Serial Case of MR Immunization Not Carried Out Related to Incidence of Measles Complicating as Pneumonia in Ende East Nusa Tenggara: Awareness of Re-emerging Disease After Covid-19 Pandemics

Abstract

BACKGROUND:  Indonesia is one of the nations which reported measles outbreaks by the CDC in October 2023. During COVID-19 pandemics in Indonesia reported low MR immunization coverage about 67.32%-68.67%. Several provinces in Indonesia including East Nusa Tenggara has been reported measles outbreak in 2022. This serial case aimed to report two cases of measles complicating as pneumonia in Ende General Hospital during less than two weeks. These cases related to MR immunization not carried out in both of the patient.

CASE: We reported two cases of measles complicating as pneumonia hospitalized during less than two weeks. Both of the them suffered from high grade fever, typical morbiliform maculopapular rash has risen from posterior side of the auricula to body trunk and the rest of the body, purulent eye discharge, cough, and coryza. The MR immunization did not carried out in both of the patients. The similar finding on physical examination showed body high grade fever, typical maculopapular rash, chest wall retractions, and ronchi were heard during auscultation. The laboratory result revealed leucopenia and lymphocytosis, and chest radiography revealed bilateral patchy infiltrate that characterized as pneumonia. Both of patients hospitalized in isolation room, intravenous fluid, parenteral ampicilin and gentamycin, and vitamin A were given.

CONCLUSION: Certain provinces in Indonesia announced measles outbreak in 2022. This deserves strategic plan to overcome. Promoting immunization, expanding basic and advanced immunization coverage and catching up with the target in certain areas are all essential for avoiding measles re-outbreaks.