Objective To analyze the epidemiological characteristics of a measles outbreak in international schools in Minhang district of Shanghai during May - June in 2019.
Methods An epidemiological investigation was conducted in all the suspected measles cases detected in the outbreak. Blood samples and throat swabs were collected from the cases to detect measles antibody and viral nucleic acid. Clinical and epidemiological characteristics of measles cases were discussed and described. Risk factors of measles transmission were assessed.
Results A total of 18 suspected measles cases were reported in the outbreak, in which 12 were laboratory confirmed (66.67%). Three cases studied at Shanghai American School, 9 cases studied at the British International School Shanghai. In the 12 confirmed measles cases, a total of 11 were with foreign nationality（91.67%）. The peak time of measles outbreak was from May 28 to June 6, during which 9 cases were confirmed (75.00%). The age of the 12 cases ranged from 4 years to 15 years. Among them, 1 had 3-dose measles-containing vaccine (MCV) immunization history (8.33%), 7 had 2-dose MCV immunization history (58.33%), 4 cases had 1-dose MCV immunization history (33.33%).
Conclusion The investigation results suggested that the cause of the outbreak might be the common exposure to the index case during school sports meeting and Shanghai tennis club activity, indicating some students are susceptible to contracting measles infection in international schools. It is essential to strengthen joint prevention and control of infectious diseases in international schools according to local management requirement. It is strongly suggest that Shanghai education commission as well as Shanghai health department to formulate regulations and laws on vaccination certificate admission and supplementary vaccination in foreign students. Increasing the coverage rate of 2-doseMCV shots is an effective measure to prevent and control measles outbreak in schools.
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