Why is India witnessing measles outbreaks in kids

    In 2014, a researcher Sudhir Sane from Jupiter hospital in Mumbai’s neighbouring district of Thane, conducted an epidemiological study of measles outbreak in the area and published it in a journal on paediatric infectious diseases.

    He examined 32 patients who were diagnosed with measles and had approached doctors in private hospitals and standalone clinics for treatment. At the time he found that ‘nearly 33 per cent of these patients got the disease in spite of vaccination. Comparison between vaccinated and non-vaccinated children showed higher age of the disease in those who got vaccinated.

    The study also highlighted that nearly 20 per cent children got the disease before the suggested age of vaccination.

    Measles is a highly infectious disease with high morbidity and mortality. As per Sane’s report, ‘In 2012, global measles-related mortality was estimated to be 1,57,700. India contributed to more than one-third of the estimated cases.’ Outbreaks of measles continue to occur throughout India but they are sparsely recorded. One such outbreak was seen in 2012–2013 in Thane, Maharashtra. And the most recent has been the one in which Mumbai reported more than 500 cases of measles until November 26 this year and eight deaths suspected to be caused by it, as per the city’s health department and the BMC (Brihanmumbai health department).

    As per the state health department, measles outbreak was reported from 26 places in Maharashtra – 14 in Mumbai, seven in Bhiwandi (Thane district) and five in Malegaon town (Nashik district). Eight municipal wards in Mumbai were affected by measles and five outbreaks were found in M-East ward and three in L ward. Eight suspected patients of measles succumbed to death. “Out of these, only one child had taken one dose of measles vaccine, while the rest were unvaccinated,” said the health department bulletin.

    Emphasis is being given to vaccinating kids in the lower age groups that, is between nine months and five years. Experts say that due to two years of Covid, during which the emphasis was not so much on other vaccinations, many children may have missed out on the vaccine and the virus has caught up with them.

    In 2021, Maharashtra had recorded 92 cases of the infection, while this figure was 193 in 2020, said the health bulletin by the BMC. In a telephonic interview with THE WEEK, Dr Suresh Birajdar, neonatologist and paediatrician from Mumbai’s Motherhood hospital said that vaccinations tend to protect children from the measles infection which can otherwise get worse and lead to a lowering of the immunity.

    In the 1990s, India’s national vaccination programme made one dose of the measles vaccine part of routine vaccinations through much of the country to help reduce the number of measles deaths. However, it was one of the last countries to add a second dose of measles vaccine as recommended by the World Health Organisation. In 2008, the Indian government announced it would introduce a second dose of measles vaccine to its routine vaccine schedule for children from 2010 onwards.

    However, as per research conducted prior to Covid, a high number of infections were reported even among those who were vaccinated. “Vaccination helps to a large extent by keeping the child infection free. It is our shield from the virus. During covid, this shield was not put to use for sometime,” said Dr Birajdar. As per a report by Anindya Sekhar Bose affiliated with the World Health organization in New Delhi, Results from a case-based measles surveillance system in Pune district (November 2009 through December 2011) was undertaken and of the 1,011 suspected measles cases reported to the surveillance system, 76 per cent were confirmed measles. Of the confirmed measles cases, 95 per cent were less than 15 years of age and

    Thirty-nine per cent of the confirmed measles cases were vaccinated with one dose of measles vaccine (MCV1). ‘Surveillance demonstrated high measles incidence and frequent outbreaks in Pune where MCV1 coverage in infants was above 90 per cent.

    Results indicate that even high coverage with a single dose of measles vaccine was insufficient to provide population protection and prevent measles outbreaks,’ wrote Bose in her paper.

    Measles is an acute viral respiratory illness characterised by fever as high as 105°F and cough, conjunctivitis, rashes and lowering of the immunity. The rash usually appears about 14 days after a person is exposed, starting on the face and upper neck and slowly spreads downwards.

    Young children lacking proper nourishment including vitamin are at high risk of contracting measles, especially those with weak immune systems. The Centre recently directed states to administer an additional dose of measles and rubella vaccines to all children aged nine months to five years in vulnerable areas. This will be in addition to the primary vaccination schedule of the first dose at nine-12 months and the second dose at 16-24 months.

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