Looming Measles Threat

The latest rise in the cases of measles spreading as a possible epidemic has again drawn attention to the importance of routine immunisation. The vaccine-preventable disease has reportedly spread to more than 16 districts, including Kathmandu, with over 1,300 cases. The World Health Organisation (WHO) update covering data from November 24, 2022, to March 10, 2023, shows that the majority of the cases (86 per cent) were reported in children under 15 years of age, and over half of the cases (58 per cent) were unvaccinated.

From March until mid-June, the cases seem to have doubled. Since the beginning of 2023, Nepal has committed to eradicating the disease. However, at least one fatality and more than 1,300 cases of measles have been detected. According to the latest preliminary data released by the Ministry of Health and Population (MoHP) among the infected people, the majority were unvaccinated. It shows that it requires seriousness about vaccinations and public awareness of the disease. 

In 2004, there was a massive outbreak of measles in Nepal. Around 12,000 people were infected at that time. But in the years since then, people have been found sporadically infected in certain pockets. However, the current outbreak is considered 'extraordinarily high' compared to that of previous years. For that reason, the government needs to consider various mechanisms to control the spread of measles. Measles is an infection that can be prevented with immunisation. However, it is affecting Nepal due to poor vaccine potency. Regular measles outbreaks in various sections of the nation are caused by several factors, including poor vaccination rates, shifting populations, a lack of public knowledge of the value of vaccinations, and apathy on the part of the concerned authorities responsible for cleaving the gaps.

The WHO has recently called for focused efforts to provide life-saving childhood vaccines to the unvaccinated. The UN health agency says that the number of unvaccinated children more than doubled from 2 million in 2019 to 4.6 million in 2021 in the Southeast Asia region, despite efforts by countries to maintain or restore routine childhood immunisation. It has called to urgently address the immunisation gaps and challenges aggravated by the COVID-19 pandemic. Measles is one of the infectious diseases that spread hastily — more rapidly than COVID-19 variations. It is so contagious that if one person has it, nine out of 10 people around them will likely catch it if they are not vaccinated. Unvaccinated people are most vulnerable to infection if they come into contact with patients through coughing, sneezing, or talking. 

Main symptoms of measles include a high fever, red eyes, watery eyes, runny nose, coughing, and tiny white patches on the cheeks. It can also lead to several more serious side effects, including pneumonia, encephalitis and diarrhea. Patients should not self-medicate but should take the advice of medical personnel to avoid potential complications. According to the Nepal Demographic and Health Survey-2022, at least 4 per cent of children aged 12 to 23 months had not received any vaccinations.

In 2016, this figure was below 1 per cent. Low vaccination rates have led to a recurrence of measles. The entire vaccination campaign has to take a more forceful implementation to prevent childhood impairment and death. The COVID-19 pandemic has demonstrated the importance of preparedness, precaution, and planning when dealing with contagious disease outbreaks. As the virus may be infectious and fatal, it is to plan imperative beforehand and minimise the threat. In this respect, as the threat of another disease looms, the government must focus on the task at hand and take action urgently.