A Measles Outbreak in a Myanmar Migrant Worker Camps, Bang Wan Sub-district, Kuraburi District, Phang-nga, Thailand, May - June 2012

Abstract

A cluster of measles was notified by Phang-nga Provincial Public Health Office on June 20^th, 2012 about two Myanmar children living in migrant worker camps in the village No.3 and No.5 of Bang Wan Sub-district. They were admitted at the in-patient department of Phang-nga hospital. The Surveillance Rapid Response Team (SRRT) of Kuraburi District started outbreak investigation during 20^th – 27^th June 2012. The objectives aimed to confirmed diagnosis and outbreak, to describe the epidemiological characteristics, to identify the source of outbreak and to implement control and prevent measures.
Both index cases developed fever, cough and rash. First index case was a 2-years-old girl and had fever on 10^th June 2012 and then developed pneumonia as a complication. A second index case was a male 9- months-old infant had fever on 11^th June 2012 and presented diarrhea. After active case finding in the communities revealed a total of 36 patients met the case definition, these were including 15 (41.7%) confirmed cases and 21 (58.3%) suspected cases. Measles virus was isolated in two cases and subsequently into genotype 9. Of those 36 patients, most were female, aged between 1 and 5 years. They presented with classical signs and symptoms of measles: all with high fever and maculopapular rash, followed by cough (94.5%), runny nose (71.6%), conjunctivitis (27%), diarrhea (8.1%) and complicated pneumonia (2.7%) respectively.
The first case was an 18-year-old female patient who was residing in the village No.5. She stays in village No. 5 Bangwan sub-district and she moved from village No. 3. Then, there were spreading into two villages and subsided within one month. Additionally, there were 16 Myanmar school children in both villages who were measles case and attending the school A. There was no measles among Thai student due to MMR coverage among Thai student was 100%. Among Myanmar students, there were highest number in grade 1 and 3, respectively. There was no document of vaccination history among Myanmar students. The SRRT of Kuraburi District vaccinated MMR to the 136 Myanmar students at the school A and others in the sub-district to prevent the measles.
There was confirmed the measles outbreak among Myanmar migrant workers and their children. The outbreak was spreading to two epi-linkage villages. Overcrowded and unvaccinated was the major factor in this outbreak. The delay notification additionally played a role for spreading the outbreak.