Assessing the Effectiveness of Anti-epidemic Measures in a Measles Outbreak

Relevance. The high contagiousness of measles makes organized groups of children and adults epidemiologically significant due to the ease of aerosol transmission and the risk of persistent secondary transmission. The literature describes various measles outbreaks, varying in duration and number of cases. The evaluation of the anti-epidemic measures implemented in these outbreaks was assessed based on the timeliness of the initiation of anti-epidemic measures, including vaccination of contacts of eligible individuals, the outbreak duration, the ratio of outbreaks with one case to outbreaks with spread of infection, and the number of cases in absolute and relative terms. However, we did not find any studies evaluating the quality of anti-epidemic measures in terms of the magnitude of prevented financial losses and the number of prevented cases.

Aims. To evaluate the effectiveness of antiepidemic measures using the example of a measles outbreak among university students.

Materials and methods. The materials used for this study included emergency notifications, a report on the investigation of the outbreak with the establishment of a cause-and-effect relationship, «Epidemiological Investigation Cards for Measles Cases and Suspected Cases», and laboratory test results for the presence of IgM and IgG to the measles virus. The study utilized descriptive retrospective epidemiological analysis, serological, and statistical methods.

Results. A measles outbreak was recorded in May-June 2024 among 266 dormitory residents. The total number of contacts, including the university, was 502 and was small relative to the total number of students and staff. This was due to the end of academic term and the academic exam period from May 12th to 30th, followed by examinations from June 3rd. Immediately after receiving the emergency notification, an epidemiological investigation was initiated and anti-epidemic measures were implemented. The contact circle and the boundaries of the outbreak were determined. Since the source of infection for the first three simultaneous cases of measles was unclear and all contacts had been vaccinated against measles twice, serological testing was conducted using the ELISA method to detect M antibodies and G anti-measles antibodies. The suspected source of infection was identified among the international students in the dormitory who had not sought medical care. 48 students with questionable G antibody results were vaccinated, and a restrictive measure in the form of distance learning was introduced.

Discussion. Although serological testing of contacts is not included in the list of mandatory anti-epidemic measures, given the risk of infection spread, it was conducted. This allowed us to identify not only suspected sources of infection but also individuals who were conditionally seronegative for the measles virus but had been vaccinated against it. This study is the first to use an objective approach to assessing the effectiveness of anti-epidemic measures, expressed in economic terms as the amount of losses prevented. We believe this is very important and promising.

Conclusion. The anti-epidemic measures proved effective, limiting the outbreak to 13 days, preventing the infection of 1,822 people, and preventing losses totaling 173,454 rubles.

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