Measles is a highly contagious, serious disease caused by a virus [1,2]. Any person with fever, and non-vesicular rash, and cough, runny nose or red eyes is the suspect of measles case. Confirmed measles case is a suspected case with laboratory confirmation (positive for immunoglobulin M (IgM) antibody) [3]. Measles is caused by a virus in the paramyxovirus family and it is normally passed through direct contact and through the air. The virus infects the respiratory tract, and then spreads throughout the body. Measles is a human disease and is not known to occur in animals [4].
Before the introduction of measles vaccine in 1963 and widespread vaccination, major epidemics occurred approximately every 2–3 years and measles caused an estimated 2.6 million deaths each year [1, 2].
The disease remains one of the leading causes of death among young children globally, despite the availability of a safe and effective vaccine [1,5]. Approximately 89 780 people died from measles in 2016 – mostly children under the age of 5 years [1].
In populations with high levels of malnutrition, particularly vitamin A deficiency, and a lack of adequate health care, about 3–6%, of measles cases result in death, and in displaced groups, up to 30% of cases result in death. Women infected while pregnant are also at risk of severe complications and the pregnancy may end in miscarriage or preterm delivery. People who recover from measles are immune for the rest of their lives [4, 6].
The case fatality rate of measles disease was increased with travel distance from the nearest health facility. The difference in the access to health care can affect the burden of the disease in low-income settings [7].
In countries with weakly functioning health care systems, measles mortality reduction or elimination was addressed through second dose periodic supplementary immunization activities (SIAs) in the form of mass campaigns. Strengthen routine vaccination service can improve measles control, measles death reduction and elimination program which can help build up primary health care capacity [8].
Measles has been difficult to eliminate historically, but there is a global goal to eradicate it, and measles was first eliminated in the Americas [9].
In Ethiopia, implementation of measles death reduction approach was launched in 2002. The national Expanded Program on Immunization was started in 1980, and the first dose of measles-containing vaccine (MCV1) is given at or after the ninth month of age [10]. About 54% of 12-23 months children were received routine measles vaccination in 2016 [11]. Supplementary immunization activities were conducted every two to four years, targeting all children between nine months and 14 years of age [12].
Suspected measles outbreak is defined as occurrence of five or more reported suspected cases in one month in a defined geographic area, like, kebele(the smallest administrative unit of the woreda in Ethiopia), district or health facility catchment area whereas Confirmed measles outbreak is defined as occurrence of three or more laboratory confirmed cases in one month in a defined geographic area, like, kebele, district or health facility catchment area [3].
Measles outbreaks can occur in areas with high vaccination coverage [13]. It is also common in many low- income countries but there is limited information in confirming the outbreak, describing the outbreak in terms of person, please and time, and identifying determinants of outbreak [14].
Measles is one of immediately reportable disease in Ethiopia. On Wednesday morning, July 12/2018, one Suspected measles case was reported from Golbo Arba kebele in Artuma fursi woreda. Within two hours, three field Epidemiology residents and one Artuma Fursi woreda health office Public health Emergency officer visited the reported Kebele to confirm the existence of the outbreak, describe cases in person, place and time, and identify determinants of measles case status.