Decline in immunizations may have caused measles outbreaks

A decline in routine immunization activities during the pandemic may have contributed significantly to the current measles outbreak in Malappuram. But public health experts say the goal of eradicating measles and rubella by 2023 isn’t realistic unless the health department looks beyond the obvious to study the altered epidemiology of the disease in the state. I warn you that it may not.

forgot to drink

Nearly 150 cases have been reported in the district since 15 October, mostly in unimmunized areas of the district. Health officials said nearly 100,000 of her children in the district had not received her first dose at nine months of age, and 11,600 children had not received her second dose. Stated. According to official data, measles vaccination coverage (both doses) in Malappuram is 76%.

Cases have been reported in all age groups, including infants as young as 3 months and the elderly. Health officials said there were three cases in which children who received both doses contracted mild illness. I reasoned that I might have been infected. However, epidemiologists warn that the measles vaccine is such a powerful vaccine that even one case of a fully vaccinated child developing measles should not be taken lightly.

There have been no measles outbreaks anywhere in the state for the past two years. This is due to the reduced interaction of people with mask mandates and the natural reduction in transmission of all respiratory viruses.

“This outbreak should not be viewed as a problem limited to Malappuram. Malappuram was the first to experience a flare-up for obvious reasons. Measles is historically a childhood disease, but measles vaccination coverage in the state is about 80%, so other districts We also see susceptible cohorts (people susceptible to the virus) in all age groups, so we might expect smaller outbreaks statewide,” said a senior public health expert. increase.

global revival

In 2018-2019, the pattern of global resurgence of measles was also mirrored in Kerala, where the state reported more than 600 cases in the first four months of the year alone. However, the majority of cases were reported from Thiruvananthapuram, a district that has consistently maintained good vaccination coverage. Cases have been reported among well-nourished people who received at least one vaccination in their lifetime. The majority of cases he was in the 19–35-year-old group, and 60% required hospitalization, including her ICU care.

Reports of measles in the elderly and in infants as young as 3 months, when maternal antibodies are thought to protect them, raise much concern. It also raises questions about the appropriate age for vaccination and whether a third dose is necessary to protect adults who may suffer serious complications after measles infection.

“In the post-Covid stage, we do not know how the measles virus will behave in older adults. Measles in early infancy, even before children reach the age of vaccination, is subject to more in-depth research.” Should measles vaccination start at a young age?Research is needed to determine whether it is advisable to give adults, especially young women, a booster vaccination given the age-variability of infection. It’s a problem,” said K. Purushothaman, former head of pediatrics at Thrissur Government Medical College.

Interestingly, a 2017 study (Indian Paediatrics 2021) conducted by SAT Hospital, Thiruvananthapuram, Rajiv Gandhi Biotechnology Center in 80 children aged 4 to 12 years showed that two doses were 13.6% of children who received the infantile measles vaccine had no measles-specific antibody titers at 7-8 years of age.

“The measles outbreak in Malappuram should be viewed as an opportunity for the state to adopt a research mode and delve deeper into the new unknown. We may never get rid of it,” said public health experts.