, 1370 measles cases and 32 deaths (CFR, 2.3%) were reported. A total of 821 cases (60.1%) were aged ≥15 years, 906 (82.1%) arrived to the camps in 2011, and 1027 (79.6%) were unvaccinated. Camp-specific ARs ranged from 212 to 506 cases per 100 000 people. In Dollo-Ado, 407 cases and 23 deaths (CFR, 5.7%) were reported. Adults aged ≥15 years represented 178 cases (43.7%) and 6 deaths (26.0%). Camp-specific ARs ranged from 21 to 1100 cases per 100 000 people. Immunization activities that were part of the outbreak responses initially targeted children aged 6 months to 14 years and were later expanded to include individuals up to 30 years of age.

CONCLUSIONS

The target age group for outbreak response-associated immunization activities at the start of the outbreaks was inconsistent with the numbers of cases among unvaccinated adolescents and adults in the new population. In displacement of populations from areas affected by measles outbreaks, health authorities should consider vaccinating adults in routine and outbreak response activities.

Authors+Show Affiliations

Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.United Nations High Commissioner for Refugees (UNHCR), Nairobi, Kenya.UNHCR, Geneva, Switzerland.UNHCR, Addis Ababa, Ethiopia.United Nations High Commissioner for Refugees (UNHCR), Nairobi, Kenya.CDC, Nairobi, Kenya.Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.UNHCR, Geneva, Switzerland.UNHCR, Geneva, Switzerland.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

25117754

Citation

Navarro-Colorado, Carlos, et al. "Measles Outbreak Response Among Adolescent and Adult Somali Refugees Displaced By Famine in Kenya and Ethiopia, 2011." The Journal of Infectious Diseases, vol. 210, no. 12, 2014, pp. 1863-70.
Navarro-Colorado C, Mahamud A, Burton A, et al. Measles outbreak response among adolescent and adult Somali refugees displaced by famine in Kenya and Ethiopia, 2011. J Infect Dis. 2014;210(12):1863-70.
Navarro-Colorado, C., Mahamud, A., Burton, A., Haskew, C., Maina, G. K., Wagacha, J. B., ... Spiegel, P. (2014). Measles outbreak response among adolescent and adult Somali refugees displaced by famine in Kenya and Ethiopia, 2011. The Journal of Infectious Diseases, 210(12), pp. 1863-70. doi:10.1093/infdis/jiu395.
Navarro-Colorado C, et al. Measles Outbreak Response Among Adolescent and Adult Somali Refugees Displaced By Famine in Kenya and Ethiopia, 2011. J Infect Dis. 2014 Dec 15;210(12):1863-70. PubMed PMID: 25117754.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Measles outbreak response among adolescent and adult Somali refugees displaced by famine in Kenya and Ethiopia, 2011. AU - Navarro-Colorado,Carlos, AU - Mahamud,Abdirahman, AU - Burton,Ann, AU - Haskew,Christopher, AU - Maina,Gidraf K, AU - Wagacha,John B, AU - Ahmed,Jamal A, AU - Shetty,Sharmila, AU - Cookson,Susan, AU - Goodson,James L, AU - Schilperoord,Marian, AU - Spiegel,Paul, Y1 - 2014/08/12/ PY - 2014/8/14/entrez PY - 2014/8/15/pubmed PY - 2015/2/20/medline KW - acute malnutrition KW - adults KW - famine KW - measles KW - mortality KW - population displacement KW - refugees KW - vaccination SP - 1863 EP - 70 JF - The Journal of infectious diseases JO - J. Infect. Dis. VL - 210 IS - 12 N2 - BACKGROUND: The refugee complexes of Dadaab, Kenya, and Dollo-Ado, Ethiopia, experienced measles outbreaks during June-November 2011, following a large influx of refugees from Somalia. METHODS: Line-lists from health facilities were used to describe the outbreak in terms of age, sex, vaccination status, arrival date, attack rates (ARs), and case fatality ratios (CFRs) for each camp. Vaccination data and coverage surveys were reviewed. RESULTS: In Dadaab, 1370 measles cases and 32 deaths (CFR, 2.3%) were reported. A total of 821 cases (60.1%) were aged ≥15 years, 906 (82.1%) arrived to the camps in 2011, and 1027 (79.6%) were unvaccinated. Camp-specific ARs ranged from 212 to 506 cases per 100 000 people. In Dollo-Ado, 407 cases and 23 deaths (CFR, 5.7%) were reported. Adults aged ≥15 years represented 178 cases (43.7%) and 6 deaths (26.0%). Camp-specific ARs ranged from 21 to 1100 cases per 100 000 people. Immunization activities that were part of the outbreak responses initially targeted children aged 6 months to 14 years and were later expanded to include individuals up to 30 years of age. CONCLUSIONS: The target age group for outbreak response-associated immunization activities at the start of the outbreaks was inconsistent with the numbers of cases among unvaccinated adolescents and adults in the new population. In displacement of populations from areas affected by measles outbreaks, health authorities should consider vaccinating adults in routine and outbreak response activities. SN - 1537-6613 UR - https://www.unboundmedicine.com/medline/citation/25117754/Measles_outbreak_response_among_adolescent_and_adult_Somali_refugees_displaced_by_famine_in_Kenya_and_Ethiopia_2011_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1093/infdis/jiu395 DB - PRIME DP - Unbound Medicine ER -