Measles outbreak in Mumbai: Warning signs, treatment, deadly complications of measles in children

Measles is a highly contagious viral infection and is associated with high mortality in children less than 2 years of age. All you want to know about warning signs, treatment, deadly complications and vaccination of measles.

Amid the outbreak of measles in Mumbai, a one-year-old boy lost his life on Monday due to complications from the disease. So far seven deaths have been suspected due to the viral infection and 164 cases of measles have been reported in the city as per Brihanmumbai Municipal Corporation (BMC). Measles is a highly contagious viral infection and is associated with high mortality in children less than 2 years of age. There is no specific cure of measles and it is advised for parents to get their kids in the age group of 9-16 years vaccinated against the disease. The symptoms of measles are fever, rash, cough, running nose and red eyes. However, the complications of the disease in partially vaccinated or unvaccinated can be severe and deadly. (Also read: Measles outbreaks in Govandi slums since January due to poor vaccination coverage)

The symptoms of measles are fever, rash, cough, running nose and red eyes.

What is measles

"Measles is a highly contagious viral infection that is characterised by fever, typical rash(maculopapular) and the 3 Cs - cough, coryza (running nose) and conjunctivitis (red eyes). Since the disease is highly infectious - which means anyone who is not immune and gets exposed will get the disease - it is important that all children are vaccinated against it. The mortality is highest in children less than 2 years of age, malnourished children and non-immune adults," says Dr Amin Kaba, Consultant Pediatrician & Neonatologist, Masina Hospital.

Symptoms of measles

Dr Sanjeev Dutta, HOD and Sr Consultant Pediatrics, Marengo QRG Hospital, Faridabad says the disease starts with very high fever followed few days later by tiny red rashes on face and behind ears which then spread to all over the body; eyes and oral cavity also become red.

Treatment

"The treatment is ensuring good hydration with oral rehydration solution and other liquids and paracetamol for controlling fever. Measles may be complicated with pneumonia and ear infection which may require appropriate treatment and even hospitalisation," says Dr Dutta.

Deadly complications of measles

Unvaccinated and malnourished children are at high risk of developing life-threatening conditions from measles which could cause death or disability.

"The measles infected child has a suppression of the immunity and hence can land up with complications like blindness, pneumonia, diarrhoea and even death. A devastating late onset complication is SSPE (subacute sclerosing panencephalitis) which leaves the child with irreversible brain damage. All children diagnosed with measles are given mega doses of Vitamin A to prevent complications," says Dr Kaba.

How to prevent measles

The disease is easily preventable by getting vaccinated against it. The Government of India recommends 2 doses of measles containing vaccine at 9 months and 16 months. The IAP recommends an additional booster at the age of 5 years.

Why measles is rising in India, vaccination for measles

"India has the dubious distinction of having the highest number of measles cases in the world. To counter this there was a nationwide Measles elimination campaign in 2017-2018 wherein all school going children were immunised with an extra dose of Measles containing MR vaccine. India even managed to achieve the target in most states. However, with the onset of the Covid pandemic, the pool of unvaccinated children ballooned and as soon as a few cases came up the infection spread rapidly. The government has geared up to rapidly immunise these unvaccinated children over the next one month and get the outbreak under control. There is a surveillance system already in place wherein all children presenting with fever and rash are to be reported to the health authorities by the treating doctor. These cases are checked for the virus as well as measles antibodies and a watch is maintained for any sudden increase in the number of cases in a particular area," says Dr Kaba.

"The only way to prevent measles is to get vaccinated. There maybe some adults who haven't been immunised. They can get themselves tested for the antibody levels and take the vaccine if indicated. Another important preventive measure is to maintain good nutrition in the child and avoiding contact with sick children. Basically, all the measures we practiced for Covid 19," adds Dr Kaba.

"A highly effective Measles-Mumps-Rubella (MMR or MR) vaccine is available to prevent this dreaded infection. The vaccine is given in National Immunisation Programme at 9 months and 16-18 months age. There has also been an additional mop-up round of MR vaccination in school to augment vaccination coverage. Moreover, a sustained measles-rubella surveillance program is required to identify measles outbreak in the society," says Dr Dutta.

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