Number of measles cases on the rise

Rawalpindi

The incidence of measles – a highly contagious respiratory infection among children is continuously on the rise hinting towards a possible outbreak of the disease as the weather conditions from February to April are considered as the most suitable for its transmission in this region of the world.

Around five to 10 per cent of the total patients reaching allied hospitals in town in need of indoor treatment are with measles and its complications, said Head of paediatrics Department at Rawalpindi Medical College and allied hospitals Professor Dr. Rai Muhammad Asghar while talking to ‘The News’ on Saturday.

He said all the child patients so far diagnosed with measles at the allied hospitals were found to be unvaccinated against measles through the Expanded Program on Immunisation. The more alarming fact is that a number of child patients diagnosed with measles were below nine months of age and they were with severe pneumonia, a complication of measles, he said.

It is important that measles vaccine is administered to children twice, first at the age of nine months and then at the age of 15 months and two doses of vaccine is a must for protection against the disease.

Dr. Rai said the incidence of measles among children below nine months of age is alarming as infants get immunity against the infection through mothers’ placenta and are protected against measles for the first six months. That is why vaccination against measles is started at the age of nine months, he said.

He said at present a few child patients with measles and its complications are on ventilators at Holy Family Hospital. The situation may get worse and the child population in this region of the country may face an outbreak of the infection if proper attention is not given to the problem, he said.

The allied hospitals are receiving 15 to 20 child patients per day on average with measles and severe complications and it is time to create awareness among parents on various aspects of the disease along with a vaccination campaign, said Dr. Rai.

He said many patients may recover from measles after seven to 10 days however sometimes it can lead to serious complications including pneumonia, infection of the membranes surrounding spinal cord and brain known as meningitis or infection of the brain itself that is encephalitis.

Studies reveal that other common complications of measles include diarrhoea and vomiting that may lead to dehydration, middle ear infection, eye infection, inflammation of the voice box, infections of the airways and lungs and fits caused by a fever (febrile seizures).

Giving details about the onset of measles, Dr. Rai said the illness starts from runny nose, watering of eyes, mild cough and photophobia along with low-grade fever. On fourth day of illness, maculopapular rash appears on skin, first behind the ear then on face and the next day on chest and then on abdomen and legs. On eighth day of the illness or four days after appearance of the first rash, maculopapular rash becomes full blown, all over the body, he explained.

He said the characteristic feature of measles is that as the rash appears, the intensity of fever increases and fever remains high even up to 102 or 103 degree centigrade. The patient suffers intense cough and refuses feeding and develops respiratory distress leading to pneumonia, he said. He added sometimes patient develops encephalitis.

All such patients who develop complications need indoor treatment in hospital, said Dr. Rai.

He added that measles may lead to vitamin A deficiency leading to ulceration of cornea and in this situation, the chance of blindness in a patient may not be ruled out. Such patients should be administered Vitamin A units as recommended that Rs100,000 international units to a child between the age of six months and one year while Rs200,000 international units to a child over one year of age, he said.

Measles is a highly contagious infection of the respiratory system. It is caused by a virus. Its symptoms include severe coughing, sneezing, runny nose, high fever, watery red eyes and full-body rash. The measles virus reduces the immunity and children who have had measles – especially those who are undernourished – may die of pneumonia, diarrhoea and encephalitis later on.

It is worth mentioning here that the child population in this region of the country faced the longest epidemic of the infection in known history in the summer of 2012 that lasted till August 2013. During the spike, around 1200 patients were registered at the allied hospitals of which 15 died of the infection and its co-morbidities.

The best prevention against measles is administration of measles vaccine at the age of nine months and 15 months, said Dr. Rai. Children who have missed the routine measles vaccination can be administered measles vaccine as catch-up activity at any time in life, he said.

He explained that measles is spread through coughing or sneezing either through aerosol transmission or through contact with fluids from an infected person’s nose or mouth. It is believed that up to 90 per cent of people without immunity sharing living space with an infected person may catch the infection, he said. “Two doses of measles vaccine is a must to safeguard a child from the disease.”

He said in case a child is diagnosed with measles, he or she should be isolated at home for at least a week and if the child patient is school-going, the child should not be sent to school for at least one week for the sake of other children as they may contract infection.