Davuth - a 7-month-old baby boy in the village of Trataing Svay, Kampong Speu province was the first case reported in an outbreak of measles in Cambodia in 2016—the first the country had seen in more than four years. A swift and decisive response to the outbreak stopped measles from getting re-established in the country, thanks to efforts by the Government with support from the World Health Organization (WHO) and partners.
Cambodia: On a path to measles elimination
Measles is the most infectious disease on Earth, and until relatively recently, one of the most common diseases among children in Cambodia. But since 1998, the country has been improving its systems for detecting measles and expanding the reach of immunization services. In 2006, the Ministry of Health set out on a course to eliminate measles from Cambodia.
This approach paid off. Until the outbreak in 2016, Cambodia had not had a single laboratory-confirmed case of measles since November 2011. In March 2015, Cambodia was verified as having eliminated endemic measles, making it one of eight countries in the WHO Western Pacific Region to have achieved this goal.
But as long as measles virus circulates in other parts of the world, the job is not done. Cambodia is particularly aware of this, sharing a border with countries that still have endemic measles. Their systems are tested every time a new case of measles is imported. They must stamp it out fast to make sure measles does not make a come-back.
Outbreak and response
When Davuth was found to have measles in January 2016, it triggered an investigation by experts at the Ministry of Health and WHO. They found that he was not the only case in Cambodia. Over the course of a few months, more cases were detected across 16 provinces.
When Davuth first fell sick, his parents took him to a clinic close to his village, where he was admitted, but soon transferred to a paediatric hospital in Phnom Penh due to his worsening condition. As soon as his diagnosis was confirmed to be measles, National Immunization Programme staff and WHO led an investigation that began in the child’s village, where they visited all 47 households searching for additional suspected measles cases and identifying unimmunized children to be vaccinated. Thanks to their swift action, there were no other measles cases reported in that village. And, after 20 days, Davuth recovered.
Elsewhere in the country, the Government, supported by WHO and partners, immediately conducted vaccination drives, identifying and vaccinating children at-risk of measles in the communities where other cases were found. This helped protect the most vulnerable, but due to the virulence of the disease, measles cases kept popping up in different villages and districts.
At WHO’s suggestion, a planned nationwide immunization campaign was moved up from October 2017 to March 2017. In addition, the target population was expanded to include babies aged 6-9 months, to protect those most at risk of severe measles.
All told, there were 66 confirmed cases in the outbreak, 40% of which were children under the age of 9 months. The last case occurred on 8 June 2017. No new cases have been identified in the country since then, but authorities remain vigilant, and on the look-out for the next importation.
Looking ahead
The supplementary immunization campaign that was rolled out in the country in response to the outbreak reached children who had previously missed out. It raised the vaccination coverage rate in the country to more than 94.3% of children aged 6 months to 5 years. This level of coverage makes the population less vulnerable to future outbreaks.
Cambodia remains focused on improving its preparedness to respond to outbreaks and providing universal access to vaccination so that every child can benefit from protection. And WHO will continue supporting all countries in Western Pacific to strengthen their systems and increase their population’s immunity against measles, to bring the Region closer to the goal of eliminating measles once and for all.
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