A measles outbreak among the inmates in a provincial prison, Amnat Charoen Province, Thailand, January - February 2018

Abstract

A measles in Thailand is no sign of stopping. This analytical cross-setional study aimed to invetigate and confirm the measles outbreak among the inmates in Amnat Charoen Provincial prison between 29th January and 1st February 2018.

A total of 1,731 samples with median age 26 years were screened , and 98 cases met a mesles definition. The first case was 25-year old male who had illness before entering into the prison. The measles virus was indentified as Genotype D8 strain which 11 cases were confirmed. Two cases were rubella. The measle was continuously spreading in the prision from 5th February to 11th February 2018. The overall attack rates were 5.7 per 1,000 population. Fiveteen cases were hospitalized, but no death case was fonnd. Fever and rash were found as the most clinical presentation at 100 percent, followed by cough (84.7%), Koplik’s spots (63.27 %), diarrhea (61.22%) and then conjunctivitis (54.08%) respectively. Multivariate regression analysis showed that sharing drinking glasses (OR 23.79, 95%CI 9.26 to 61.08), sharing spoon (OR 5.38, 95%CI 2.97 to 9.74) and closed contact with the case (OR 2.66, 95%CI 1.61 to 4.38) were statistically significant with the measles outbreak (p<0.001)

Therefore, the new inmates should be screened before entering into the prison. The strict rule in a prison should be addressed to isolate the index case from another inmate. Mumps, Measles and Rubella (MMR) vaccines should be provided to all inmates and staff to increase herd immunity and prevent the spreading of these diseases in the prison.