Responding to a Measles Epidemic in Chad

April 28, 2005, N’Djamena/New York - A measles epidemic has hit at least three provinces in Southern and Eastern Chad, as well as the capital, N’Djamena. Doctors Without Borders/Médecins Sans Frontières (MSF) has started to provide emergency assistance by treating patients with measles, continuing assessments, and carrying out vaccination campaigns.

More than 6,000 cases have reported nationwide – over 3,400 in N’Djamena – and the official death toll stands at 115. From January until April 2005, the capital reported as many cases as during all of 2004. Moreover, the total number of individuals now infected is likely to be two or three times higher than the reported figure. In the pediatric ward of some hospitals, 50% of the death toll in April is from measles.

To tackle this emergency, the MSF teams have started to treat patients in five health centers located in the most populated area of N’Djamena, and are attending the most severe cases in two hospitals of the city. Chadian authorities have announced that treatment is free, and have made drugs available to the health centers.

“We have to collect epidemiological data to define if the epidemic has already reached its peak or not,” explained Kate Alberty, an epidemiologist for MSF’s research affiliate, Epicentre. “This will help us to identify the areas at risk and the most affected age bracket. Accordingly, we’ll be able to determine where it would be necessary to start the vaccination campaigns.”

Early April, MSF led an exploratory mission in the Bousso district, 200 miles (300 kilometers) south of N’Djamena, revealing several sources of infection and a very low vaccination coverage among a dispersed and nomadic population. Medical teams are now providing medical support and drugs for 2,300 patients with measles.

On Thursday April 21, MSF launched, in collaboration with local medical authorities and the Ministry of Health, a first vaccination campaign aimed at immunizing an estimated 40,000 children under five years of age. “The immunization campaign is almost complete,” said Wim Fransen, head of mission for MSF in Chad. “Which will protect people and cut the spread of the epidemic.”

Measles, a highly contagious viral infection, opens the door to other infections such as those of the respiratory system, and can lead to severe complications and death. Anyone who has not been immunized is at risk, and children are the most vulnerable. There is no specific treatment for measles, but antibiotics are frequently used against resulting infections. Measles can be prevented by vaccination, but coverage in Chad has been low for the last several years.

Currently, MSF has a team of 11 specialists in Chad to fight the epidemic.

Other MSF activities in Chad include medical and nutritional assistance for Sudanese refugees near the Sudanese border, as well as a malaria and a surgical project in the Bongor district.