Abstract
This report describes an investigation of a measles outbreak in Umphang District,
Tak Province, in the period 2004-2005 and emphasizes the importance of coverage of
measles immunization in children. Medical records of measles cases diagnosed between
January 2004 and April 2005 in the district were reviewed. Data on measles immunization
in children 9 months of age or older and measles-mumps-rubella immunization in
school children were retrieved from Umphang Community Hospital and 4 out of the 7
health centers to determine the coverage. Over the outbreak period, among the 187 measles
cases, about 85 percent were Thai and 15 percent were cases among citizens of Myanmar.
One case died from pneumonia, producing a fatality rate of 0.5 percent. Of the 187 cases,
89.8 percent were children 0 - 14 years old and 10.2 percent were 15 years of age or older.
Measles cases were reported from all subdistricts in Umphang District. Sporadic cases
were reported from January to April 2003 and the cases increased thereafter. Clinical manifestations
included fever (100%), rash (100%), cough (80.2%), and rhinorrhea (67.9%).
Measles complications in these cases were pneumonia (17.6%), diarrhea (10.7%), and otitis
(5.9%). About 61.6 percent of the Thai cases had not received measles immunization
and the remainder could not be determined. Of the 106 measles cases examined for
measles-specific IgM by ELISA, 80.2 percent were positive. The coverage of measles immunization
in both > 9-month and school children was low in some areas of the district.
The outbreak tapered off after providing preventive and control measures. The authors
suggest that full coverage of measles immunization among the target children is essential.
For remote areas in the district where people face difficulty in traveling and limited
outreach of health services, the provision of an immunization program in dry season may
be useful.
