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State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
State measles review may 2010
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State measles review may 2010

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Nilanjan Mitra

Nilanjan Mitra

Published in: Health & Medicine, Technology
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  • 1. Dr.Nilanjan Mitra Sub-Regional Team Leader - WB WHO-NPSP Status of Measles Surveillance
  • 2. Measles Surveillance-India Source: DLHS-3 (2007-08); Gujarat – NFHS-3 (2005-2006) States Measles Immunization coverage (%) Fully Immunized (%) Year of introduction of measles surveillance Andhra Pradesh 88.6 67.1 2006 Karnataka 85.2 76.7 2006 Kerala 87.9 79.5 2007 Tamil Nadu 97.6 83.2 2006 West Bengal 82.8 75.8 2007 Gujarat * 65.7 45.2 2007 Rajasthan 67.5 48.8 2009
  • 3. 2007 16478 cases 2008 Clinical measles cases through routine weekly reporting * data as on 15 th Feb, 2010 24258 cases
  • 4. Clinical measles cases through routine weekly reporting 2009 * data as on 15 th Feb, 2010 2046 cases 2010* 32921 cases More clinical measles cases are pouring over the years
  • 5. Measles Seasonal Trend (6 states) -2008-09 Source: Routine weekly reports – cases of clinical measles Among 6 states - WB dictates the seasonality
  • 6. Death Source – Routine weekly reports
  • 7. Source – Routine weekly reports
  • 8. Popln. density / sq.km WB – 903 KOL – 24718 HRA – 2913 BBM – 663 BDN - 982 Source – Routine weekly reports Measles immunization coverage – 61% (DLHS-3)
  • 9. Serologically confirmed measles, rubella and mixed outbreaks India (Andhra Pradesh, Gujarat, Karnataka, Kerala, Rajasthan, Tamil Nadu and West Bengal) 151 outbreaks 111 36 39 61 52 38 2008 2009* 186 outbreaks * data as on 15 th Feb, 2010 decreased increased Measles outbreaks confirmed Rubella outbreaks confirmed Mixed outbreaks confirmed
  • 10. Summary of OBI – 6 States – 2007 - 2009 States Year No. of suspected outbreaks No. of serologically investigated outbreaks % No. of cases Identified in measles outbreaks No. of cases Identified in rubella outbreaks Deaths in serologically confirmed measles outbreaks AP 2007 54 54 100 678 0 4 2008 46 32 70 490 382 1 2009 44 32 73 1017 81 0 GUJ 2007 19 16 84 1044 0 3 2008 47 25 53 2092 0 4 2009 27 11 41 334 220 1 KAR 2007 337 52 15 2357 132 7 2008 115 51 44 1755 938 4 2009 77 27 35 768 631 1 KER 2007 76 9 12 314 153 2 2008 66 19 29 382 249 0 2009 55 15 27 128 218 1 TN 2007 101 32 32 1034 87 0 2008 32 13 41 384 0 0 2009 29 5 17 266 105 1 WB 2007 238 23 10 1704 0 19 2008 429 59 14 1967 1286 14 2009 577 67 12 951 3008 3
  • 11.  
  • 12. Results of OBI – 6 States – 2007 - 2009 State Year Total no. of outbreaks investigated SEROLOGICALLY CONFIRMED OUTBREAKS Measles % Rubella % Mixed % Negative % AP 2007 54 47 87.1 0 0 7 12.9 2008 32 14 43.6 6 18.8 6 18.8 6 18.8 2009 32 17 53.1 4 12.5 2 6.2 9 28.1 GUJ 2007 16 15 93.8 0 0 1 6.2 2008 25 24 96.0 0 1 4.0 0 2009 11 7 63.6 2 18.2 2 18.2 0 KAR 2007 52 42 80.8 2 3.8 3 5.8 5 9.6 2008 51 29 56.8 11 21.6 6 11.8 5 9.8 2009 27 14 51.8 6 22.2 6 22.2 1 3.8 KER 2007 9 6 66.7 3 33.3 0 0 2008 19 9 47.4 4 21.0 6 31.6 0 2009 15 6 40.0 6 40.0 2 13.3 1 6.7 TN 2007 32 29 90.7 1 3.1 1 3.1 1 3.1 2008 13 8 61.5 0 5 38.5 0 2009 5 3 60.0 2 40.0 0 0 WB 2007 23 19 82.7 0 3 13.0 1 4.3 2008 59 27 45.8 15 25.4 15 25.4 2 3.4 2009 69 10 14.5 33 47.8 26 37.7 0
  • 13. Measles Outbreak – 2007 (from1 st July – Dec 07) Confirmed Measles Outbreak - 19 Measles & Rubella Outbreak - 3 Outbreak – neither Measles nor Rubella - 1 Kalimpong II (2) Dhupguri Kharibari-Phansidewa Jalpaiguri Rajganj Karandighi Ratua I & Harishchandrapur II Farakka Sagardighi Murarai II Katwa I Andal-Pandebswar Raghunathpur II Kulpi Nandigram II (2) – 1 mixed & 1 measles Ramnagar II Canning I Goalpokhar II Total outbreaks investigated - 23 Raghunathganj II Baruipur Mathurapur II
