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Chad: Measles Outbreak - May 2018

Disaster description

Since the start of the year, 400 cases, including 14 deaths, were reported as of 20 May compared to 205 cases and one death over the same period in 2017. Three districts have reached the epidemic threshold. (OCHA, 28 May 2018)

A measles outbreak has been declared on 30 May in five districts of Chad (Bokoro, Gama, Ati, Am dam and Goz Beida), where 474 cases and 18 deaths have been reported. Medecins Sans Frontières is conducting a Measles outbreak investigation field mission in the affected area. Based on the Multiple Indicator Cluster Survey, only one in four children aged 12-23 months (25%) is fully immunised. A stock of 60 000 vaccination doses funded by DG ECHO is available in-country for the local response. (ECHO, 2 Jun 2018)

Health authorities on 8 June declared a measles epidemic after 540 cases and 23 deaths were recorded. The disease has erupted in 89 districts, 10 of which have reached the epidemic level. A US$589,000-response plan by the Government, NGO and UN partners is underway to vaccinate around 572,000 children. Measles is one of the leading causes of death among young children. (OCHA, 19 Jun 2018)

Between week 1 and week 26 (ending 1 July 2018) of 2018, a total of 1284 suspected cases with 49 deaths (CFR 3.8%) have been reported. The cases have been reported from 95 out of 117 health districts in the country. As of 1 July 2018, 90 cases have been laboratory confirmed, 376 confirmed by epidemiological link, and 21 clinically compatible. As of 1 July 2018, 11 districts have had confirmed ongoing measles outbreak, these include: Bokoro, Gama, Amdam, Goz Beida, Haraze Mangueigne, Abeche, Arada, Ati, Mongo, Rig Rig, Tissi and Bardaï. (WHO, 6 Jul 2018)

The measles epidemic declared on 30 May continues to spread affecting 24 districts in the north, east and central parts of Chad. According to the latest data, there have been more than 2 000 suspected cases and 77 deaths. A national response plan is currently being developed. Based on the latest survey, only one in four children aged 12-23 months is fully immunised. A stock of 60 000 vaccination doses funded by DG ECHO is being used for the local response.(ECHO, 29 Aug 2018)

The measles outbreak in Chad which started at the beginning of 2018 continues to evolve. Between week 1 and week 36 (week ending 9 September 2018), a total of 2 734 suspected cases of measles were reported including 78 deaths (case fatality ratio 2.9%)...The average age is 9.9 years and the median age was 6 years. About 39% of the affected people are four years of age and below, 23% are between five and nine years and 37% are 10 years and above. Only 15% (150) of the investigated cases had previously been vaccinated against measles. In the reporting week, two new district reported a confirmed case, Mao and Karal. As of reporting date, a total of 27 districts have had a confirmed measles outbreak. (WHO, 21 Sep 2018)

In week 36, 155 suspected cases with no deaths were reported. An increase in the number of cases compared to the previous week when 122 cases and 1 death were reported. Twelve districts: Faya, Mondo, Moussoro, Amzoer, Iriba, Kalait, Chadra, Oum Hadjer, Mangalme, Biltine, Isseriom and Ngouri have reported at least 5 suspected cases of measles during the last 4 weeks (week 31-35). The last 2 districts crossed the threshold for the first time. (WHO, 12 Oct 2018)

In week 48 (ending 2 December 2018), 259 suspected cases were reported. There has been an increasing trend in the reported number of cases since week 43. Of the total confirmed cases, 356 were laboratory confirmed by IgM. Thirty-nine districts have reported a confirmed epidemic. (WHO, 14 Dec 2018)

Thirty-nine districts across the country have been affected by the outbreak as of 26 December 2018. The mean age among cases is nine years. Of the 1 338 cases with available information, only 13% were vaccinated against measles. The outbreak is reportedly controlled in 31 districts. (WHO, 18 Jan 2019)

The Ministry of Health of Chad reported a new peak of the measles epidemics which was declared on 30 May 2018. According to latest information, between 1 January and 15 February 2019, more than 2 000 cases and 11 deaths were registered in 73 out of 117 districts in the east, south and central parts of the country and in the capital N’Djamena. The Ministry of Health reported current shortage of the vaccination doses at central level. (ECHO, 22 Feb 2019)

