Measles is a highly contagious disease caused by a virus, a member of paramyxovirus family. The virus is normally passed through direct contact and air. It infects the respiratory tract, spreading throughout the body. Measles is a human disease and not known to occur in animals.
Epidemiology: Before the introduction of measles vaccine in 1963, major epidemics occurred approximately every 2-3 years and measles caused an estimated 2.6 million deaths each year. More than 40,000 people died from measles in 2018, mostly children under the age of 5 years, despite the availability of a safe and effective vaccine.
Nearly 17,500 cases of measles were recorded in Africa from January to march 2022, representing 400% increase compared with the same period in 2021(WHO,2022).
A total of 20 countries in Africa reported measles outbreak in the first quarter of 2022, eight times more than in the same period in the 2021(WHO,2022) Inequalities in accessing vaccines and disruptions caused by the covid-19 pandemic with a huge strain on health system capacity, impaired routine immunization services in most African countries Uganda inclusive with only 6 countries attaining 95% vaccine coverage for the first dose.
At present, children in Uganda receive a single dose of measles rubella (MR) containing vaccine at 9 months of age (MOH,2019a). From 2010 to 2020, the vaccine of single-dose improved from 73% to 95% in Uganda (WHO,2021). Despite this vaccine, of all the vaccine –preventable diseases, measles outbreaks are still the most common reported cases to the ministry of health in Uganda.
Due to the continuing outbreaks, a nationwide MR vaccination campaign targeting children aged 9 months -15 years was conducted in Uganda in October 2019(MOH,2019b, c) and still with its partners continue to intensify routine vaccination.
Signs and symptoms
- High fevers
- Red and westerly eyes
- Small white spots inside the cheeks
- Rash usually starts on the face and upper neck to cover the entire body in a period of 4-5 days.
Most measles-related deaths are caused by complications associated with the disease. Serious complications are more common in children under the age of 5, or adults over the age of 30.
The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhea and related dehydration, ear infections, or severe respiratory infections such as pneumonia. 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 or other diseases.
Who is at risk: Measles is still common in many developing countries, particularly in parts of Africa and Asia. The overwhelming majority (more than 95%) of measles deaths occur in countries with low per capita incomes and weak health infrastructures. Measles outbreaks can be particularly deadly in countries experiencing or recovering from a natural disaster or conflict.
Damage to health system interrupts routine immunization and overcrowding in residential camps greatly increases the risk of infection. Other factors include risk to unvaccinated young children and the complication of death as well as unvaccinated pregnant mothers.
Measles is one of the world’s most contagious diseases spread by coughing and sneezing, close personal contacts or direct contact with infected nasal or throat secretions. The virus remains active and contagious in the air or infected surfaces for up to 2 hours. Measles outbreaks can result in epidemics that cause many deaths especially among young, malnourished children.
In countries where measles has been largely eliminated, cases imported from other countries remain an important source of infection
Treatment: No specific antiviral treatment exists for measles virus. All children diagnosed with measles should receive two doses of vitamin A supplement, given 24 hours apart. This treatment restores low vitamin A levels during measles that occurs even in well-nourished children and can help prevent eye damage and blindness. Vitamin A supplements have also been shown to reduce the number of measles deaths.
Severe complications from measles can be reduced through supportive care that ensures good nutrition, adequate fluid intake and vitamin A supplements.
Prevention: Routine measles vaccination for children and other at risk combined with mass immunization campaigns. In 2018, about 86% of the world’s children received 1 dose of measles vaccine by their first birthday through routine health services – up from 72% in 2000. Two doses of the vaccine are recommended to ensure immunity and prevent outbreaks, as about 15% of vaccinated children fail to develop immunity from the first dose. In 2018, 69% of children received the second dose of the measles vaccine.
— The writer(Dr. Matovu Richard) is a doctor in Jinja at Specialist Doctors International. This article is published through a partnership with Specialist Doctors International