Measles: Summary of Current and Recent MSF Projects as of June 2010

Malawi, 2010:
Emergency Immunizations Underway for Around 3 Million Children and Adolescents

From the beginning of 2010 until May 23, there have been more than 9,200 cases and 44 deaths recorded in Malawi, primarily in the southern region. MSF is supporting the Ministry of Health in eight districts (Lillongwe, Blantyre, Mzimba, Chiradzulu, Thyolo, Mangochi, Michinga and Balaka) in three areas: surveillance, patient care, and immunizations for a target population from 6 months to 15 years of age. The most affected city was Blantyre, with more than 6,800 cases and 23 deaths among a population of 1 million.

From May 3 to May 18, 1.1 million children aged 6 months to 15 years of age were immunized in the districts of Blantyre, Chiradzulu and Mzimba. In these three districts, MSF distributed treatment kits for more than 8,000 patients to district health centers. In the district of Thyolo, there are consistently more than 50 measles patients in an isolation unit set up in the hospital. One of four people contaminated with this disease are over 14 years old. A measles vaccination campaign that ended on June 9 vaccinated 328,000 children. By mid-June, a total of 1.3 million children aged 6 months to 15 year were vaccinated, and the emergency intervention is ongoing.

Ministry of Health and MSF vaccination teams are beginning new campaigns in Mangochi district, for a target population of 380,000, and in the southwestern districts of Michinga and Balaka for a target population of 400,000 children. In the capital of Lilongwe (population: 2 million), 900,000 individuals will be immunized in June. This last operation will mobilize 90 vaccination teams for two weeks. Malawi’s Ministry of Health has announced a national measles vaccination campaign starting in July for children aged 6 months to 15 years. The districts where children have already been vaccinated won’t be included.

Yemen, 2010:
Mass Immunization Campaign in the Governorate of Sa’adah

This year, between the end of February and the middle of April, about 700 cases of measles were treated in the Al Talh Hospital in northern Yemen. More than 1 million cases have been recorded throughout the Sa’adah governorate, mostly in the Sahar district. MSF is supporting the Ministry of Health in nine districts, or about two-third of the governorate, in three areas: surveillance, treatment of patients, and immunizations for a target population aged 6 months to 15 years old. A dedicated treatment unit was set up in the Al Talh hospital with a capacity of up to 40 beds. Additionally, more than 80 teams were mobilized to conduct a mass immunization campaign. At present, 125,000 children aged 6 months to 15 years have been immunized. The total target population includes more than 200,000 persons.

Zimbabwe, 2010:
Supporting the Ministry of Health in Two Areas Affected by the Outbreaks

In Zimbabwe, the outbreak that began in September 2009 has affected 55 of the country’s 62 districts and claimed the lives of 384 children. In the Buhera district of Manicaland province, the outbreak is still underway. More than 1,800 cases have been recorded over roughly seven months, primarily within a community that is refusing immunization. As of February 2010, one portion of the at-risk population has been immunized in the most affected areas and the Ministry of Health carried out non-selective activities at the end of May for children aged 6 months to 14 years. MSF supported these activities and continues to search out and care for people who need treatment for measles while also vaccinating children who have not been vaccinated previously.

In Epworth, a neighborhood in the capital, Harare, the epidemic started in early 2010. Through June 6, 1,946 suspected cases and 12 deaths had been recorded. MSF teams are participating in the treatment of patients while referring complicated cases to a Ministry of Health hospital. An immunization campaign just completed in Epworth vaccinated 46,881 children.

South Africa, 2010:
Measles Epidemics in Nine Provinces

From early 2000 through May 2010, the South African government recorded more than 14,000 measles patients in 9 provinces. In some areas, the number of new cases has increased on weekly basis, notably in KwaZulu-Natal and Mpumalanga. MSF is also participating in an immunization campaign in Khayelitsha township for more than 100,000 children aged 6 months to 15 years.

Swaziland, 2010:
Ongoing Epidemic, Intervention in Shishelweni

Swaziland is in the midst of an ongoing measles epidemic. The most affected region is Shishelweni, where MSF is already running an HIV/TB project. A vaccination campaign has been planned by the Ministry of Health for children aged 5 to 15 years. In order to deal with suspected and confirmed measles cases, treatments kits will be distributed in all Shishelweni health structures.

