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. 1989;67(4):381–388.

Measles prevention and control in emergency settings.

M J Toole, R W Steketee, R J Waldman, P Nieburg
PMCID: PMC2491262  PMID: 2805216

Abstract

Outbreaks of measles continue to be a common occurrence among refugee and famine-affected children in emergency relief camps. Extremely high measles-associated mortality rates have been reported from refugee camps--where undernutrition is common--in several countries over the past 10 years. Mortality from measles is, however, preventable, and immunization against the disease is a high priority in emergency relief programmes, second only in importance to the provision of adequate food rations. All children aged 6 months to 5 years should be immunized with measles vaccine as soon as they enter an organized camp or settlement. Should supplies of measles vaccine be inadequate, children in feeding centres, or those otherwise identified as undernourished, are the top priority for immunization. The occurrence of measles in a camp is not a contraindication to conducting an immunization campaign. Strong coordination by a designated lead agency is needed if such campaigns are to be successful; however, cooperation with the local expanded programme on immunization is essential to ensure that existing cold chain equipment, training protocols, and management manuals are used. If additional equipment is necessary, a complete immunization kit developed by the Office of the United Nations High Commissioner for Refugees, the World Health Organization, and Oxfam can be procured from Oxfam headquarters in the United Kingdom. Vitamin A supplements should be given routinely at the time of measles immunization in situations where malnutrition is severe. Mortality and morbidity in children with clinical measles can be reduced by administering high doses of vitamin A.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aaby P., Bukh J., Lisse I. M., Smits A. J. Measles mortality, state of nutrition, and family structure: a community study from Guinea-Bissau. J Infect Dis. 1983 Apr;147(4):693–701. doi: 10.1093/infdis/147.4.693. [DOI] [PubMed] [Google Scholar]
  2. Aaby P., Bukh J., Lisse I. M., Smits A. J. Overcrowding and intensive exposure as determinants of measles mortality. Am J Epidemiol. 1984 Jul;120(1):49–63. doi: 10.1093/oxfordjournals.aje.a113874. [DOI] [PubMed] [Google Scholar]
  3. Aaby P., Jensen T. G., Hansen H. L., Kristiansen H., Thårup J., Poulsen A., Sodemann M., Jakobsen M., Knudsen K., Clotilde da Silva M. Trial of high-dose Edmonston-Zagreb measles vaccine in Guinea-Bissau: protective efficacy. Lancet. 1988 Oct 8;2(8615):809–811. doi: 10.1016/s0140-6736(88)92780-8. [DOI] [PubMed] [Google Scholar]
  4. Assaad F. Measles: summary of worldwide impact. Rev Infect Dis. 1983 May-Jun;5(3):452–459. doi: 10.1093/clinids/5.3.452. [DOI] [PubMed] [Google Scholar]
  5. Barclay A. J., Foster A., Sommer A. Vitamin A supplements and mortality related to measles: a randomised clinical trial. Br Med J (Clin Res Ed) 1987 Jan 31;294(6567):294–296. doi: 10.1136/bmj.294.6567.294. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Borgoño J. M. Current impact of measles in Latin America. Rev Infect Dis. 1983 May-Jun;5(3):417–421. [PubMed] [Google Scholar]
  7. Clements C. J., von Reyn C. F., Mann J. M. HIV infection and routine childhood immunization: a review. Bull World Health Organ. 1987;65(6):905–911. [PMC free article] [PubMed] [Google Scholar]
  8. Dave K. H. Measles in India. Rev Infect Dis. 1983 May-Jun;5(3):406–410. doi: 10.1093/clinids/5.3.406. [DOI] [PubMed] [Google Scholar]
  9. Galazka A. M., Lauer B. A., Henderson R. H., Keja J. Indications and contraindications for vaccines used in the Expanded Programme on Immunization. Bull World Health Organ. 1984;62(3):357–366. [PMC free article] [PubMed] [Google Scholar]
  10. Halsey N. A., Boulos R., Mode F., Andre J., Bowman L., Yaeger R. G., Toureau S., Rohde J., Boulos C. Response to measles vaccine in Haitian infants 6 to 12 months old. Influence of maternal antibodies, malnutrition, and concurrent illnesses. N Engl J Med. 1985 Aug 29;313(9):544–549. doi: 10.1056/NEJM198508293130904. [DOI] [PubMed] [Google Scholar]
  11. Klein-Zabban M. L., Foulon G., Gaudebout C., Badoual J., Assi Adou J. Fréquence des rougeoles nosocomiales dans un centre de protection maternelle et infantile d'Abidjan. Bull World Health Organ. 1987;65(2):197–201. [PMC free article] [PubMed] [Google Scholar]
  12. Koster F. T., Curlin G. C., Aziz K. M., Haque A. Synergistic impact of measles and diarrhoea on nutrition and mortality in Bangladesh. Bull World Health Organ. 1981;59(6):901–908. [PMC free article] [PubMed] [Google Scholar]
  13. Loening W. E., Coovadia H. M. Age-specific occurrence rates of measles in urban, peri-urban, and rural environments: implications for time of vaccination. Lancet. 1983 Aug 6;2(8345):324–326. doi: 10.1016/s0140-6736(83)90299-4. [DOI] [PubMed] [Google Scholar]
  14. MCGREGOR I. A. MEASLES AND CHILD MORTALITY IN THE GAMBIA. West Afr Med J. 1964 Dec;13:251–257. [PubMed] [Google Scholar]
  15. Morley D. Severe measles: some unanswered questions. Rev Infect Dis. 1983 May-Jun;5(3):460–462. doi: 10.1093/clinids/5.3.460. [DOI] [PubMed] [Google Scholar]
  16. Shears P., Berry A. M., Murphy R., Nabil M. A. Epidemiological assessment of the health and nutrition of Ethiopian refugees in emergency camps in Sudan, 1985. Br Med J (Clin Res Ed) 1987 Aug 1;295(6593):314–318. doi: 10.1136/bmj.295.6593.314. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Sinha N. P. Measles in children under six months of age: an epidemiological study. J Trop Pediatr. 1981 Apr;27(2):120–122. doi: 10.1093/tropej/27.2.120. [DOI] [PubMed] [Google Scholar]
  18. Taylor W. R., Mambu R. K., ma-Disu M., Weinman J. M. Measles control efforts in urban Africa complicated by high incidence of measles in the first year of life. Am J Epidemiol. 1988 Apr;127(4):788–794. doi: 10.1093/oxfordjournals.aje.a114860. [DOI] [PubMed] [Google Scholar]
  19. Toole M. J., Nieburg P., Waldman R. J. The association between inadequate rations, undernutrition prevalence, and mortality in refugee camps: case studies of refugee populations in eastern Thailand, 1979-1980, and eastern Sudan, 1984-1985. J Trop Pediatr. 1988 Oct;34(5):218–224. doi: 10.1093/tropej/34.5.218. [DOI] [PubMed] [Google Scholar]
  20. Toole M. J., Waldman R. J. An analysis of mortality trends among refugee populations in Somalia, Sudan, and Thailand. Bull World Health Organ. 1988;66(2):237–247. [PMC free article] [PubMed] [Google Scholar]
  21. Williams P. J., Hull H. F. Status of measles in The Gambia, 1981. Rev Infect Dis. 1983 May-Jun;5(3):391–394. doi: 10.1093/clinids/5.3.391. [DOI] [PubMed] [Google Scholar]

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