Measles outbreak investigation in Dwarahat block of District Almora, Uttarakhand.

Background: We report an assessment of measles outbreak during the months of February 2014 to April 2014 in Dwarahat block of district Almora and the response mounted to it. Materials and Methods: An intensive door‑to‑door search to six measles affected villages in Dwarahat block of district Almora, covering a population of 2,408 was carried out to identify the cases of measles by a rapid response team (RRT). A total of ten blood samples were randomly collected for detecting IgM antibody against measles. For all cases, information on personal details, place of residence, time of onset and status of immunization were obtained. Results: Overall attack rate (AR) was 2.8%. AR among the population of age‑group 0–16 was 7.2%. Statistically significant higher AR (16.26%) was seen for the age‑group of 0–5 years as compare to 6–10 and 11–16 years of age (AR‑8.71, relative risk‑0.53, 95% confidence interval‑0.32–0.88, P value‑0.012 and AR‑0.57%, relative risk‑0.035, 95% confidence interval‑0.00–0.14, P value‑0.000, respectively). Males were affected more often than females 35 [59.2%] vs. 24 [40.8%]. Measles‑related complications were seen in three children. No death was reported. Of the 10 samples, nine were positive for measles IgM antibodies by enzyme‑linked immunosorbent assay (ELISA). Conclusion: The recognition of early warning signals, timely investigation and application of specific control measures can contain the outbreak. The unvaccinated or partially protected human beings serve as the reservoir of measles virus. Hence, there is a need for sero surveillance for measles in Uttarakhand and one catch up measles immunisation campaign to prevent future outbreak.

Pre-septal cellulitis--varied clinical presentations.

Preseptal cellulitis has a typically benign course when treated with antibiotics, the clinical course depending on age of the patient, aetiology and the causative organism. In this study, 14 cases of preseptal cellulitis are documented with the age ranging from 2 to 55 years. The organisms isolated were Staphylococcus aureus (7 cases), Streptococcus pyogenes (2 cases) and Pseudomonas aeruginosa (1 case). In the remaining four patients no organism could be identified. All except four patients were cured within 6 weeks. Complications seen included lagophthalmos, lid abscess, cicatricial ectropion and lid necrosis in one patient each. The prognosis for preseptal cellulitis is good with appropriate antibiotics and surgical therapy.