1. Measles Outbreak Tham Hin Temporary Shelter May - June 2012

2. Background Situated in Ratchaburi Province Home to 8,000+ refugees High number of visitors and new arrivals Last measles outbreak in 2007

3. 18 YR Nurse Zone 2 First Case 19 YR Pregnant Zone 2

4. Initial Measures IsolationSupportive treatmentContact tracingActive case findingReport to MOPH

5. Contacts 18 yr Nurse Attend church service on day of onset Work at OPD and dressing room

6. Household contacts Church goers Neighbours Clinic staffs Total 109 Immediate measures “Immunisation” done on same day

7. 11 May Rash Who is the source? 5 May Fever ~14 days 27 April

8. 9 month Zone 1 More patients 40 yr Zone 1

9. 9 month Zone 1 40 yr Zone 1 ?

10. We found her! 7 year old girl Visitor from Myanmar Onset on 26 April Visited OPD with ILI

11. We found her! Rash seen on follow up on 2 May Measles was not suspected Next follow up 4 May, but not show up Already went back to Myanmar

12. MOPH Involvement

14. Our Control Plan Supplementary measles immunisation to “People at Risk ”

15. 9 month - 20 years with Incomplete Immunisation

16. Students: 5 - 20 years In KG & Grade 1 with no or one previous measles vaccination Any grade with no or unverified measles vaccination Day 1

17. In Community: 9 month - 20 years with NO or Unverified measles vaccination status Day 2

18. MOPH provided All vaccines Human resources Technical support

19. Vaccination at School

22. Vaccination in community

23. Epidemiology

24. Weekly Epidemic Curve

25. Attack Rate by Age

26. Number by Age

27. Contact Tracing

29. Final Situation

30. Total 23 cases Last case 15 June

31. Lessons Learned

32. New Arrivals may introduce outbreaks children not covered by EPI are at risk Early detection is vital in outbreak control

33. Support and involvement of MOPH is important Prompt response and good coordination key to success

34. Thank You