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. 2023 Feb 8;10(2):ofad032.
doi: 10.1093/ofid/ofad032. eCollection 2023 Feb.

Nationwide Measles and Rubella Outbreaks in South Sudan, 2019

Megan E Peck  1 , Sylvester Maleghemi  2 , Lidia Kayembe  3 , Margaret Hercules  3 , Atem Anyuon  4 , Sudhir Bunga  5 , Jeff McFarland  3 , Olushayo Olu  2
Affiliations

Nationwide Measles and Rubella Outbreaks in South Sudan, 2019

Megan E Peck et al. Open Forum Infect Dis. .

Abstract

Background: South Sudan confirmed a measles outbreak in December 2018. An investigation was conducted to assess underlying causes of the outbreak.

Methods: Vaccination coverage and measles surveillance data were analyzed. A suspected measles case had fever, maculopapular rash, and cough or conjunctivitis. A confirmed measles case had generalized maculopapular rash lasting >3 days, a temperature >38°C, and cough or conjunctivitis; or serologic confirmation (anti-measles immunoglobin M [IgM] antibody detection) in serum samples collected ≤30 days from rash onset. A confirmed rubella case tested measles IgM-negative and rubella IgM-positive.

Results: Nationwide, 3727 suspected measles cases were reported in 2019. Seventy-five percent of all suspected measles cases were in children aged <5 years. Thirty-six percent of patients with suspected measles were admitted to the hospital, and 36 measles-related deaths were reported. Among cases, 922 (25%) were tested for measles; of these, 317 (34%) were measles IgM-positive. Among cases that tested measles IgM-negative, 149 (33%) were rubella IgM-positive. Immunization coverage for 1 dose of measles-containing vaccine (MCV) varied by state, ranging from 6% to 67%.

Conclusions: Measles and rubella remain public health problems in South Sudan. To reduce measles incidence, South Sudan needs to achieve >95% coverage with 2 doses of MCV.

Keywords: South Sudan; disease outbreaks; measles; rubella; vaccination coverage.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts of interest.

Figures

Figure 1.
Figure 1.
Reported suspected measles cases and laboratory-confirmed measles and rubella cases, by date of rash onset, South Sudan, 2019.
Figure 2.
Figure 2.
Confirmed rubella cases (n = 149) and measles cases (n = 3131) by county, South Sudan, 2019.
See this image and copyright information in PMC

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