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Outbreak Investigation : Measles outbreak investigation in Buah health district, Grand Kru County, Liberia, February-April 2020

Francis Bobway
Faith Tina Whesseh
Chukwuma David Umeokonkwo
Obafemi Joseph Babalola
Jimmy Lawubah
Himiede Wede Seysay
Lily Sanvee-Blebo
Maame Amo-Addae


Introduction: Measles is a highly contagious illness and remains one of the leading causes of death of children worldwide. Measles is one of the epidemic-prone diseases for weekly reporting in the revised Integrated Disease Surveillance and Response in Liberia. In 2020, Liberia reported a total of 623 measles cases, of which, Grand Kru County accounted for 28.6%. We present the epidemiological characterization of the measles outbreak in Grand Kru County in 2020.

Methods: The study employed a descriptive cross-sectional design. We conducted an active case search using the outbreak case definition and interviewed affected persons and caretakers using the case investigation forms. We conducted contact tracing, line-listed cases and reviewed medical records of patient charts. The following variables for analysis were used: laboratory results, age categories, sex, community of residence, and vaccination status. We calculated frequencies and proportions using Epi-info version 7.2 software to summarize socio-demographic characteristics, outcome and vaccination status and presented the timeline of the outbreak in Epi-curve using epi-weeks.

Results: A total of 178 measles cases were identified during the outbreak. Of the total cases, 4.5% (8/178) were positive and 95.5% (170/178) were epidemiologically linked. The median age was 6 (interquartile range: 3-12) years with females accounting for 57.3% of the cases. The age group 0-4 years accounted for 39.3% (70/178) of the total cases, followed by 5-9 years 28.1% (50/178) and 10-14 years 18.5% (33/178). Parluken community reported 65.2% (116/178) of the cases, followed by Forpoh Wropluken at 14.1% (25/178). Twenty-one percent (37/178) of the cases were vaccinated while 79.0% (140/178) were not vaccinated. The attack rate was 126.2 per 10,000 population and the case fatality rate was 1%.

Conclusion: This was a confirmed measles outbreak in Buah health district, Grand Kru County. The attack rate was high, but the case fatality rate was low. The majority of the cases were not vaccinated against measles. There is a need to improve vaccination coverage through routine immunization and supplemental immunization activities.

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eISSN: 2664-2824