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Measles outbreak in Sakteng Lower Secondary School and Joenkhar community under Tashigang District in October and November 2016

Suspected Measles is one of the immediately notifiable diseases where every health center in Bhutan has to notify it to Royal Centre for Disease Control (RCDC) under National Early Warning Alert and Response Surveillance (NEWARS) through web based online Information System (NEWARSIS) As per the Measles and Rubella surveillance, the last single measles case was reported in 2012 and no measles was detected in 2013 and 2014. However, sporadic cases of (12 laboratory confirmed) Measles were reported from different district during the last quarter of 2015 which were all classified as imported or imported related case since source of infection was epidemiological linked to Indian boarder town; Jaigon under West Bengal. Around the same time, Trashigang district also reported a measles case which was also epidemiological link to Jaigon. Since then 24 Measles were reported sporadically from most districts till date.
On 24 October 2016, Sakten BHU under Trashigang district notified event (cluster of suspected measles cases) in Sakten Lower Secondary School in NEWARSIS. RCDC and VPDP immediately instructed Trashigang District Health Authority to dispatch District Rapid Response Team (DRRT) to investigate an event and submit the report. On 14 November 2016, Joenkhar BHU under Trashigang district also notified similar event (cluster of suspected measles cases). Following the two measles event notification, the RCDC dispatched the team on 15th November to investigate measles outbreaks in Merak and Sakteng gewog with DRRT. The main objectives of the investigation were to verify measles outbreaks reported by Sakteng and Joenkhar BHU, determine the possible source of infection and epidemiological characteristics of the outbreak, describe the vaccine coverage in the outbreak locality, describe risk factors and implement the control measure.