Down to Earth

An old enemy strikes again 15,698 183,796

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In the past couple of years, confirmed cases of measles have been reported across the world, even from the United States, where it was eradicated in 2000

Syria

2017

Countries reporting confirmed measles cases in The number of confirmed cases

2016 Jan-April, 2017

Countries that reported confirmed cases in

Jan-Dec, 2016

The number of confirmed cases

this unwillingn­ess to vaccinate is why measles is common in Jaunpur and other districts of Uttar Pradesh.

The state is one of the focus areas of measles vaccinatio­n in India. An assessment carried out by the Union Ministry of Health and Family Welfare (mohfw) for the year 2016-2017 shows that only 77.1 per cent of children under the age of one year received it. This is lower than the national average of 83.7 per cent.

The global scene

Moldova Guinea India is not the only country reporting measles cases. A World Health Organizati­on document shows that as many as 77 countries have reported cases this year. In Europe, Italy and Romania are the worstaffec­ted. Romania reported 317 confirmed cases as of April 11. In Italy, 684 cases have been reported (see `An old enemy strikes again'). It is expected that the number of measles cases in Europe in 2017 would be more than 850 reported in 2016. In the United States, 61 people from 10 states reported measles between January 1 and April 22, 2017. It had been eradicated from the United States in 2000.

Australia too is witnessing an outbreak. Sydney’s western suburbs reported 16 locally acquired cases till mid-April. New Italy Nigeria France Niger Gabon Democratic Republic of The Congo Pakistan Ethiopia Sudan South Wales, where Sydney is located, has reported 23 cases this year. Unlike these developed nations, cases in Africa and Asia are not making news. In all areas reporting measles, the cause has been attributed to lack of vaccinatio­n.

This does not come as a surprise as there is a massive global campaign against vaccines in general. It is often pointed out that diseases like measles and rubella were non-fatal before the advent of vaccines. They would occur in childhood and provide life-long immunity. Continuous exposure to the virus would work like booster doses and increase antibodies against the disease. This immunity would also pass from mother to child. With the coming of vaccines, this natural immunity was lost, explains a doctor, requesting anonymity due to pressures from the vaccine lobby. He believes that because of this, it would be impossible to meet the target of measles eradicatio­n by 2020 not just in India but globally. Meeting the target would be more difficult for India which accounts for 37 per cent of global measles deaths. This year, a total of 5,064 cases of confirmed measles have been reported from the country.

The government is trying to increase vaccinatio­n coverage. In the Rajya Sabha’s March session, Minister of State for Health Tajikistan India Malaysia Bangladesh China Myanmar Afghanista­n Thailand and Family Welfare Faggan Singh Kulaste informed that the government had been making efforts to allay parents’ apprehensi­on and create awareness through organisati­ons such as the Indian Academy of Pediatrics, Indian Medical Associatio­n and Lions Clubs. Health workers and schools have been trained to communicat­e the benefits of vaccinatio­n through personal communicat­ion.

The measles vaccine was introduced in India’s Universal Immunisati­on Programme in 1985. Initially, only one dose was prescribed at the age of 12 months. But then, to further reduce the measles burden, a second dose was introduced in 2010. In addition, the mohfw has introduced a combinatio­n vaccine for measles and rubella (MR) in February 2017. Under this campaign, 36 million children in five states and union territorie­s would be vaccinated. This vaccine would then be introduced in routine immunisati­on and replace the two doses of measles vaccine.

But in Jaunpur, it seems, nothing is working. The MR vaccine, which could have made a difference is not available in this area. Even if it were, it is doubtful the populace would have used it. For Narainpur then, the trauma continues.

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