measles outbreak in bath april - may 2008 dr jo williams spt public health avon, gloucestershire and...
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MEASLES OUTBREAK IN BATHApril - May 2008
Dr Jo WilliamsSpT Public Health
Avon, Gloucestershire and Wiltshire Health Protection Unit
Descriptive epidemiology: time
Cases of measles, by date of onset
0
1
2
3
25
/04
/20
08
26
/04
/20
08
27
/04
/20
08
28
/04
/20
08
29
/04
/20
08
30
/04
/20
08
01
/05
/20
08
02
/05
/20
08
03
/05
/20
08
04
/05
/20
08
05
/05
/20
08
06
/05
/20
08
07
/05
/20
08
08
/05
/20
08
09
/05
/20
08
10
/05
/20
08
11
/05
/20
08
Date
Nu
mb
er
of
ca
se
s
Possible cases
Probable cases
Confirmed cases
B C
D A
Notification received
E F
Descriptive epidemiology: person
• Age and MMR status– 3 cases aged <13 months
• too young to have received MMR
– 2 preschool age• 1 case with possible vaccine• 1 no vaccine
• Relationships– All part of the same social group– Two confirmed cases were siblings (B & D)
Cases of measles, by date of onset
0
1
2
3
17/0
4/20
08
18/0
4/20
08
19/0
4/20
08
20/0
4/20
08
21/0
4/20
08
22/0
4/20
08
23/0
4/20
08
24/0
4/20
08
25/0
4/20
08
26/0
4/20
08
27/0
4/20
08
28/0
4/20
08
29/0
4/20
08
30/0
4/20
08
01/0
5/20
08
02/0
5/20
08
03/0
5/20
08
04/0
5/20
08
05/0
5/20
08
06/0
5/20
08
07/0
5/20
08
08/0
5/20
08
09/0
5/20
08
10/0
5/20
08
11/0
5/20
08
Date
Nu
mb
er o
f ca
ses
Possible cases
Probable cases
Confirmed cases
Descriptive epidemiology: place
E played with B & D
A, B, C & D at cafe
B
C
D A E F
A’s birthday party
Control of outbreak
• Exclusion of cases• Vulnerable contacts identified
– Unvaccinated communities– Immunocompromised– Pregnant women– Babies under vaccination age
• Vaccination of contacts 4 children given earlier MMR who attended the café on 17th April
Communication
• Outbreak control meeting (19th May)• External communication
– Aims• Early identification of cases• Identify vulnerable contacts• Increase MMR uptake
– Press release and press work– Letter to all GPs and primary care staff– Information to groups attended by cases
• Outbreak control meeting (23rd May) – outbreak declared over unless more cases
MMR uptake in Bath
BANES PCT GP1 (5 cases)
MMR 1st dose
(2006-7)
87.9% 84.9%
MMR 1st dose
(2007-8)
90.3% 81.9%
MMR 2nd dose
(2006-7)
89.1% 83.5%
MMR 2nd dose
(2007-8)
89.6% 83.1%