Thursday, 18 July, 2019

Where India stands in battle against measles, how Sri Lanka eliminated it


  • The World Health Organisation (WHO) has declared that measles infection has been eliminated in Sri Lanka after the island nation had three years free of any new cases.
  • Sri Lanka has become the fifth country in the WHO Southeast Asia region to eliminate measles, after Bhutan, Maldives, DPR Korea and Timor-Leste.

Theme of the topic: The topic analysis how Sri Lanka eliminated Measles and India’s efforts in fighting Measles.

About Measles:

  • Measles is a highly contagious virus, spread by contact with an infected person through coughing and sneezing.
  • Measles weakens the immune system and lead to secondary health problems, such as pneumonia, blindness, diarrhea, and encephalitis.
  • Severe measles is more likely among poorly nourished young children, especially those with insufficient vitamin A, or whose immune systems have been weakened by HIV/AIDS or other diseases.
  • The symptoms include a high fever, severe skin rash and cough.
  • Being immune means someone has been vaccinated or has previously contracted the disease
  • There are two types of measles:
    • Measles: This is the standard form caused by the rubeola virus.
    • Rubella, or German measles: This is caused by the rubella virus.
      • Rubella can have severe consequences during pregnancy.
      • An infection just before conception and in early pregnancy may result in miscarriage, foetal death or congenital defects known as congenital rubella syndrome (CRS).
      • A woman infected with the rubella virus early in pregnancy has a 90% chance of passing the virus to the foetus.
  • Measles is preventable through two doses of MR vaccine

Note:

  • Under the Global Vaccine Action Plan, measles and rubella are targeted for elimination in five WHO Regions by 2020.
  • WHO is the lead technical agency responsible for coordination of immunization and surveillance activities supporting all countries to achieve this goal.

How Sri Lanka got successful in eliminating Measles?

  • Sri Lanka is the fifth country in WHO’s Southeast Asia region to eliminate measles. The other four countries are Bhutan, Maldives, DPR Korea and Timor-Leste.
  • Sri Lanka’s success follows its persistent efforts to ensure maximum coverage with two doses of measles and rubella vaccines being provided in the childhood immunisation programme.
    • The vaccination coverage in the country has been consistently high i.e. over 95% with both the first and second doses provided to children under the routine immunisation programme.
  • Additionally, mass vaccination campaigns with a measles-rubella vaccine have been held periodically to plug immunisation gaps.
  • The country has a strong surveillance system and all vaccine-preventable diseases are an integral part of the communicable disease surveillance system.

Comeback concerns

  • Globally, there are concerns about vaccination gaps that are allowing the disease to resurface in areas where it is not very common.
  • In 2019, a large number of American states have reported measles cases to the Centers of Disease Control (CDC) Atlanta.
  • In 2017, over 109,000 deaths occurred from measles all around the world.
  • According to global report by WHO and CDC Atlanta of 2018, since 2000, over 21 million lives have been saved through measles immunisation. However, reported cases increased by more than 30 per cent worldwide from 2016.
  • The main reason for the comeback of measles is low vaccine coverage.
    • For several years, the global coverage with the first dose of measles vaccine has stalled at 85 per cent. This is far short of the 95 per cent needed to prevent outbreaks, and leaves many people, in many communities, susceptible to the disease.
    • Second dose coverage stands at 67 per cent.

Measles in India

  • While India is still far from that milestone, the latest Global Measles and Rubella Update says India had 56,399 confirmed measles cases and 1,066 confirmed rubella cases in 2018.
  • The achievement of its southern neighbour means that travellers from Sri Lanka will no longer import fresh infections into the country.

Efforts in controlling Measles

  • India, as part of the global initiative, has targeted elimination of measles and control of rubella by 2020.
  • Rubella control is achieved when a country reduces the number of rubella cases by 95% as compared to cases in 2008.
  • India currently gives a measles rubella vaccine i.e. MR vaccine (began in February 2017) in its universal immunisation programme to tackle both measles and rubella.
  • India has initiated the world’s largest Measles-Rubella (MR) Campaign targeting vaccination of 410 million children and adolescents aged between 9 months and 15 years.
  • Under the programme, two doses of measles and rubella vaccines are to be given at ages 9-12 months and 16-24 months.

Note: In 2018 the Delhi High Court had put on hold a vaccination campaign citing lack of parental consent, which is a major setback in the efforts made.

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