Measles outbreak response among adolescent and adult Somali refugees displaced by famine in Kenya and Ethiopia, 2011

Carlos Navarro-Colorado, Abdirahman Mahamud, Ann Burton, Christopher Haskew, Gidraf K. Maina, John B. Wagacha, Jamal A. Ahmed, Sharmila Shetty, Susan Cookson, James L. Goodson, Marian Schilperoord, Paul Spiegel

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)1863-1870
Number of pages8
JournalJournal of Infectious Diseases
Volume210
Issue number12
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Refugees
Ethiopia
Kenya
Measles
Starvation
Disease Outbreaks
Immunization
Vaccination
Somalia
Health Facilities
Population
Age Groups
Mortality
Health

Keywords

  • Acute malnutrition
  • Adults
  • Famine
  • Measles
  • Mortality
  • Population displacement
  • Refugees
  • Vaccination

ASJC Scopus subject areas

  • Infectious Diseases
  • Immunology and Allergy
  • Medicine(all)

Cite this

Measles outbreak response among adolescent and adult Somali refugees displaced by famine in Kenya and Ethiopia, 2011. / Navarro-Colorado, Carlos; Mahamud, Abdirahman; Burton, Ann; Haskew, Christopher; Maina, Gidraf K.; Wagacha, John B.; Ahmed, Jamal A.; Shetty, Sharmila; Cookson, Susan; Goodson, James L.; Schilperoord, Marian; Spiegel, Paul.

In: Journal of Infectious Diseases, Vol. 210, No. 12, 2014, p. 1863-1870.

Research output: Contribution to journalArticle

Navarro-Colorado, C, Mahamud, A, Burton, A, Haskew, C, Maina, GK, Wagacha, JB, Ahmed, JA, Shetty, S, Cookson, S, Goodson, JL, Schilperoord, M & Spiegel, P 2014, 'Measles outbreak response among adolescent and adult Somali refugees displaced by famine in Kenya and Ethiopia, 2011', Journal of Infectious Diseases, vol. 210, no. 12, pp. 1863-1870. https://doi.org/10.1093/infdis/jiu395
Navarro-Colorado, Carlos ; Mahamud, Abdirahman ; Burton, Ann ; Haskew, Christopher ; Maina, Gidraf K. ; Wagacha, John B. ; Ahmed, Jamal A. ; Shetty, Sharmila ; Cookson, Susan ; Goodson, James L. ; Schilperoord, Marian ; Spiegel, Paul. / Measles outbreak response among adolescent and adult Somali refugees displaced by famine in Kenya and Ethiopia, 2011. In: Journal of Infectious Diseases. 2014 ; Vol. 210, No. 12. pp. 1863-1870.
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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.",
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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

PY - 2014

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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.

AB - 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.

KW - Acute malnutrition

KW - Adults

KW - Famine

KW - Measles

KW - Mortality

KW - Population displacement

KW - Refugees

KW - Vaccination

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