Measles surge in India: Govt directs states to boost fever, rash surveillance

With the rising cases, the central government has directed affected states to strengthen fever and rash surveillance, Hindustan Times has reported citing people familiar with the matter. 

“The Union health ministry has been asking states to heighten surveillance so that cases are not missed, and also detected early so that treatment reaches on time. This will help save lives,” official aware of the matter said told HT, requesting anonymity.

The two states, Maharashtra and Kerala have seen rise in measles cases. As per the health department’s bulletin on 3 December, Maharashtra has so far recorded 807 measles cases and 18 deaths linked to the disease, most of them from the Mumbai Metropolitan Region (MMR). Earlier on November 28, a one-year-old girl died in Mumbai after contracting measles.

On 30 November, Kerala’s Malappuram reported 160 cases of measles reported in the district. The Indian Academy of Paediatricians stepped in and appealed for vaccination amid the reportedly alarming hike in the cases. Dr Jose Ouseph, State President of Indian Academy of Pediatrics, Kerala told ANI that so far there hasn’t been any mortality due to measles in the district. Apart from these 2 states, increased numbers of measles cases have also been reported in Bihar, Gujarat, Haryana, Jharkhand.

Earlier, the Central government had also deployed high-level teams to Ranchi (Jharkhand), Ahmedabad (Gujarat) and Malappuram (Kerala) to look into the surge in measles cases among children. 

Measles is one of the most contagious human viruses and is almost entirely preventable through vaccination. However, it requires 95 percent vaccination coverage to prevent community outbreaks.

What are the symptoms of Measles? 

The most common measles virus symptoms include high fever, tiredness, severe cough, red or bloodshot eyes, and a runny nose. It can also cause red rashes on the body, which start at the head and then spread to various other body parts. Other symptoms include sore throat, white spots in the mouth, muscle pain etc.

When do it surges?

According to the health ministry, the disease is known to witness a surge in case numbers during the period of November to March, annually. Hence, an active fever and rash surveillance mechanism needs to be strengthened for early case identification.

Why is the country seeing rise in Measles infections?

According to official sources, there has been a massive drop in the vaccination rate in the past few years, owing to which many children are completely unprotected against the virus. Citing the same, Health ministry Joint Secretary P Ashok Babu asserted, “It is also clear that in all such geographies, the effected children were predominantly unvaccinated and the average coverage of Measles and Rubella Containing Vaccine (MRCV) among the eligible beneficiaries is also significantly below the national average.”

In a recent release, WHO said that in 2021, there were an estimated 9 million cases and 128,000 deaths from measles worldwide. Twenty-two countries experienced large and disruptive outbreaks. In the same year, a record high of nearly 40 million children missed a measles vaccine dose: 25 million children missed their first dose and an additional 14.7 million children missed their second dose.

“The paradox of the pandemic is that while vaccines against COVID-19 were developed in record time and deployed in the largest vaccination campaign in history, routine immunization programmes were badly disrupted, and millions of kids missed out on life-saving vaccinations against deadly diseases like measles,” WHO Director-General Dr Tedros Adhanom Ghebreyesus said. “Getting immunization programmes back on track is absolutely critical. Behind every statistic in this report is a child at risk of a preventable disease.”

Steps to control the spread and vaccine:

Earlier on 23 November, the Centre had strictly directed the states and UTs to consider administering one additional dose (special dose for measles and rubella vaccination) to all children of 9 months to 5 years in vulnerable areas showing recent increase in numbers of measles cases. 

The union health ministry had further directed to identify cases of measles and conduct “outbreak response immunization” (ORl) mode. This dose would be in addition to the primary vaccination schedule of first dose at 9-12 months and second dose at 16-24 months.

“One dose of MRCV to be administered to all children aged 6 months and up to less than 9 months in those areas where the Measles cases in the age group of less than 9 months are above 10% of the total measles cases, to be identified by the State Govt / UT Administration. Since this dose of MRCV is being given to this cohort in “outbreak response immunization” (ORl) mode, therefore, these children should also be covered by first and second dose of MRCV as per the primary (routine) Measles and Rubella vaccination schedule,” the official said.

The disease is known to be fatal among children with moderate and severe malnourishment, therefore, health ministry had also directed for house-to-house search activities to identify such vulnerable children and provide pre-emptive care with nutritional and vitamin A supplementation along with early identification and prompt management of measles cases.

Furthermore, states are also directed for immediate isolation of laboratory confirmed cases must be done for at least 7 days from the date of identification.