Chad, 2010:
Large Outbreak in the Capital, N’Djamena

In N’Djamena, more than 8,500 cases and 30 deaths were reported between the start of the year and the end of April. On March 26, an emergency immunization campaign was initiated in four districts of the capital. More than 60 fixed and mobile teams activated in N’Djamena to provide immunization for all children aged 6 months to 15 years (around 580,000 children in all). A treatment unit established for complicated cases enabled the care of 503 children in the first five weeks of the intervention. The organization provides medications and supervises care in the health centers and has established therapeutic feeding centers to accept children suffering from severe malnutrition detected during consultations and immunizations.

Nigeria 2010:
More than 11,000 Cases of Measles at the Start of 2010

A measles outbreak was identified in the state of Kebbi in mid-December 2009. In spite of a responsive immunization campaign conducted by the Ministry of Health, the epidemic has continued. There have been nearly 12,000 cases of measles in Kebbi between January and April of this year. In April, MSF teams participated in a targeted immunization campaign in Argunfu. Twenty immunization teams were mobilized, each composed of eight individuals. A total of 47,596 were immunized.

DRC, 2009:
Prevention in North Kivu Hindered by Lack of Security

In certain areas of the Masisi health zone, in the eastern reaches of the Democratic Republic of Congo (DRC), health departments are no longer able to provide systematic immunizations due to a lack of security. This is a particular problem because the high concentration of families who have fled their homes and are seeking sanctuary in overcrowded camps is significantly increasing the risk of infection. Between January and November of last year, 1,036 children with measles were counted in the Masisi territory and 85 of them died from the disease.

MSF has supported the health system in the health zones of Miandgja, Ngomashi, and Lwibo, and is ensuring that patients with measles can be isolated and receive the necessary treatment in time. Last October, a large-scale immunization campaign was organized during which more than 175,000 children and adolescents aged 6 months to15 years were immunized. MSF teams also intervened around Kisangani, in the Oriental province, and in Lubutu, in the Maniéma province, in 2009. In all, MSF immunized more than 600,000 children in DRC in 2009.

Mali, 2009:
Mobile Teams Provide Care for Patients

A measles outbreak struck the north of Mali in 2009. More than 2,500 individuals contracted measles in the regions of Tombouctou and Gao between January and June. Starting in mid-April, MSF began providing care for these patients and conducted a massive immunization campaign for more than 320,000 children aged six months to 15 years in the region of Tombouctou. Three measles treatment centers were established in Tombouctou and two more in Gao. In addition, four mobile teams were circulating the region to search for patients, provide outpatient care, or refer complicated cases to treatment centers.

Somalia, 2009:
The Most Measles Victims in Five Years

Between April and June 2009, a measles outbreak ravaged the city of Guri El and its surroundings in the region of Galgaduud in the center and south of Somalia. Normally, young children contract the most severe cases of measles. However, 65 percent of the patients in this case were older than five, and some were adults. Children under five were the beneficiaries of systematic immunization activities that MSF has conducted in the hospital over the past three years. The irregularity of the previous immunization campaigns could explain the high proportion of older children and adults affected. Two isolation tents were installed in the Galgaduud hospital to care for the most severe cases. In the last two weeks of April, MSF teams immunized more than 16,000 children between six months and 15 years of age in Belet Weyne, in the region of Hiraan, just south of Galgaduud. In Galcayo, in the region of Mudug, the teams cared for more than 230 patients between mid-April and mid-June.

Burkina Faso, 2009:
A Very Serious Outbreak

In 2009, Burkina Faso was struck with its most serious measles outbreak in several decades. In the first six months of the year, there were more than 51,000 cumulative suspected measles cases, with 333 reported cases, for a case fatality rate of 0.65 percent. The outbreak had started in February and reached its peak at the beginning of May. Starting in March, MSF began to offer treatment kits and to provide free care for persons with measles in five public health centers in the capital of Ouagadougou. In May, another intervention began in the districts of Bogande, Pama, Manni and Diapaga, in the east of the country. More than 3,600 treatment kits were distributed and almost 400 complicated cases were referred to MSF facilities. An emergency MSF team proposed a collaboration with the Ministry of Health at the start of March to perform an immunization campaign in the five districts of Ouagadougou. The Ministry of Health finally organized a measles immunization campaign between June 17 and June 21 in 31 of the country’s 63 districts, for a target age group of 6 months to 14 years of age.