Measles outbreak: Here’s how you can protect your children

A few districts in at least five states of India are witnessing an outbreak of measles, an acute viral respiratory disease that strikes and sometimes kills small children, prompting authorities to initiate immediate measures to protect vulnerable kids.

The outbreak, being reported in the country after a long time, has already killed at least 12 children in Mumbai alone while more than 1,200 kids are ill in the city due to the ailment characterised by fever, malaise and rashes over the body.

There is no confirmation of kids dying due to the disease in any other parts of the country, so far, but four districts, Ranchi in Jharkhand, Malappuram in Kerala, Nuh in Haryana and Ahmedabad in Gujarat, have seen many kids getting hospitalised.

On their part, authorities — both at the Centre and state levels — are worried because the outbreak threatens to derail the target to eliminate the disease from India by 2023.

What is measles and why is it serious?

Though vaccine-preventable, measles may be of serious consequence for small children. The highly contagious disease spreads through the air by respiratory droplets produced from coughing or sneezing and symptoms may appear nearly 10-14 days after exposure. They include cough, runny nose, inflamed eyes, sore throat, fever and a red, blotchy skin rash.

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There's no treatment to get rid of an established measles infection but over-the-counter anti-pyretic (fever reducer) or supplementation with vitamin A may help with symptoms.

Most infected kids, mainly those who are unvaccinated or partially vaccinated, recover but some who go on to develop pneumonia and swelling of the brain may die. The disease incidence is extremely rare in kids who are fully vaccinated.

Virologist Dr T Jacob John, who is the co-chair of the India expert Group on Measles and Rubella, pointed out that while normally the case fatality rate due to measles is 1-3 percent, it may go as high as 5-10 percent in instances of an outbreak.

He said as measles messes up the body's immunity for several years, in some kids other infections — even months after the recovery — can also prove fatal.

What is the vaccine available against measles?

Under the Union government’s Universal Immunisation Programme, a vaccine against measles and rubella (MR) vaccine is offered in two doses: the first one at 9-12 months and the second dose at 18-24 months.

The Union health ministry says that as per the estimates by the World Health Organization and the United Nations International Children's Emergency Fund, the coverage of the first dose of the MR vaccine was 89 percent in India while it was 82 percent for the second dose.

The vaccine in the form of mumps-measles-rubella (MMR) is also available in the private sector.

Senior paediatrician and medical researcher Dr HPS Sachdeva said that in all likelihood, the current outbreak may be a result of slip up in MR vaccination coverage in 2020 and 2021 due to Covid-19-related disruptions, lockdown and the resulting impact on the government’s UIP.

What can you do to protect your kid?

Two doses of MR vaccine for all kids are suggested at 9-12 months and 18-24 months. The Indian Academy of Paediatricians, on the other hand, prescribes MMR vaccine in three doses, the first one at 9 months followed by the next at 15 months and the last one between 4 and 6 years.

Sachdeva said people in affected areas can take some measures to reduce the chance of infection in their young kids.

“For example, overcrowding in affected areas should be totally avoided. There should be community surveillance for identifying sick kids and the use of masks should be promoted as far as possible,” he said.

What measures is the government taking to end the outbreak?

Under the measles outbreak management initiative, the Union government has now decided to offer an additional dose of MR vaccines to all kids between children of 9 months to 5 years in vulnerable areas which include geographies that are showing the recent increase in numbers of measles cases. This dose would be in addition to the primary vaccination schedule of two doses.

The Centre has said that states will soon notify the districts or areas where the additional MR vaccine dose is being recommended.

In addition, as many children reporting sick are under 9 months of age and hence not eligible for the MR vaccine, in areas where young infants comprise more than 10 percent of total cases, a dose of this vaccine will be given to kids aged 6-9 months. This dose, too, will be an extra cover of protection while the infants will later need their routine vaccination at the prescribed age.

The states are soon likely to identify and announce the clusters where MR vaccination will be provided to children aged 6-9 months.

Sachdeva said the swift decision by the government to provide an additional dose of MR vaccine was appropriate.