MSF responding to measles epidemics in the Democratic Republic of Congo

November 26, 2010

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MSF responding to measles epidemics in the Democratic Republic of Congo © Haavar Karlsen

Médecins Sans Frontières is currently carrying out several mass immunization campaigns to increase measles vaccination coverage in the Democratic Republic of Congo (DRC) after health authorities declared a number of measles epidemics. Medical teams have treated hundreds of measles cases.

Measles is a highly contagious viral infection which can spread quickly and can have deadly consequences for vulnerable populations. The DRC is one of the countries where the disease persists despite its successful control elsewhere in the world.

“Epidemics like these are avoidable if the population has been vaccinated” said Karla Bil, MSF’s Health Advisor. “Mass immunization campaigns are so important because they raise the level of vaccination coverage and prevent unnecessary deaths” she added.

In Fizi, South Kivu province, MSF aims to vaccinate 120,000 children between the ages of 6 months and 15 years. Over the next six weeks, medical teams will keep trying to reach remote locations even as military operations are expanded in the area and the rainy season looms. If successful, nearly every child in the health zone will be immunized against measles. Preparations started after a measles epidemic was confirmed at the end of September. Since then MSF has treated around 300 people suffering from measles and its complications.

Simultaneously in Katanga province, MSF has been responding to a measles epidemic around Dilolo, near the Angolan border. Since September, 368 measles cases have been confirmed. Yesterday, MSF started a campaign to vaccinate 72,000 children in and around Dilolo. Teams are hoping to vaccinate 90% of children in the area. MSF will also carry out an epidemiological assessment in the neighbouring health zone of Kasaji, after measles cases were reported there.

In Bendera, MSF teams are vaccinating 12,000 children, half of whom were displaced from their homes in South Kivu last year. MSF teams have also treated several cases of measles in the region.

Logistical challenges

“I was working in the fields when I heard the news about the measles vaccination programme from some other mothers. Then I decided to go there with my children” said Bisoci Mulasi, a 31 year old mother from Kilungu in South Kivu, who travelled over 30 kilometres with her five children to get them vaccinated.

In the lead up to the campaign, MSF employed more than a hundred extra staff in South Kivu to visit villages in the region and inform them about the free vaccination programme. There were also radio announcements in several local languages.

“It’s been a huge logistical challenge sourcing 150,000 doses of measles vaccine at fairly short notice, certainly considering the heightened demand in the region ” said Grace Tang, MSF’s Head of Mission in South Kivu.

In addition to sourcing the vaccines, MSF had to ensure that they were kept cold during transportation throughout Congo so that they reached the populations in optimal condition. The measles vaccine contains live microorganisms and to be effective must be kept at a controlled temperature between 2 and 8 °C.

“We’ve had to use cooling elements, solar powered fridges, and locate fridges along the route” said Grace. “But it’s been so worthwhile seeing children in the area getting a lifetime’s protection from this disease”.

In 2009 alone, MSF vaccinated more than half a million children against measles in the Democratic Republic of Congo.

Treating Measles in Lubilo, South Kivu

The village of Lubilo (population around 3,500) was at the epicentre of the measles outbreak. It is located in South Kivu, on the eastern side of a peninsula that extends into Lake Tanganyika. The village is extremely isolated and only reachable by boat.

After the local health authority reported that 12 cases of measles had resulted in the deaths of two children, an MSF team left for the village the next day. After a five hour journey by boat over the lake, they were greeted by concerned villagers. The first priority was setting up an isolation tent where suspected cases could receive treatment and the spread of the disease could be contained. Measles is one of the most contagious diseases known and almost all non-immune children contract the infection if exposed to the virus.

The next task was informing villagers via megaphone to bring any sick children immediately to the heath post for free medical care. Soon, the wooden benches were full of mothers with sick children waiting for a consultation. Panic had broken out in the village as a child had died in the night and people were desperate to get their children seen first. Many were severely dehydrated, malnourished and suffering from complications such as pneumonia or diarrhoea. 50 cases were confirmed that day alone, and five seriously ill children were immediately put onto IV drips. The next day, the four who had survived the night were transferred via boat to the MSF supported hospital in Baraka.

MSF has treated around 300 children who have been affected by the measles epidemic in and around Lubilo. Julienne, an 8-year old girl was one of them…

Her mother brought her to the MSF health post when a rash appeared on her face and then spread rapidly to her arms, legs and rest of her body. She had a high fever, infected eyes, had been coughing for several days and had difficulties breathing. She was very lethargic and had been unable to eat. Concerned by her fragile state, the team transferred her by boat to an MSF supported hospital in Baraka for treatment.

Julienne responded well to treatment and fully recovered. She has now returned with her mother to Lubilo.

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