India is second among 57 nations affected. The immunisation against infection remains stagnant, says report
The recent past has seen a massive upswing in India’s measles outbreak and this has halted India’s vaccination great process and has widened speculation and implications of missed immunization. According to the WHO global report and CDC, India had the second-highest number of measles cases in 2023, after the Democratic Republic of the Congo, with 65,150 cases. This alarming increase is part of a rising global measles incidence which rose by 20 percent worldwide.
Measles is viral disease that is transmitted easily from one person to the other, and the symptoms include fever, cough, runny nose, and the skin rash. Although it can be eradicated using a vaccine, this disease poses a risk of developing serious side effects like the swelling of the brain, pneumonia, and blindness or even death. Children who have not been immunized or are undernourished have it worse; about three out of every thousand infected children may die from respiratory or neurological diseases.
The last one of the reasons is too little immunization rates to have continued to stabilize rather than decrease or increase dramatically. Vaccination has been hampered by the COVID-19 pandemic all over the world, thus contributing to reduced convergence. The global first-dose measles-containing vaccine (MCV1) coverage rate in 2023 was 83 per cent, the same as in 2022 but below the 86 per cent rate before the Covid outbreak in 2019. Likewise, MCV2 coverage for the second dose was at 74% which is very low for preventing outbreaks further reaching 95%.
While the percentage of MCV1 attainment for the WHO Southeast Asia region which include the India was 94% in 2022 but had declined to 91% in 2023. MCV2 coverage in the region likewise slightly declined to 85% in 2023 but remain above the pre-pandemic level. The Indian government reported that the percentage of immunization through MCV1 reached 93% in 2023, however, the awareness of the performance of the vaccination program is still in discussion.
According to a recent estimate, over 1.1 million Indians missed their first dose of the measles vaccination in 2022. Worldwide, 22.2 million children have not received their first measles vaccine in 2023; it was 1.2% higher than in 2022. India may also have figured in the list of countries with 10 percent or more infants missing their doses: Two countries in the World Health Organisation’s Southeast Asia region were among the ten worst-hit; the WHO report does not name them.
Medical practitioners have called for concerted effort to avert a continued outbreak of measles. They call on the governments to step up their efforts in providing vaccines especially in the vaccination drives and enhancing access to vaccines, especially in the high-risk areas. According to the WHO Director-General Dr. Tedros Adhanom Ghebreyesus, to save more lives and halt the virus that causes death, communities, countries, regions, and the world must invest in immunization for all people irrespective of where they lives.
The WHO and CDC emphasised as in today’s world outbreaks of the diseases are common when the coverage is low. Measles vaccines particularly when given in combination with mumps, rubella, varicella vaccines is important for the children. WHO says it suggests that the first shot should be administered at 9-12 months in high risk countries and the second at 15-18 months for booster effect.
Understanding Measles: Causes, Signs, and How to Avoid Getting It
Measles is an acute graft viral disease that is brought about by measles virus which belongs to the paramyxovirus family. Measles remains a serious public health problem where it is still present because of less availability if vaccine.
Causes and Transmission
The measles virus causes the illness, which is conveyed via the air when an infected person coughs or exhales. The Virtus has shown to be airborne and can be contracted from contaminated surfaces, taking up to two hours to die off. An individual who has not been vaccinated may get measles through respiratory tract if he breathes them in, or by touching objects contaminated with the disease and touching the face. It mainly impacts in the respiratory system, even though it can spread to the other organs in the body through bloodstream.
Symptoms and Complications
Measles are characterized by a group of signs and symptoms that develop within the range of 10 days up to fourteen days since the time of exposure to the virus. The early sign include high temperature, respiratory problems, common cold and infected eyes that are red and watering (conjunctivitis). After a few days of the sickness, little white spots known as Koplik's spots may also appear in the mouth. This is followed by a bright red, blotchy rash that begins on the face and then progresses to the rest of the body.
Most people have fever for two to three weeks and while the disease can led to severe complications, it’s very dangerous for young children, pregnant women and those with a low immune system. Some of the expected side effects are, ear infection, diarrhoea or pneumonia. This is accompanied by symptoms of a rod like high fever, coughing and a runny nose occasionally.
Prevention
Administration of the measles vaccination is most efficient way to get protection against it. Measles vaccine is often given as part of measles, mumps and rubella (MMR) vaccine which contain live attenuated viruses. According to WHO, kids should be administered two MMR shots, with the first one attained at age of 9 months to 12 months and the second at an age of 15 months to 18 months. This two-dose schedule gives good and prolonged immunity for measles.
Global Health Efforts
Measles continues to be one of the most potent causes of vaccine-preventable deaths globally even though a vaccine exits. The WHO and other international health organizations remain involved in efforts to improve vaccination and to curb measles. Some of the measures that have been made include launching mass vaccination, enhancing the approved immunization system, and enhancing people’s knowledge regarding immunization.