  • 14. Measles Outbreak – 2008 Confirmed Measles Outbreak (27) Measles & Rubella Outbreak (15) Outbreak – neither Measles nor Rubella (2) Total outbreaks investigated - 59 Confirmed Rubella Outbreak (15) Result Pending (0) Data as on 08.04.09 Nakashipara (2) – 1 Mixed & 1 measles Patashpur -I (2) 1 Rubella + 1 Mixed Jalpaiguri ( 2 ) 1 Rubella + 1 Measles Basirhat – I (2) 1 Mixed + 1 Rubella Raiganj (3) 2 Measles + 1 Mixed Arambagh (2) - 1 Negative + 1 Measles Swarupnagar (2) 1 Mixed+ 1 Rubella Basirhat – M (2) 1Measles+ 1Mixed ? ? ? KOLKATA
  • 15. Measles Outbreak – 2009 Total outbreaks investigated - 71 Data as on 22.02.2010 Confirmed Measles Outbreak – (10) Measles & Rubella Outbreak – (26) Confirmed Rubella Outbreak (33) Neither Measles nor Rubella (0) Result Pending (2) Kaliganj (2) - 1 Rubella + 1Mixed Goalpokhar-II(2) Egra – II (2) - 1 Rubella + 1Pending ? ?
  • 16. Average TIME-LAG Analysis (in days) - 2007-2009
  • 17. Vaccination status of measles cases – serologically confirmed measles outbreaks, India, 2009
  • 18. OBI (23) - Cases by vaccination status, 2007 N=783 West Bengal <1 Years of age 1-4 Years of age 5-9 Years of age 10-14 Years of age >15 Years of age N=200 N=788 N=153 N=89 N=644 Cases from serologically confirmed measles outbreaks Vaccinated Not Vaccinated Unknown
  • 19. OBI (59) - Cases by vaccination status, 2008 N=783 West Bengal <1 Years of age 1-4 Years of age 5-9 Years of age 10-14 Years of age >15 Years of age N=397 N=1203 N=734 N=485 N=1588 Cases from serologically confirmed measles outbreaks Vaccinated Not Vaccinated Unknown
  • 20. OBI (67) - Cases by vaccination status, 2009* N=783 West Bengal <1 Years of age 1-4 Years of age 5-9 Years of age 10-14 Years of age >15 Years of age N=425 N=1681 N=1131 N=821 N=2178 Cases from serologically confirmed measles outbreaks Vaccinated Not Vaccinated Unknown
  • 21. 2009
  • 22. 2009
  • 23. Total cases- 1060 Total cases- 431 Total cases- 266 Andhra Pradesh Gujarat Tamil Nadu Total cases- 236 Kerala Total cases- 3228 West Bengal Total cases- 1238 Karnataka Measles cases by age, 2009* Cases from serologically confirmed measles outbreaks % % % % % % Total cases- 146 Rajasthan % * data as on 15 th Feb, 2010
  • 24. Total cases- 1967
  • 25. Total cases- 991 77% Measles cases in 1-10 yrs age group
  • 26. SILENT AREAS and AREAS with < 10 cases of Clinical Measles Weekly Reporting of Measles Surveillance -2008 - WB
  • 27. SILENT AREAS and AREAS reported < 10 cases of Clinical measles in 2009 - WB Source: Routine weekly Reports -data up to 53 wks
  • 28.  
  • 29. 51% Urban areas under-represented 23% Rural areas under-represented
  • 30.  
  • 31. Recommendations
    • More sensitization workshop
    • Reporting from Medical Colleges
    • Merging with IDSP reports
    • Activation of ERT
    • Serious desk review
    • Supervised preliminary investigation
    • Ensure promptness in notification of clinical
    • measles and quick decision for OBI
    • OBI should be monitored by district
    • Follow-up corrective immunization action
  • 32. END
  • 33. Blocks with poor RI Source: Analysis of 2250 AFP cases in 2007 SUMMARY 63 AFP cases in with less than 3 RI doses in 6-24mns. age group in 35 blocks & 12 Municipalities in 13 districts Total AFP cases in 6-24 mns age group - 372
  • 34. Blocks with poor RI Source: Analysis of 1853 AFP cases in 2008 SUMMARY 83 AFP cases in with less than 3 RI doses in 6-24mns. age group in 41 blocks & 15 Municipalities in 16 districts Total AFP cases in 6-24 mns age group - 449
  • 35. N=237 Andhra Pradesh N=913 Gujarat N=151 Tamil Nadu N=174 Kerala N=930 West Bengal N=883 Karnataka Measles cases (1-4 years) by vaccination status, 2008 Cases from serologically confirmed measles outbreaks Vaccinated Not Vaccinated Unknown
  • 36. N=327 Andhra Pradesh N=142 Gujarat N=84 Tamil Nadu N=43 Kerala N=1049 West Bengal N=534 Karnataka Measles cases (1-4 years) by vaccination status, 2009* Cases from serologically confirmed measles outbreaks N=59 Rajasthan * data as on 15 th Jan, 2010 Vaccinated Not Vaccinated Unknown
  • 37. Total cases- 1498 (22 + ve Outbreak) Data as on 12.11.08
  • 38.  

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