Abstract
BackgroundSri Lanka was the first country in the Southeast Asian region to achieve its measles elimination goal in 2011. In 2012, the measles immunization schedule changed from a measles vaccine at 9 months to a measles, mumps and rubella vaccine at 12 months. However in 2013, Sri Lanka reported its worst recent outbreak of measles. This study investigated a part of this outbreak in order to describe its epidemiology.MethodsA prospective study was carried out at the university medical unit of the Teaching Hospital, Anuradhapura (THA), the third largest hospital in Sri Lanka, from October 2013 until March 2014. An epidemiological profile of patients was constructed, case confirmation was done on all suspected cases and the basic demographic details of these suspected cases were obtained from the available records.ResultsFrom January 2013 to March 2014, 101 measles suspects were admitted to the THA. Until June 2013, all suspected cases were aged below 12 months of age. During the study period (15 months), the total number of patients aged below 9 months, 9 to 12 months, 1 to 11 years, 12–29 years and over 29 years were 10 (9.9 %), 11 (10.9 %), 6 (5.9 %), 37 (36.6 %) and 36 (35.6 %), respectively (data missing-1). Out of the 33 patients clinically suspected, 32 tested positive for measles. Common clinical features included: fever (n = 33, 100 %), maculopapular rash (n = 33), conjunctivitis (n = 31), posterior cervical lymphadenopathy (n = 23) and Koplik’s spots (n = 8). Features suggestive of pneumonia were observed among 30 (90.9 %) patients and 26 (78.8 %) had diarrhoea. Two patients (6.1 %) who developed severe pneumonia received care at an intensive care unit due to respiratory difficulties. Out of 33 patients, 15 (45.5 %) had prior immunization for measles, two (6.1 %) reported that they never had a measles immunization and 16 (48.5 %) were unsure about their immunization status. Out of those who reported they were previously immunized, 11 (73.3 %) belonged to the age group of 12–29 years.ConclusionBecause the first cases of this outbreak were infants, an increase in susceptible infants due to the change in the vaccine schedule could partly explain the outbreak.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-015-0084-7) contains supplementary material, which is available to authorized users.
Highlights
Sri Lanka was the first country in the Southeast Asian region to achieve its measles elimination goal in 2011
The purpose of this study is to describe the epidemiology of the 2013 measles outbreak in Sri Lanka
Study site and design To describe the spatio-temporal distribution of measles, we used secondary data on measles patients admitted to the Teaching Hospital, Anuradhapura (THA)
Summary
Sri Lanka was the first country in the Southeast Asian region to achieve its measles elimination goal in 2011. In 2013, Sri Lanka reported its worst recent outbreak of measles. In 1980, the global number of deaths attributed to measles was exceeding 2.5 million [1]. The first MCV was licensed in the USA in 1963 based on the pioneering work of Enders [2, 3]. This vaccine has since become one of the most effective interventions that mankind has ever invented [4]. After the successful eradication of small pox, measles elimination was the number one priority in vaccine preventable disease control programmes worldwide. More than 200,000 cases and more than 1400 deaths were reported during this outbreak [11]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