Initiatives by India in tackling measles
According to the different Government policies established in India to fight the increase in measles cases and a better vaccination coverage, and the social and economic determinants to which vaccination is related. Such endeavours are operational in the larger plan in attaining the goal and sustainability of measles and rubella control. Here are some key initiatives:
- National Strategic Plan for Measles and Rubella Elimination: The specific preventive strategy mentioned in this plan is designed for the improvement of immunization programs, surveillance, and time sensitive outbreak identification and response. The plan is in accordance with the National Technical Advisory Group on Immunization (NTAGI) and the India Expert Advisory Group for Measles-Rubella (IEAG-MR) advertising for measles elimination and rubella control in India.
- Intensified Mission Indradhanush 4.0: This entails full immunization coverage of 90% and above. All IMI 4.0 plans to implement interventions for high risk and priority population groups such as pregnant women and children. The mission has been rolled out in phases to ensure that every child received the right vaccines they required.
- Measles-Rubella Vaccination Campaign: India has implemented measles-rubella vaccination drives to reach millions of children across the country. This has a very high success rate. The campaigns are intended to administer two doses of the measles-rubella vaccine to make one immune to the diseases for a long time.
- Strengthening Surveillance and Reporting: In response to prevent the constant spread of measles, the surveillance and reporting systems in India have been enhanced. National surveillance of fever and rash has been increased to cover all regions of the country, while the measles-rubella laboratory network has now grown to 27 laboratories. This improved surveillance also assists in identification of conditions that require early intervention.
- Public awareness and community engagement: Evaluating community awareness about vaccination forms a vital part of eradicating measles. India has embarked on campaign which aims at informing immunization beneficiaries and other people within the society through other approaches that courage people from taking vaccines. Awareness creation mechanisms have included community engagement exercises in form of workshops as well as other outreach programs aimed at ensuring that each child is administered the vaccines he/she requires.
- Central Teams for Compounds Technical Support: Due to recent outbreaks, the Union Ministry of health and Family Welfare has sent multi-disciplinary central teams to support states technically. These teams comprise staff drawn from the public health, paediatrics, and microbiologists who evaluate the situation and give advice on the best immunization strategy as well as coping with an outbreak.
- Roadmap for Measles and Rubella Control: National plans of the country’s government regarding the eradication of measles and rubella have been established. This roadmap is a guidance tool meeting the need of planning the elimination of activities and also improves vaccination and surveillance. It also contains special recommendations for states exposed to illness outbreaks with particular activities that must be implemented.
WHO and Its Efforts towards Measles Eradication
The WHO has for decades played a leading role in combating measles, which is a virulent disease caused by a virus and a major threat to child health. Influenced by several strategies and framework that are being done by WHO, it endeavours to stop measles and rubella in the whole world. Here are some key initiatives and efforts by WHO:
Measles and Rubella Initiative (M&RI)
Measles and Rubella Initiative (M&RI) was initially established in 2001 by WHO in collaboration with its partners including the American Red Cross, United States centres for disease control and prevention (CDC), United Nations foundation, UNICEF, Gavi and the Bill and Melinda gates foundation. This partnership aims at the mobilization of intervention measures with the aim preventing children morbidity and deaths due to measles. To date, through its support to M&RI has contributed to facilitating delivery of measles vaccines to millions of children around the world, making a contribution to the saving of more than 56 million lives.
Measles and Rubella Strategic Framework 2030
The Measles and Rubella Strategic Framework 2030 was released in 2020 by the WHO, and keyed on seven strategic directions to promote and sustain regional measles and rubella elimination targets. These priorities include reinforcement of immunization, improvement of surveillance, and improvement of the early recognition and response to the events. In fact, Immunisation A2genda 2030 is fully integrated into the proposed framework since the latter is designed to contribute to the global effort to enhance the vaccination’s potential for saving lives.
Immunization Agenda 2030 (IA-2030)
IA-2030 has officially been named as WHO’s robust global framework to make the most of vaccines. In this regard, the WHO is committed to extending the lives of 50 million more people through immunization by the year 2030. Measles immunization is also part of this agenda because in order to reach the goals that have been set vaccines need to provide protection to as many people from dangerous diseases as possible.
Global Immunization Efforts
WHO has been focusing on supporting the immunization programs in the countries and enhancing vaccination rate. They include promotion of mass vaccination, mobilization and improvement of routine immunization, and management of vaccine dropout. WHO also assists the countries to set strategies that may enable them to attain the aimed elimination of measles.
Managing the Effect of COVID-19 Pandemic
The Covid-19 has been a challenge in immunization worldwide whereby immunization coverage has reduced and become susceptible to measles. These setbacks have however been responded to by WHO which has been involved in helping the countries in effort to recover the stalled vaccination programs as well as improve surveillance systems. High vaccination coverage is stressed as one of the main principles of the organization for measles prevention and public health promotion.