Factors in measles outbreaks in the country (Part 1)

The recent outbreaks of measles in different regions in the country tell us two realities in the long-running war against this viral infection.

First, the Philippines is far from being measles-free since 1998 or earlier. Second, the Department of Health (DOH) is facing an uphill battle against this relentless disease. Consequently, the recent outbreaks are not new in the country.

In 2013, four regions had measles outbreaks that had spread throughout the country. These regions were Calabarzon, Central Luzon, the Cordillera Autonomous Region and Western Visayas. This is according to the report by Yoshihiro Takashima and a team of epidemiologists affiliated with World Health Organization (WHO) Western Pacific Regional Office in Manila, DOH’s National Center for Disease Prevention and Control, the WHO’s Department of Immunization, Vaccines and Biologicals in Geneva, and the Global Immunization Division of the U.S. Centers for Disease Control and Prevention.

This study, which was published in the 2015 issue of the Morbidity and Mortality Weekly Report, demonstrated significant challenges from the administrative side of the WHO recommended strategies by the DOH. This is so despite DOH’s ability to achieve high immunization performance in 2014, which was 91 percent for the nine to 59 months age group and 94 percent for the nine months to 14 years age group. This performance was achieved through routine free immunization services using measles-containing vaccines and supplementary immunizations.

The problem appeared to be an increase to 29 percent (from 18 percent) in the measles cases in the age 15 or more age group, while the nine months to four years age group had declined to 28 percent (from 38 percent). Was the increase in the age 15 group due to child resistance against immunization?

One important factor in this persistent problem appeared to be the changing genotypes of the measles virus, which may require different vaccines to ensure protection. D3 genotypes predominated prior to 2007. Then D9 and G3 predominated from 2007 to 2009. D9 again in 2010 to 2012. Then B3 and D9 in 2013 to 2014. D3 and G3 appeared to be eliminated since 2005 and 2010, respectively.

There are four other factors that we will cover next week.

J.R.R. Tolkien wrote in “The Two Towers”: “War must be, while we defend our lives against a destroyer who would devour us all.” However, in the authoritarian propaganda, the rationale of this war can be twisted though.