title: Measles outbreak response among adolescent and adult Somali refugees displaced by famine in Kenya and Ethiopia, 2011.
abstract: BACKGROUND
  The refugee complexes of Dadaab, Kenya, and Dollo-Ado, Ethiopia, experienced measles outbreaks during June-November 2011, following a large influx of refugees from Somalia.
  
  
  METHODS
  Line-lists from health facilities were used to describe the outbreak in terms of age, sex, vaccination status, arrival date, attack rates (ARs), and case fatality ratios (CFRs) for each camp. Vaccination data and coverage surveys were reviewed.
  
  
  RESULTS
  In Dadaab, 1370 measles cases and 32 deaths (CFR, 2.3%) were reported. A total of 821 cases (60.1%) were aged ≥15 years, 906 (82.1%) arrived to the camps in 2011, and 1027 (79.6%) were unvaccinated. Camp-specific ARs ranged from 212 to 506 cases per 100 000 people. In Dollo-Ado, 407 cases and 23 deaths (CFR, 5.7%) were reported. Adults aged ≥15 years represented 178 cases (43.7%) and 6 deaths (26.0%). Camp-specific ARs ranged from 21 to 1100 cases per 100 000 people. Immunization activities that were part of the outbreak responses initially targeted children aged 6 months to 14 years and were later expanded to include individuals up to 30 years of age.
  
  
  CONCLUSIONS
  The target age group for outbreak response-associated immunization activities at the start of the outbreaks was inconsistent with the numbers of cases among unvaccinated adolescents and adults in the new population. In displacement of populations from areas affected by measles outbreaks, health authorities should consider vaccinating adults in routine and outbreak response activities.
authors.affiliation: Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
authors.forename: Carlos
authors.initials: C
authors.lastname: Navarro-Colorado
authors.affiliation: Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
authors.forename: Abdirahman
authors.initials: A
authors.lastname: Mahamud
authors.affiliation: United Nations High Commissioner for Refugees (UNHCR), Nairobi, Kenya.
authors.forename: Ann
authors.initials: A
authors.lastname: Burton
authors.affiliation: UNHCR, Geneva, Switzerland.
authors.forename: Christopher
authors.initials: C
authors.lastname: Haskew
authors.affiliation: UNHCR, Addis Ababa, Ethiopia.
authors.forename: Gidraf K
authors.initials: GK
authors.lastname: Maina
authors.affiliation: United Nations High Commissioner for Refugees (UNHCR), Nairobi, Kenya.
authors.forename: John B
authors.initials: JB
authors.lastname: Wagacha
authors.affiliation: CDC, Nairobi, Kenya.
authors.forename: Jamal A
authors.initials: JA
authors.lastname: Ahmed
authors.affiliation: Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
authors.forename: Sharmila
authors.initials: S
authors.lastname: Shetty
authors.affiliation: Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
authors.forename: Susan
authors.initials: S
authors.lastname: Cookson
authors.affiliation: Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
authors.forename: James L
authors.initials: JL
authors.lastname: Goodson
authors.affiliation: UNHCR, Geneva, Switzerland.
authors.forename: Marian
authors.initials: M
authors.lastname: Schilperoord
authors.affiliation: UNHCR, Geneva, Switzerland.
authors.forename: Paul
authors.initials: P
authors.lastname: Spiegel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005002:Ethiopia; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya; D008297:Male; D008457:Measles / Q000453:epidemiology* / Q000401:mortality; D008458:Measles Vaccine / Q000008:administration & dosage; D008875:Middle Aged; D012036:Refugees; D012998:Somalia; D013217:Starvation; D014611:Vaccination / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D008458:Measles Vaccine
keywords: acute malnutrition; adults; famine; measles; mortality; population displacement; refugees; vaccination