t least 13 children have died over the last six months in a measles outbreak in Peshawar, Dera Ismail Khan, Mardan and Malakand divisions.

A recent report of the Expanded Programme on Immunisation in Khyber Pakhtunkhwa says that there have been 3,889 suspected cases of measles. Out of those 1,445 were found positive. According to the EPI report, 13 deaths were attributed to measles across Khyber Pakhtunkhwa.

At least 185 positive measles cases were reported in DI Khan, 147 in Peshawar, 113 in Charsadda, 92 in Swabi and 83 in Lower Dir. The Health Department says that children older than two years and younger than five years were the most affected group.

A majority of measles-positive cases were reported in the southern districts. Farukh Jamil, the director of DI Khan Hospital, says 327 positive measles cases were reported. “At least five children diagnosed with measles have died,” he says.

To contain measles, the Health Department has launched an outbreak response initiative in 24 districts and 118 union councils. Health Minister Syed Qasim Shah has directed the EPI to establish district-level outbreak response committees and ensure prompt action in case of any health emergency, including measles.

According to a Health Department report, at least 200,000 children received measles vaccinations during the intensified outreach activity from February 12 to 24.

Despite these efforts, challenges persist, particularly regarding the lack of isolation wards in major teaching hospitals in Peshawar. This deficiency has accelerated the spread of measles among children.

Measles is a highly contagious disease. It spreads easily when an infected person breathes coughs or sneezes. It can affect anyone but is most common in children.

The health minister has asked for setting up isolation wards in all MTI hospitals. On March 19, the minister wrote a letter to the health secretary directing that all medical teaching institutions, Category A and DHQ hospitals ensure the establishment of isolation wards to control the spread of measles in the province.

Dr Arif Khan, the EPI director, says the measles outbreak is a national problem. He says during the Covid-19 pandemic, the government had suspended the immunisation campaigns. Now 75 per cent of measles-positive cases have been reported among children under five. “We have recently completed an intensified outreach campaign against measles in the southern districts of Khyber Pakhtunkhwa. The children were vaccinated with MR1 and MR2,” says Dr Arif Khan.

To bridge the immunity gap in children older than 23 months, a special initiative called the Big Catch-up is under way. The first phase of this initiative is scheduled to be completed in June 2024.

Dr Arif Khan says Khyber Pakhtunkhwa is the first province to implement the National Electronic Immunisation Registration. “The NEIR aims to register all vaccinated children under 2 years, facilitating nationwide tracking and ensuring completion of vaccination courses,” he says.

“However, there are persistent obstacles, including strikes by vaccination staff and logistic constraints,” says Dr Khan.

Javed Sattar, deputy medical superintendent of the District Headquarters Hospital Charsadda says a dedicated isolation ward has been established to contain measles and infectious diseases.

A World Health Organisation report says the Covid-19 pandemic led to setbacks in surveillance and immunisation efforts. The suspension of immunisation services and decline in immunisation rates and surveillance across the globe left millions of children vulnerable to preventable diseases like measles. The areas with low immunisation allow the virus to circulate, increasing the likelihood of outbreaks and putting all unvaccinated children at risk.

According to the WHO, in 2021, at least 128,000 measles deaths were reported globally, mostly among unvaccinated or under-vaccinated children under the age of five years. In 2022, about 83 per cent of the world’s children had received a dose of measles vaccine by their first birthday through routine health services, the lowest since 2008.

The writer is a freelance multimedia journalist. He tweets @daudpasaney