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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