Responding to measles outbreak: closing the immunity gap in children of Timor-Leste

Abstract

Background: An outbreak of measles was reported in Timor-Leste during 2011. A concertedresponse at national level utilized this opportunity to improve measles immunization coveragerates.Methods: Health Management Information System and Surveillance System data were utilized todescribe the outbreak. Attack rates and case fatality rates (‎CFR)‎ were calculated using standardmethods. Evaluation surveys were used to access immunization coverage. Proceedings of weeklymeetings of the National Committee for Control of Disease Outbreaks were reviewed.Results: A total of 739 cases and 8 deaths were reported to the Surveillance Unit. Most (‎>82%)‎of the measles cases were reported from Dili and Ermera districts. The attack rate was 1.3 per1000 population and CFR was 1.1%. The response was coordinated by the National Committee forControl of Disease Outbreaks, which included case management, active and passive surveillance,communication and measles immunization among six-month to 14-year old children. Immunizationactivity targeted 495 000 children, i.e. almost one-half of the Timor-Leste population and achievedhigh coverage (‎85%)‎.Conclusions: The outbreak highlighted gaps in the immunity against measles. The NationalCommittee for Control of Disease Outbreaks ensured a coordinated response which led to preventionof deaths from measles due to early case management with vitamin A supplementation, and highmeasles immunization coverage