Measles on the rise again

While Filipinos were glued on their television watching the eruption of Mayon Volcano, four children in Davao City reportedly died of measles.

Some 224 others were suspected to be infected with the virus that causes the disease, according to Davao City Councilor Mary Joselle Villafuerte.

Of the 224 suspected cases, 16 have been confirmed.  Thirty two barangays, out of 182, have been reported to have measles cases with Barangay 23-C as having the most number with 60 cases.

The Regional Epidemiology Surveillance Unit of the Department of Health recorded 299 measles cases from January to December last year.  Like dengue, most of those infected with the virus, of which 21 strains have been identified by scientists so far, were children.

“About 17 percent of the cases belong to the bracket of children 0-5 months old, 16 percent of cases belong to children 6 to 18 months old.  About 31 percent were children 9 to 12 years old, 18 percent were 15 to 59 months old and 19 percent were children 5 years old and above,” the state-owned Philippine Information Agency reported.

Although there is already a safe and cost-effective vaccine available, measles remains as one of the leading causes of death among young children, according to the Geneva-based World Health Organization (WHO).

In fact, measles outbreak happens from time to time.  An outbreak, explained a health official, means “there have been cases of a disease—either suspected or confirmed—in a community or a locality where in the past there was none.”

“Measles outbreaks can result in epidemics that cause many deaths, especially among young, malnourished children,” the WHO pointed out.  “In countries where measles has been largely eliminated, cases imported from other countries remain an important source of infection.”

Measles—locally known as tigdas or tipdas—is a very contagious illness caused by a virus in the paramyxovirus family [which also caused mumps, German measles and chicken pox]. “The measles virus normally grows in the cells that line the back of the throat and lungs,” the WHO said.  “Measles is a human disease and is not known to occur in animals.

“The highly contagious virus is spread by coughing and sneezing, close personal contact or direct contact with infected nasal or throat secretions,” the WHO explained.  “The virus remains active and contagious in the air or on infected surfaces for up to two hours.  It can be transmitted by an infected person from four days prior to the onset of the rash to four days after the rash erupts.”

Measles is considered an endemic disease, meaning it is continually present in a community, and many people develop resistance.

Outbreaks happen when there is low vaccination coverage among the population.  Such was the recent case in Davao City.  Angie Saveron, EDGE Davao’s roving reporter, quoted Villafuerte as saying: “One factor behind the outbreak of measles in the city is the victims’ lack of immunization, the reason being the mothers were too busy to have their children immunized.”

Of the 224 suspected measles cases, 80 percent were not vaccinated, while the remaining 20 percent were immunized but have a weak immunity.

Another reason cited was the influx of transient residents in the city.  A bulk of people come to the city starting on the month of September until December, the height of the holiday season.

In some parts of the world, there are parents who do not allow their children to be vaccinated for fear that the MMR vaccine, which protects against measles, mumps and rubella, can cause autism.  However, large studies of thousands of children have found no connection between this vaccine and autism.

“Not vaccinating children can lead to outbreaks of a measles, mumps and rubella—all of which are potentially serious diseases of childhood,” reminded Dr. Neil K. Kaneshiro, Clinical Assistant Professor of Pediatrics at the University of Washington School of Medicine.

The WHO also reminded: “Measles outbreaks can be particularly deadly in countries experiencing or from a natural disaster or conflict.  Damage to health infrastructure and health services interrupts routine immunization, and overcrowding in residential camps greatly increases the risk of infection.”

According to Dr. Enrique Tayag, a person infected with measles can infect up to 12 to 13 more people.

So, how will you that a person has measles?

“The first sign of measles is usually a high fever, which begins about 10 to 12 days after exposure to the virus, and lasts four to seven days,” the WHO informed.  “A runny nose, a cough, red and watery eyes and small white spots inside the cheeks can develop in the initial stage.

“After several days, a rash erupts, usually on the face and upper neck. Over about three days, the rash spreads, eventually reaching the hands and feet. The rash lasts for five to six days, and then fades. On average, the rash occurs 14 days after exposure to the virus [within a range of seven to 18 days].”

Medical News Today says complications from measles are fairly common.  Some, however, can be serious. Most measles-related deaths are caused by complications associated with the disease. Complications are more common in children under the age of 5, or adults over the age of 20.

Complications can include: diarrhea, vomiting, eye infection, respiratory tract infections (such as laryngitis and bronchitis), difficulty breathing, ear infections (which lead to permanent hearing loss) and febrile seizures.

“As high as 10 percent of measles cases result in death among populations with high levels of malnutrition and a lack of adequate health care,” the WHO said. “Women infected while pregnant are also at risk of severe complications and the pregnancy may end in miscarriage or preterm delivery.”

One good thing: People who recover from measles are immune for the rest of their lives.

Among those who are at risk of being infected with measles are unvaccinated young children; they are at highest risk of measles and its complications, including death. Unvaccinated pregnant women are also at risk. Any nonimmune person (who has not been vaccinated or was vaccinated but did not develop immunity) can become infected.

Until now, no specific antiviral treatment exists for measles virus.  Severe complications from measles can be avoided, though supportive care that ensures good nutrition, adequate fluid intake and treatment of dehydration with WHO-recommended oral rehydration solution. This solution replaces fluids and other essential elements that are lost through diarrhea or vomiting. Antibiotics are prescribed to treat eye and ear infections, and pneumonia.

Although measles is a highly contagious disease, it can be prevented through vaccination.  Data from the health department showed that only 40 percent to 45 percent of infants who are given measles vaccines at 9 months receive booster shots when they are 12 to 15 months old.

According to the WHO, routine measles-vaccination program for children together with mass immunization campaigns are the key public health strategies to reduce global measles deaths. The measles vaccine has been in use for over 40 years. It is safe, effective and inexpensive.

Before the introduction of measles vaccine in 1963 and widespread vaccination, major epidemics occurred approximately every two to three years and measles caused 2.6 million deaths each year.

Between 2000 and 2016, measles vaccination resulted in a 84-percent drop in measles deaths worldwide, the WHO reported.  In those span of years, measles vaccination prevented an estimated 20.4 million deaths.

This is the reason the health department urged parents of children ages 6 months to 59 months to have their children vaccinated against measles.  Vaccinations are available at health centers.

Image Credits: Henrylito D. Tacio

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