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Monday, Oct 21, 2019

Measles cases up threefold globally, but down in SE Asia: WHO

cities Updated: Sep 07, 2019 21:02 IST

Measles cases have declined in South East Asia in 2018 despite there being a major resurgence in the rest of the world. Till July 31 this year, 182 countries have reported 364,808 measles cases to the World Health Organization (WHO), compared to 129,239 cases from 181 countries during the same period in 2018, according to a WHO report on measles activity in the first six months of 2019 released in August. There has been a tenfold increase in the Africa, a twofold increase in the Europe, and a threefold increase in the Western Pacific countries.

In Asia, Bhutan, DPR Korea, Maldives, Sri Lanka and Timor-Leste have eliminated measles, while six — Bangladesh, Bhutan, Maldives, Nepal, Sri Lanka and Timor-Leste — have controlled rubella.

This week, the World Health Organization South-East Asia Region (WHO-SEARO) committed to eliminate measles and rubella by 2023 in a resolution adopted at the 72nd Session of WHO Regional Committee for South-East Asia in New Delhi. Eliminating both infections so there is zero local transmission for 12 months, builds on the 2014 SEARO target for measles elimination and rubella control by 2020.

Measles is a highly contagious and potentially fatal disease that causes cough, rash and fever. In children with low immunity, measles can cause life-threatening complications such as encephalitis, severe diarrhoea and pneumonia. Rubella, also known as German measles, causes mild disease in most people, but leads to pregnancy complications, miscarriage, stillbirth and irreversible birth defects in pregnant women.

Both diseases can be prevented by giving two doses of the measles-rubella (MR) vaccine, which is available for free to all children and has saved at least 21 million lives worldwide since 2000. In India, 322 million children from between ages nine months and 15 years in 32 states and UTs have got additional vaccination under the MR campaign launched in February 2017.

“Around 82% of India’s 26 million birth cohort gets vaccinated against measles under the Universal Immunisation Programme, and since February 2017, 322 million children in 32 states and union territories have got additional vaccination. The MR vaccination campaign is ongoing in Rajasthan and Sikkim, and needs to be done in Delhi and west Bengal,” said Dr Pradeep Haldar, deputy commissioner, immunisation, Union ministry of health and family welfare, India.

Mass vaccination is needed to end infection, as an immunisation coverage of at least 95% is necessary to achieve ‘herd immunity’, the threshold above which protects even unvaccinated people in a community are protected, according to the WHO.

“Eliminating measles will prevent 500,000 deaths a year in the Region, while eliminating rubella will prevent about 55,000 cases that can threaten the health of pregnant woman and babies,” said Dr Poonam Khetrapal Singh, regional director for WHO South-East Asia, the region home to one-fourth of the world’s population.

The WHO’s Strategic Plan for Measles and Rubella Elimination 2020-2024 lays down the roadmap to achieve the elimination by strengthening immunisation and outbreak preparedness, setting up lab-supported case surveillance and mobilising political, societal and financial support.

Cervical cancer, however, remains a significant public health problem, with an estimated 158,000 new cases and 95,766 deaths making it the third most common cancer in South East Asia.

“Countries need to expand vaccination, screening, detection and treatment services for everyone, everywhere, to address the growing problem of cervical cancer,” said Dr Khetrapal Singh. Vaccination against human papillomavirus (HPV), screening and treatment of pre-cancer and early detection saves lives. The global target is to fully vaccinate 90% girls with the HPV vaccine by 15 years of age; screen 70% women screened with a high-precision test at 35 and 45 years of age, and 90% women identified with the cervical disease receive treatment and care by 2030.

All countries, including India, are screening for common pre-cancers while Bhutan, Maldives, Sri Lanka and Thailand have introduced the HPV vaccine nationally.

First Published: Sep 07, 2019 21:02 IST

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