The measles epidemic in Chad, declared on 30 May 2018, continues to spread. According to the latest information, between 1 January and 12 April 2019, more than 10 333 cases and 84 deaths were registered in 112 out of 126 districts in the east, south and central parts of the country and in the capital N’Djamena. (ECHO, 23 Apr 2019)

A measles epidemic since May 2018 has been declining in the past two weekscording to health authorities. In the week ending on 12 May, 846 cases were recorded, compared with 921 the week before and 1,296 in late April. The drop is attributed to the start of the rainy season in some provinces. Measles outbreak usually occurs during the dry seasons between September and May. (OCHA, 20 May 2019)

In week 37 (week ending 15 September 2019), 265 suspected cases and 2 associated deaths were reported. 15 districts were in the epidemic phase in week 37. Since the beginning of the year, a total of 24 330 suspected cases and 241 deaths (CFR 1.0%) have been reported with Am Timan, N’Djamena East, N’Djamena South, Bongor, Moundou, Bousso and N’Djamena Centre districts all exceeding 1 000 suspected cases. (WHO, 29 Sep 2019)

In week 52 (week ending 29 December 2019), 168 suspected cases were reported. 22 districts were in the epidemic phase in week 52. Since the beginning of the year, a total of 26 623 suspected cases and 259 deaths (CFR 1.0%) have been reported with Am Timan, N’Djamena East, N’Djamena South, Bongor, Moundou, Bousso and N’Djamena Centre districts all exceeding 1 000 suspected cases. Among the 1 895 cases investigated, 296 were IgM-positive, 79% were not vaccinated, and 47% were aged between 1 and 4 years old. (WHO, 05 Jan 2020)

The measles outbreak in Chad has been ongoing since it was first notified by the Chadian government in May 2018. In week 1 of 2020 (week ending 5 January 2020), 123 suspected measles cases were reported from 22 of the 126 districts in Chad. (WHO, 19 Jan 2020)

The measles outbreak in Chad continues to evolve, with the number of new cases rapidly increasing in the last weeks, as is the growing number of affected districts. [...] The number of new cases has been gradually increasing since week 1 of 2020, when 127 suspected cases were reported. From weeks 1-6, 2020, a cumulative total of 1 276 suspected measles cases, including 14 deaths (case fatality ratio 1.1%), have been reported from 52 (41%) out of 126 districts of the country. [...] The measles outbreak in Chad has been ongoing since 2018. In 2019, a total of 26 623 suspected measles cases, including 259 deaths (case fatality ratio 1.0%) were reported from 36 districts. (WHO, 16 Feb 2020)

In week 8 (week ending 23 February 2020), 621 suspected cases were reported. 29 districts were in the epidemic phase in week 8. Since the beginning of the year, a total of 2 410 suspected cases and 23 deaths (CFR 1.0%) have been reported from Beboto, Kyabe, Goundi, Korbol, Kelo and Guelao. (WHO, 15 Mar 2020)

As attention and resources are shifting more and more towards COVID-19 prevention and response activities in Chad, the country is still grappling with a persistent measles epidemic that shows no signs of slowing down. 118 out of 126 health districts in Chad have been affected since the epidemic outbreak in May 2018, with southern provinces facing a rapid increase in cases. As of 30 April 2020, 28 health districts were in a declared measles epidemic. The Ministry of Public Health reported 7,635 suspected cases, with the highest number of registered cases in Beboto, Kyabe and Goundi health districts. In February, and before the first COVID-19 case in Chad was confirmed on 19 March, a Médecins Sans Frontières (MSF) emergency response team travelled to measles-affected regions, including Bebote, which is the most heavily impacted. As a result, 25,177 children aged between six months and nine years were vaccinated against measles. (OCHA, 22 May 2020)

As of 25 October, 8,601 suspected cases of measles and 39 deaths have been notified in 100 out of 126 districts (during the same period in 2019, the tally was 25,283 suspected cases and 242 deaths). However, a period of higher transmission of the disease is expected. This is prompting the planning of a vaccination campaign in epidemic-prone health districts. Two national campaigns are envisaged, requiring funding of 3 million USD, of which 2 million are available through GAVI funds. (OCHA, 13 Nov 2020)

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