Measles Epidemiology and Outbreak Investigation Using IgM Test in Laos.

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  • Kuroiwa Chushi
    Bureau of International Cooperation, International Medical Center of Japan, and Japan International Cooperation Agency in Lao PDR, and Department of Epidemiology, Juntendo University
  • Vongphrachanh Phengta
    National Center for Laboratory and Epidemiology, Ministry of Health
  • Xayyavong Phoxay
    Local staff for Japan International Cooperation Agency in Laos
  • Southalack Kongmany
    National Center for Laboratory and Epidemiology, Ministry of Health
  • Hashizume Masahiro
    Department of International Community Health, Graduate School of Medicine
  • Nakamura Satoshi
    Research Institute, International Medical Center of Japan

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Following the Pan American Health Organization (PAHO) recommendation on measles elimination, the Western Pacific Region of WHO (WPR) is emphasizing accelerated measles control programme especially since the achievement of polio eradication in WPR in 2000. This includes upgraded surveillance and mass measles vaccination campaign for children aged 9 months to 4 years. However, there are limited scientific evidences supporting the feasibility of this programme in Laos. To examine measles elimination feasibility in the country, we conducted measles outbreak investigation using immunoglobulin M (IgM). From March 1999 to March 2000, we conducted 7 outbreak investigations. At the outbreak sites, we examined clinical manifestations of cases and collected individual data. About five blood samples were drawn from each outbreak, and lgM antibodies to measles were tested. Of 7 investigated outbreaks, 5 were confirmed as measles, one was chickenpox, and one occurred in the inaccessible area due to flooding. In a village of high land Lao, blood drawn was refused. Of 185 cases, 64 (34.6%) cases were immunized, and 110 (59.5%) were unimunized. The estimated vaccine efficacy is 67.9%. The number of measles cases among school-aged children was 74 (40.0%), which represented 2.5% of the total population in investigated villages. Our findings showed various difficulties of the surveillance and the limited outcomes of mass measles vaccination campaign under the accelerated measles control programme by WPR. Efforts to improve cold chain as well as increasing routine immunization coverage must be the priority of measles control. J Epidemiol, 2001 ; 11 : 255-262

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