(With inputs from agencies)

With the rising cases, the central government has directed affected states to strengthen fever and rash surveillance, Hindustan Times has reported citing people familiar with the matter. 

“The Union health ministry has been asking states to heighten surveillance so that cases are not missed, and also detected early so that treatment reaches on time. This will help save lives,” official aware of the matter said told HT, requesting anonymity.

The two states, Maharashtra and Kerala have seen rise in measles cases. As per the health department’s bulletin on 3 December, Maharashtra has so far recorded 807 measles cases and 18 deaths linked to the disease, most of them from the Mumbai Metropolitan Region (MMR). Earlier on November 28, a one-year-old girl died in Mumbai after contracting measles.

On 30 November, Kerala’s Malappuram reported 160 cases of measles reported in the district. The Indian Academy of Paediatricians stepped in and appealed for vaccination amid the reportedly alarming hike in the cases. Dr Jose Ouseph, State President of Indian Academy of Pediatrics, Kerala told ANI that so far there hasn’t been any mortality due to measles in the district. Apart from these 2 states, increased numbers of measles cases have also been reported in Bihar, Gujarat, Haryana, Jharkhand.

Earlier, the Central government had also deployed high-level teams to Ranchi (Jharkhand), Ahmedabad (Gujarat) and Malappuram (Kerala) to look into the surge in measles cases among children. 

Measles is one of the most contagious human viruses and is almost entirely preventable through vaccination. However, it requires 95 percent vaccination coverage to prevent community outbreaks.

What are the symptoms of Measles? 

The most common measles virus symptoms include high fever, tiredness, severe cough, red or bloodshot eyes, and a runny nose. It can also cause red rashes on the body, which start at the head and then spread to various other body parts. Other symptoms include sore throat, white spots in the mouth, muscle pain etc.

When do it surges?

According to the health ministry, the disease is known to witness a surge in case numbers during the period of November to March, annually. Hence, an active fever and rash surveillance mechanism needs to be strengthened for early case identification.

Why is the country seeing rise in Measles infections?

According to official sources, there has been a massive drop in the vaccination rate in the past few years, owing to which many children are completely unprotected against the virus. Citing the same, Health ministry Joint Secretary P Ashok Babu asserted, “It is also clear that in all such geographies, the effected children were predominantly unvaccinated and the average coverage of Measles and Rubella Containing Vaccine (MRCV) among the eligible beneficiaries is also significantly below the national average.”

In a recent release, WHO said that in 2021, there were an estimated 9 million cases and 128,000 deaths from measles worldwide. Twenty-two countries experienced large and disruptive outbreaks. In the same year, a record high of nearly 40 million children missed a measles vaccine dose: 25 million children missed their first dose and an additional 14.7 million children missed their second dose.

“The paradox of the pandemic is that while vaccines against COVID-19 were developed in record time and deployed in the largest vaccination campaign in history, routine immunization programmes were badly disrupted, and millions of kids missed out on life-saving vaccinations against deadly diseases like measles,” WHO Director-General Dr Tedros Adhanom Ghebreyesus said. “Getting immunization programmes back on track is absolutely critical. Behind every statistic in this report is a child at risk of a preventable disease.”

Steps to control the spread and vaccine:

Earlier on 23 November, the Centre had strictly directed the states and UTs to consider administering one additional dose (special dose for measles and rubella vaccination) to all children of 9 months to 5 years in vulnerable areas showing recent increase in numbers of measles cases. 

The union health ministry had further directed to identify cases of measles and conduct “outbreak response immunization” (ORl) mode. This dose would be in addition to the primary vaccination schedule of first dose at 9-12 months and second dose at 16-24 months.

“One dose of MRCV to be administered to all children aged 6 months and up to less than 9 months in those areas where the Measles cases in the age group of less than 9 months are above 10% of the total measles cases, to be identified by the State Govt / UT Administration. Since this dose of MRCV is being given to this cohort in “outbreak response immunization” (ORl) mode, therefore, these children should also be covered by first and second dose of MRCV as per the primary (routine) Measles and Rubella vaccination schedule,” the official said.

The disease is known to be fatal among children with moderate and severe malnourishment, therefore, health ministry had also directed for house-to-house search activities to identify such vulnerable children and provide pre-emptive care with nutritional and vitamin A supplementation along with early identification and prompt management of measles cases.

Furthermore, states are also directed for immediate isolation of laboratory confirmed cases must be done for at least 7 days from the date of identification.

(With inputs from agencies)