An investigation of measles outbreak in a learning center, Mueang Surat Thani District, Surat Thani Province, 2024

Abstract

Background: On 3^rd July 2024, the Situation Awareness Team (SAT) of Surat Thani Provincial Public Health Office was notified that 2 Myanmar confirmed measles cases studied in the same learning center were reported via the Measles Online Database. The onset of first case was on 24^th June 2024. The joint Investigation team had investigated and controlled the outbreak during 3^rd-16^th July 2024 to confirm the diagnosis and the existence of the outbreak, to describe the epidemiological characteristics, to identify the associated factors, and to implement prevention and control measures.

Methods: These descriptive epidemiological studies conducted by interviewing relevant persons for general information, reviewing and analyzing situation of measles including the outbreaks, reviewing the medical records and performing active case finding using the case definition of the Department of Disease Control. Environmental study was done by surveying the learning center and house of the dead case. Laboratory study was carried out in all cases by specimen collection and subjected for Measles IgM and Measles genotyping.

Results: The total of 7 measles cases (5 confirmed cases and 2 suspected cases) were found, including one death. Resulting in the case fatality rate of 14.28 percent. All of them were Myanmar. The crude attack rate in the learning center was 1.18 percent. The measles vaccination coverage among students was 22.44 percent. The dead case had an underlying disease and currently used steroids. The learning center was too crowded, especially the classroom of the cases which the air ventilation was poor. In addition, there was no case isolation. The measles genotype D8 DSId 8491 was identified from 3 cases.

Conclusions and discussions: There was an outbreak of measles occurred among Myanmar migrants in a learning center in Mueang Surat Thani District, Surat Thani Province during June-July 2024 with the attack rate of 1.18 percent including 1 death. Associated factors were insufficient measles vaccination to achieve the herd immunity, the congestion in learning center. as well as failure to isolate symptomatic patients which may allow the disease spreading in the community, leading to a death of the case who had an underlying disease and was treated with immunosuppressive drugs. Therefore, the environment in the learning center together with the community should be revamped. Vaccination coverage among students should be raised and emphasizes the strictly case isolation.