Rubella Outbreak in a Boarding School, Malaysia, April 2007

Abstract

An outbreak of febrile illness associated with maculopapular rash was reported in a boarding school from 9-17 Apr 2007. An investigation was initiated to confirm the outbreak, determine the etiologic agent and mode of transmission and institute public health actions. Information on clinical data and vaccination status were collected through case finding among students and staff of the school. Those people with maculopapular rash associated with fever from 19 Mar to 2 Apr 2007 were defined as case and blood serology for measles and rubella were sent to the national reference laboratory for confirmation. Eighty nine cases were identified out of which 72% were males. Eighty-eight percents presented with low grade fever, 34% with mild upper respiratory infection, 25% with neck lymphadenopathy and 14% with conjunctivitis. 46% were positive for IgM rubella with males significantly more than females (p<0.001). All males did not have rubella immunization. Rubella was confirmed as the cause of outbreak and cases were treated symptomatically and isolated for seven days from onset of rash. Health education on self hygiene and possible risk to pregnant woman was given to students and staff. Rubella vaccination status of students entering boarding school was recommended irrespective of gender.   

Keywords: rubella, measles, maculopapular rash, control measure, Malaysia