Medical Journal of Malaysia

MJM, Vol 70 Supplement 1 September 2015

Measles outbreak in Kudat District Sabah, Malaysia 2014: a new genotype for Sabah identified

Muhammad J*, Rosemawati A*, Tuan R*, Fadhilah K*, Rujenie Y*

*Malaysia EIP, Ministry of Health Malaysia


Introduction: Many measles cases are reported annually despite the good immunisation coverage. On the 5th of June 2014, Kudat Health Office was notified of four suspected measles cases from a local General Practitioner. Investigations were carried out immediately with the objectives to identify the source of the infection and to halt the outbreak as soon as possible.

Methods: All houses in the area were visited and the households interviewed using standard investigation form. Blood samples for IgM serology was collected from all suspected cases. Nasal swabs were also taken and sent to State Public Health Laboratory for virus isolation and test for genotype identification. Routine immunisation reports were reviewed. 

Results: All four suspected cases were siblings from a non-Malaysian nomadic family with their age ranging between one to 12 years old. Active case detection revealed two additional cases. All six suspected cases were positive for Measles IgM and had no history of being vaccinated. They had history of contact with sick relatives two weeks prior to onset of first case. Review of immunisation reports reveal that there were pockets of unimmunised population involving three localities. Genotyping analysis of isolated measles virus belonged to genotype B3 that never been in Sabah before.

Conclusion: This measles outbreak among children living in close setting and nomadic family in Sabah, Malaysia making measles elimination a challenge. The presence of new B3 genotype suggested that infection might have been imported into Sabah.  SIA have been implemented among children under 15 years in the identified areas especially areas populated with illegal immigrants that immunisation status not known.

Keywords: Measles, genotype, supplementary immunisation activities