Abstract
BackgroundRubella is a vaccine-preventable contagious disease causing an estimated 100,000 children to be born with congenital rubella syndrome each year globally. Studies documented that 18 rubella outbreaks were occurred each year in Ethiopia. Yeka sub-city woreda 13 public health emergency management office reported two measles suspected cases on 8 February, 2018. We investigated this outbreak to identify its etiology, describe the outbreak and implement control measures.MethodsWe described the outbreak using descriptive epidemiology. The study population was defined as students learning in the school where the outbreak occurred. Suspected rubella case was defined as student with generalized rash whereas confirmed case was suspected case tested positive for rubella IgM. Questionnaires, checklists and students record review were used to collect data. We searched for new cases in classes daily and excluded them from classes. The school environment was assessed and the outbreak was described in person and time.ResultsWe identified 58 cases (median age: 4.6 years; IQR: 4–5 years) with six of them rubella IgM positive and 52 epidemiologically linked. The outbreak began on 8 February 2018 having multiple intermittent peaks during its course reaching its highest peak at 2 April, 2018 and ended on 20 April, 2018. Index cases were reported from two classes; however, cases were occurred in 13/15(86.67%) of the classes during the entire outbreak. Fifty five percent (32/58) and 45/58(77.59%) of the cases were females and 3–5 years children, respectively. Overall attack rate was 58/531(4.05%). Attack rate was higher in females 32/252 (12.7%) than in males 26/279 (9.32%), and higher 45/275(16.36%) in 3–5 years than those in 5–8 years 13/256(5.08%) children. Case fatality ratio was zero. All cases were vaccinated against measles but unvaccinated against rubella.ConclusionsAttack rate was higher in females than in males and higher in 3–5 years than 5–8 years children. We recommended establishing rubella surveillance system, conducting sero-prevalence of rubella among child bearing age females and establishing CRS surveillance among young infants to provide evidence-based information for RCV introduction. It was also recommended to develop a national rubella surveillance guideline which aid to exclude rubella cases from schools during outbreak.
Highlights
Rubella is a vaccine-preventable contagious disease causing an estimated 100,000 children to be born with congenital rubella syndrome each year globally
Rubella infection occurring just before conception and during the first trimester of pregnancy may result in miscarriage, fetal death, premature delivery and constellation of severe birth defects called Congenital Rubella Syndrome (CRS) [1, 2, 4, 5] in up to 90% of infections [6]; though, rubella usually occurs during childhood
Families of the index cases replied that there were no an individual with rash in their vicinity 14 days before onset of illnesses of the index cases. Both of them were vaccinated for measles but they were unvaccinated against rubella
Summary
Rubella is a vaccine-preventable contagious disease causing an estimated 100,000 children to be born with congenital rubella syndrome each year globally. Yeka sub-city woreda 13 public health emergency management office reported two measles suspected cases on 8 February, 2018. Rubella is a childhood disease usually having mild clinical presentations with maculopapular rash occurring in 50–80% of rubella-infected individuals. Rubella is the leading causes of birth defects worldwide [3]. Rubella infection occurring just before conception and during the first trimester of pregnancy may result in miscarriage, fetal death, premature delivery and constellation of severe birth defects called Congenital Rubella Syndrome (CRS) [1, 2, 4, 5] in up to 90% of infections [6]; though, rubella usually occurs during childhood. Rubella is one of the few known causes of autism [8]
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