INVESTIGATION AND RESPONSE TO A MEASLES OUTBREAK IN FACTORY AND DORMITORIES OF MYANMAR WORKERS, SUNG NOEN DISTRICT, NAKHON RATCHASIMA PROVINCE

Abstract

On January 15, 2019, the Office of Disease Prevention and Control 9th Nakhon Ratchasima, was notified from the Nakhon Ratchasima Provincial Health Office of five measles-suspect patients. They were Myanmar and worked at a factory in Sung Noen District. The investigation Team launched a joint response on January 17, 2019 with the aims to confirm the diagnosis and outbreak, assess the situation and control the outbreak. A descriptive epidemiological study consisted of interviewing measles patients, review medical history and active case finding. Definition of measles case was a person in the factory and dormitory with fever and rash during December 15, 2018 to January 31, 2019, confirmed by measles IgM. In total, we found 11 measles patients, attack rate 0.4%. All patients were Myanmar, aged between 22-35 years old, four males, and seven females. They all lived in the factory dormitories. Dormitory 4 with 6 cases having attack rate of 3.9%. Patients had fever, cough, rhinorrhea, and rash symptoms. According to the laboratory results of the Department of Medical Sciences, eight measles patients were confirmed. Among these patients, two were tested and found to be genotype D8. An environmental survey found that each room had around 10–12 foreign workers. While in the factory, they were dressed in gowns and masks, and there was a standard cleaning process. For this outbreak of measles, the factors that promote the outbreak are likely to be congestion inside the dormitories. Team from Sung Noen Hospital in collaboration with Nakhon Ratchasima Health Office, launched measles-rubella vaccination for patients who were close contacts. We recommended to the hospitals and factories to increase the monitoring of outbreaks in factories, increase knowledge and understanding of the workers about measles and good hygienic practice. Living and indoor environment were needed to be improved.