BURKINA FASO: DISASTER DECLARATION: MEASLES OUTBREAK

UNCLAS OUAGADOUGOU 000374


DAKAR FOR USAID/OFDA: RDAVIS AND SSOBOL
ACCRA FOR USAID/WARO: CBARRATT
USAID/W FOR DCHA/OFDA: A CONVERY, HPAPOWITZ, PMORRIS, SROGER AND
AFR/AA
USAID/W FOR AFR: HSUKIN AND MHARVEY
STATE FOR AF/W, AF/EPS
BRUSSELS FOR USAID PLERNER
GENEVA FOR NKYLOH
USUN FOR FSHANKS
ROME FOR USAID/OHA HSPANOS
SECDEF FOR SOLIC
JOINT STAFF WASHINGTON DC FOR J3/J4/J5
SNC FOR JBRAUSE

E.O. 12958: N/A
TAGS: SOCI EAID AMED PGOV UV
SUBJECT: BURKINA FASO: DISASTER DECLARATION: MEASLES OUTBREAK


1. This is an action request. Please see paragraph 10.


2. Summary: The largest measles outbreak in Burkina Faso in over a
decade is entering its 20th week and the total number of cases
continues to increase with 3,812 new cases reported for the most
recent reporting week. The 34,451 total cases reported to date have
already exceeded the 1996 outbreak which recorded 32,415 cases. The
largest concentrations of measles cases are in the one to four year
old group (24 percent) and in the 15 to 24 year old group (23
percent). High levels of acute malnutrition and other chronic
illnesses including the possibility of an H1N1 influenza outbreak
increase the risks associated with measles. With no end to the
epidemic in sight, the Government of Burkina Faso lacks the capacity
to purchase vaccines required to implement a large scale measles
vaccination campaign as outlined in recently revised WHO protocols.
The Charge d'Affaires therefore declares that a disaster exists in
Burkina Faso and requests USD 250,000 for the procurement of
urgently needed vaccines. Funds would be provided to the United
Nations Children's Fund (UNICEF) to procure vaccines and vaccination
supplies. End Summary.

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Scope of the Measles Epidemic
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3. The Ministry of Health (MOH) and the World Health Organization
(WHO) began formally tracking the current measles outbreak on 29
December, 2008. Since that time, the total number of reported cases
has continued to increase with 3,812 new cases reported for the most
recent reporting week (week 18) making this the most serious measles
outbreak in over a decade. Since the beginning of the outbreak, a
total of 35,451 cases have been recorded with 250 deaths for a case
fatality rate of 0.0071 percent. The number of cases in this
outbreak has already exceeded the 32,415 cases recorded in the 1996
epidemic.


4. This year's measles outbreak has impacted all age groups,
particularly children between one to four years old (24 percent of
cases) and young adults from 15 to 24 years old (23 percent of
cases). According to statistics provided by the Ministry of Health
(MOH) and UNICEF, between 85 and 90 percent of all reported cases
occurred in unvaccinated individuals. Seventeen percent of children
0-11 months of age who contracted the disease had been previously
vaccinated, as had 20 percent of 1-4 year and 28 percent of 5-9 year
olds.

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Aggravating Factors
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5. According to experts, complications from the measles are most
likely to occur in children under age five and adults over 20 years
of age. In addition, children with poor diets or weakened immune
systems are at greater risk of developing complications. Measles
can also weaken victims' immune systems for up to six months.
Current Global Acute Malnutrition (GAM) rates in BF are at critical
levels (11.4 percent rural, 12.4 percent urban). Thus, children who
are already experiencing critically high rates of acute
malnutrition, malaria, intestinal parasites, and diarrhea face
increased risks from these and other life threatening conditions
(including the possibility of an H1N1 influenza outbreak).

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Current Response and Plan for Future Action
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6. To date, the response to this year's epidemic has been through
traditinal case management procedures administered primarily by the
MOH with limited treatment provided by number of NGOs. This
response has helped contro the mortality rate and limited the
development f certain complications; however, it has not slowe the
spread of measles.


7. In order to stop th spread of the disease, a plan for a large
scale vaccination campaign targeting the most affected areas has
already been developed and adopted by the MOH, WHO, and UNICEF.
This vaccination plan implements a newly adopted WHO protocol that
uses mass vaccinations to control a measles outbreak. However, the
GOBF lacks the financial resources to purchase vaccines and other
supplies required to carry out the campaign; and has called on the
international community for assistance.


8. Under the plan, a vaccination campaign covering all people age
six months to 24 years old will be undertaken in the nineteen health
districts with the longest lasting and highest measles and mortality
rates. Eighteen other health districts will be targeted for
selective vaccinations given to children from 6 to 59 months who
have not previously been vaccinated when they arrive at health or
vaccination centers. The vaccination campaign will be carried out
by the MOH, which according to WHO and UNICEF, has a proven record
of conducting large scale vaccination campaigns including
inoculating seven million people against Yellow Fever. Under the
plan, all measles vaccinations are scheduled to be administered
during a five day period.


9. According to UNICEF, in addition to the vaccination campaign, an
investigation of the current outbreak is planned and is tentatively
scheduled to be conducted by a joint UNICEF/CDC/WHO team from 10 May
to 20 May.
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Action Required
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10. Based on a recent assessment of the ongoing measles epidemic and
in response to a request by the GOBF for assistance, the Charge
d'Affaires has determined that the outbreak in Burkina Faso is of
sufficient magnitude to warrant U.S. Government assistance. The
Charge d'Affaires therefore declares that a disaster exists in
Burkina Faso and requests USD 250,000 for the procurement of
urgently needed vaccines. Funds can be provided to the United
Nations Children's Fund (UNICEF) for the procurement of vaccines and
vaccination supplies.


11. UNICEF will work in close collaboration with WHO and the MOH to
ensure that the most vulnerable children and young adults in the
most affected districts are vaccinated. Together with USAID/OFDA
staff, the Embassy in Burkina Faso will continue to monitor the
current situation and report accordingly.

LAEUCHLI