Measles outbreak investigation in Akwon and Muntu sub-counties, Amolatar District, Uganda, November 2025–February 2026

A measles outbreak was confirmed in Amolatar District, Uganda, on February 6, 2026, following laboratory confirmation by the Uganda Virus Research Institute. A total of 120 cases were identified (5 confirmed, 29 probable, 86 suspected), predominantly affecting children aged 9–17 months, who recorded the highest attack rate at 360/100,000 population. Females accounted for 63% of cases, and Akwon Subcounty bore the greatest burden with an attack rate of 690/100,000. The epidemic curve revealed persistent low-level transmission from November 2025, with peaks in November and January, and a surge following a large social gathering a burial on January 31, 2026 which served as a key amplification event.

The outbreak was primarily driven by low measles-rubella (MR) vaccination coverage, with 52% of cases unvaccinated and only 19 children having received both recommended MR doses. Three subcounties lacked vaccinating health facilities, limiting immunisation access. Cultural and religious beliefs particularly among a Seventh-day Adventist subgroup further hindered vaccine uptake and delayed health-seeking. Gaps in surveillance, including an initial false-negative laboratory result in November 2025, contributed to delayed confirmation and response, allowing transmission to persist and expand across the district.