As cases of measles are rising in certain parts of the country, the central government has directed affected states to strengthen fever and rash surveillance, according to people familiar with the matter.
Maharashtra and Kerala have so far reported at least 914 cases of the viral disease. There have been 18 deaths in Maharashtra alone.
“The Union health ministry has been asking states to heighten surveillance so that cases are not missed, and also detected early so that treatment reaches on time. This will help save lives,” an official aware of the matter said, requesting anonymity.
Measles is a highly infectious viral disease, with a basic reproduction number of 12 to 18 by most estimates, which means one infected person can pass it on to 12 to 18 others, and each of those to a similar number further.
The disease normally sees a surge between November and March, which is why states have been directed to remain vigilant during this period. Even in healthy children, measles can cause serious illness and can require hospitalisation. It can be particularly dangerous for children who are unvaccinated, and are moderately or severely malnourished. Nearly one to three of every 1,000 children who are infected die from respiratory or neurological complications.
In a detailed advisory issued last month, the Centre asked states to undertake a headcount survey of all children aged 6 months to 5 years in the vulnerable outbreak areas to facilitate full vaccination coverage in an accelerated manner. The institutionalized mechanism of district task force on immunization under the chairmanship of the district collector must be activated to review the measles situation on a daily and weekly basis and plan the response activities accordingly, it said.
{{/usCountry}}In a detailed advisory issued last month, the Centre asked states to undertake a headcount survey of all children aged 6 months to 5 years in the vulnerable outbreak areas to facilitate full vaccination coverage in an accelerated manner. The institutionalized mechanism of district task force on immunization under the chairmanship of the district collector must be activated to review the measles situation on a daily and weekly basis and plan the response activities accordingly, it said.
{{/usCountry}}Since the disease is known to be fatal among children with moderate and severe malnourishment, the Centre asked doorstep searches be conducted in affected areas to identify vulnerable children and provide pre-emptive care with nutritional and Vitamin A supplementation.
“Any suspected cases with development of fever and maculo-papular rash must be reported and investigated. Immediate isolation of laboratory confirmed cases must be done for at least 7 days from the date of identification,” the advisory said. “Guidance for home-based care of such cases must be issued with reference to age-appropriate two doses of vitamin A supplementation with adequate nutritional support.”
Roughly 2.5 million infants, who were supposed to be inoculated with the first dose of measles vaccine, did not receive the shots last year, a number that explains why the country is recording a surge in the viral disease that is highly contagious and can lead to fatalities.
At 2.5 million, India accounts for the second highest numbers of missed doses in infants in 2021, with Nigeria recording the most at 3.1 million doses, according to a recent estimate by the World Health Organization and the US Centers for Disease Control.
The government has decided to accelerate vaccinations for all children between the age of nine months and five years, following a review meeting on the situation last month. Increasing immunization coverage is more important for India, as the government has set December 2023 as target for measles elimination.
Ideally, 95% coverage should be done among the eligible population, according to WHO.
“People must take all the vaccines that are due as per the national schedule as not taking vaccines could have serious consequences,” said Dr Anupam Sibal, senior paediatrician and group medical director, Apollo Hospitals.