title: Investigation of a measles outbreak in Cordillera, Northern Philippines, 2013.
abstract: BACKGROUND
  Measles is a highly infectious viral illness that remains one of the leading causes of death among children worldwide. In the Philippines, decreasing routine vaccination coverage from 2007 to 2011 led to local measles outbreaks. A team investigated a measles outbreak reported in Cordillera of the Philippines in May 2013.
  
  
  METHODS
  Measles case data with symptom onset from 2 February to 27 May 2013 were obtained from official sources and verified on site. Data included age, sex, residential address, signs and symptoms and vaccination status. Active case-findings were also conducted for contacts of these cases. The living environments of the cases were investigated. A survey was conducted with the cases and caregivers to understand their knowledge and attitudes about measles.
  
  
  RESULTS
  There were 50 measles cases identified with an age range from six months to 32 years (median: 16 years). Thirty-two were male (64%). Twenty (40%) were hospitalized with one death. Thirty-two (64%) cases were laboratory confirmed, and 36 (72%) received a single dose of measles vaccine. Overcrowded living environments were observed among many cases. The majority of respondents (46/48, 96%) knew about measles, but there were misconceptions about the cause of measles and how it can be prevented and managed.
  
  
  CONCLUSIONS
  This measles outbreak occurred in an area with low immunization coverage. Achieving 95% measles immunization coverage and strengthening routine immunization strategies to address high-risk populations are recommended. Also, we recommend health education campaigns to include components that address misconceptions about measles.
authors.affiliation: Field Epidemiology Training Program, Epidemiology Bureau, Department of Health, Sta Cruz, Manila, Philippines.; Department of Health, Sta Cruz, Manila, Philippines.
authors.forename: Paola Katrina
authors.initials: PK
authors.lastname: Ching
authors.affiliation: Department of Health, Sta Cruz, Manila, Philippines .
authors.forename: Ma Justina
authors.initials: MJ
authors.lastname: Zapanta
authors.affiliation: Department of Health, Sta Cruz, Manila, Philippines .
authors.forename: Vikki Carr
authors.initials: VC
authors.lastname: de Los Reyes
authors.affiliation: Department of Health, Sta Cruz, Manila, Philippines .
authors.forename: Enrique
authors.initials: E
authors.lastname: Tayag
authors.affiliation: Department of Health, Sta Cruz, Manila, Philippines .
authors.forename: Rio
authors.initials: R
authors.lastname: Magpantay
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks / Q000517:prevention & control; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008457:Measles / Q000453:epidemiology*; D008458:Measles Vaccine / Q000276:immunology*; D010679:Philippines; D012307:Risk Factors
chemical_list: D008458:Measles Vaccine