title: Measles outbreak investigation in a remote area of Solomon Islands, 2014.
abstract: OBJECTIVE
  To describe a measles outbreak and health service response in a remote location in Malaita, Solomon Islands.
  
  
  METHODS
  Epidemiological review of cases who presented to the Atoifi Adventist Hospital (AAH) during the outbreak period from July to December 2014. Rumour surveillance was used to gather information on unreported cases.
  
  
  RESULTS
  A total of 117 cases were reported to AAH. The incidence rate was 123 per 10 000 individuals. Fifty-six per cent (66/117) of cases were hospitalized. Children under 5 years had the highest number of cases (n = 41) with 10 cases below 6 months old. The age-specific incidence rate of children under 5 years was 278.5 per 10 000 individuals. Eighty-two per cent of reported cases were 18 years old or younger. Rumour surveillance revealed about three quarters of children in one area of the East Kwaio Mountains had suspected measles not reported to AAH. There were three unreported deaths from measles outside AAH. During the outbreak, a total of 2453 measles-rubella vaccines were given in the AAH catchment area.
  
  
  CONCLUSIONS
  A high incidence rate was observed in children and young people aged 18 years or younger, reflecting low childhood vaccination coverage. More than 50% of cases required hospitalization due to disease severity and challenges of accessing health services. The rumour surveillance discovered many unreported cases in the mountain areas and a few deaths possibly linked to the outbreak. Improvement of registration methods and follow-up systems and setting up satellite clinics are planned to improve measles surveillance and vaccination coverage.
authors.affiliation: Atoifi Adventist Hospital, Malaita, Solomon Islands .
authors.forename: Jason
authors.initials: J
authors.lastname: Diau
authors.affiliation: Atoifi Adventist Hospital, Malaita, Solomon Islands .
authors.forename: Christopher
authors.initials: C
authors.lastname: Jimuru
authors.affiliation: Atoifi Adventist Hospital, Malaita, Solomon Islands .
authors.forename: James
authors.initials: J
authors.lastname: Asugeni
authors.affiliation: Atoifi Adventist Hospital, Malaita, Solomon Islands .
authors.forename: Lyndell
authors.initials: L
authors.lastname: Asugeni
authors.affiliation: Atoifi Adventist Hospital, Malaita, Solomon Islands .
authors.forename: Mike
authors.initials: M
authors.lastname: Puia
authors.affiliation: Atoifi Adventist Hospital, Malaita, Solomon Islands .
authors.forename: John
authors.initials: J
authors.lastname: Maomatekwa
authors.affiliation: Pacific Adventist University, Atoifi, Malaita, Solomon Islands .
authors.forename: Humpress
authors.initials: H
authors.lastname: Harrington
authors.affiliation: James Cook University, Queensland, Australia .
authors.forename: David
authors.initials: D
authors.lastname: MacLaren
authors.affiliation: James Cook University, Queensland, Australia . ; Tropical Health Solutions, James Cook University, Queensland, Australia .
authors.forename: Rick
authors.initials: R
authors.lastname: Speare
authors.affiliation: Hunter New England Population Health, New South Wales, Australia .
authors.forename: Peter D
authors.initials: PD
authors.lastname: Massey
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008457:Measles / Q000453:epidemiology* / Q000517:prevention & control; D008458:Measles Vaccine / Q000008:administration & dosage; D008542:Melanesia / Q000453:epidemiology; D011159:Population Surveillance; D055815:Young Adult
chemical_list: D008458:Measles Vaccine