On April 16, 2020, the communicable disease department of Al-Buraimi Governorate, Oman, was notified of three cases of measles. On laboratory confirmation on 19 April, further field investigation was conducted. Oman has experienced few cases of measles since 1995; However, Al Buraimi has experienced imported measles cases in recent years. We conducted this study to investigate the epidemiology of imported measles cases at Al Buraimi, Oman, in April 2020.
Methodology
This case series retrospectively investigated reported measles cases. Epidemiological investigation began by meeting the families of the affected children. Obtained data included clinical symptoms, exposure information, travel history, immunization, and history of contact with others.
Results
The first 3 cases were reported on April 16, 2020. These children were from Afghanistan and had been exposed to three other siblings with similar symptoms (fever, cough, and rash). Later, on April 23, 2020, two Pakistani children demonstrated fever and cough, which brought the total number of positive measles cases to 8. All diseased children were either partially vaccinated or were unvaccinated.
Among the positive cases, 75% were girls; 6 were Afghani nationals and 2 were Pakistani. Most were between 10-19 years old (75%). Virus isolation and genotyping identified all the cases as Measles B3 genotype and traced the virus back to Pakistan as the country of origin. However, most cases were reported between Afghani nationals (75%) due to their low vaccination status. The cases were given MMR vaccine along with their contacts who did not have vaccination records or were unvaccinated.
Conclusion
This study demonstrated that the greatest challenge of measles elimination in Oman is non-Omanis expatriates and unvaccinated children. It should therefore be a priority to vaccinate all expatriates' children. When everyone is vaccinated in Oman, nationals or foreigners, only then can the goal of a measles-free country be realized.