Zambia Measles Outbreak – DREF Operational Update (MDRZM028)

Please refer to the attached file. Description of the Event Date when the trigger was met 08-07-2026 What happened, where and when? A measles outbreak was confirmed in Shangombo District, Western Province, Zambia, following identification of the index case during Epidemiological Week 19 of 2026 (May 4-10, 2026). The index case was a 6-year-old female from Kapengela Village who presented at Shangombo District Hospital with clinical signs consistent with measles, including fever, maculopapular rash, cough, conjunctivitis, and coryza. Her vaccination history was unknown. A blood specimen collected from the case was tested at the University Teaching Hospital (UTH) Virology Laboratory and confirmed positive for Measles IgM antibodies on 16 May 2026, leading to the formal declaration of the outbreak. On the 27th of April, 2026 Situlu1 Health Post received a client form Kalungulungu village of Nina district in Angola. The signs of measles started on the 14th April. The patient travelled with three others who also had cough and runny nose. Samples were collected from the index suspected case and the three contacts, transported to the laboratory on the 11th May, 2026. Prior to confirmation of the outbreak, on 6 May 2026, Shangombo District received an unverified alert of a suspected measles outbreak across the border in Rivungu Municipality, Angola, involving six suspected cases among children aged 2–6 years. The alert was verified through the electronic Integrated Disease Surveillance and Response (eIDSR) system, triggering activation of the Public Health Emergency Rapid Response Team (PHERRT) to investigate and coordinate response activities. Since confirmation of the index case, the outbreak has expanded within Shangombo District, with increasing numbers of suspected and confirmed cases reported which continues to rise even after the vaccination campaign which was conducted between 6th to 11th July 2026. As of 24/08/2026 Shangombo had 1313 cumulative cases, 26 confirmed cases and 13 deaths with a CF rate of 1%. With the increasing cases in the district, Zambia National Public Health Institute, a specialized Government Institution mandated to lead and coordinate public health security in Zambia made a formal request for support to the National Society on the 8th July 2026 highlighting the gaps. N’gumbele Health Post has been proposed for inclusion in the ongoing measles response based on the epidemiological and operational situation documented at the facility. The health post recorded 36 measles cases, with cases reported between 3 July and 23 August 2026. Of these, 4 were confirmed cases, 15 were epidemiologically linked, and 17 were clinically compatible, indicating a significant measles burden within the health post catchment area. The situation is particularly concerning among children, with 14 cases recorded among children aged 0–4 years and 4 cases among those aged 5–9 years. In addition, Nangandu and Masuku have been identified as hotspot villages, highlighting the need for intensified community mobilisation and vaccination messaging in these areas. The situation at N’gumbele is also associated with important operational challenges, including limited staffing, inconsistent vaccination ivities, difficult access due to flood plains, streams and sandy terrain, and a non-functional cold chain. The facility also serves a population that includes people from across the border, with the assessment noting a porous border and reported cases from Angola. Importantly, N’gumbele which has a population of 3, 372 is contributing to the measles case load being managed within Shangombo District. Cases identified at or around N’gumbele are referred to Mambolomoka Health Facility in Shangombo for further management. Therefore, excluding N’gumbele from the DREF-supported response would leave an important source of cases outside the intervention area while cases continue to be detected and referred into a facility that is within the DREF geographical scope. This creates a gap in the response, as resources would be directed towards managing cases at Mambolomoka without adequately addressing the community and facility-level factors contributing to those cases. The continued movement and interaction of populations across the Zambia–Angola border further increases the importance of addressing N’gumbele as part of the wider response. Given the porous border and the transboundary population served by the facility, measles transmission can continue across communities even after transmission has been controlled in the immediate DREF-supported areas of Shangombo. As a result, failure to include N’gumbele could contribute to continued transmission, re-introduction of cases and prolonged referral of patients into facilities such as Mambolomoka. Furthermore, N’gumbele is already recognised within the proposed response adjustments, including the planned deployment and training of additional personnel, demonstrating that the facility has been identified as relevant to the ongoing measles response. Based on the epidemiological linkage, continued referrals to Mambolomoka, the cross-border movement of populations, and the risk of continued transmission and re-introduction of measles into Shangombo District.

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