In the wake of deadly measles outbreak, Sindh being the hardest hit province, a four-member team from the Department of Paediatrics and Child Health, Aga Khan University (AKU), rushed to the measles affected areas in Sukkur, Ghotki and Khairpur districts, and assisted the local administration.
The team led by the paediatrician, Dr Ali Faisal Saleem, worked closely with local administrators, physicians, nurses and vaccinators to optimise management of children with measles at public hospitals and health centres.
During their 10-day stay in the hard-hit areas, including Taluka Saleh Pat of District Sukkur, the team observed that factors contributing to the high death rates were included inadequate supplies of medicines, shortage of measles vaccine and medical staff, high prevalence of malnutrition, and frequent electricity failures.
“During our interactions with families, we advised them to visit a doctor immediately if their child develops fever with rash or suspected measles. Initial symptoms, which usually appear 10-12 days after infection, include high fever, runny nose, bloodshot eyes, and tiny white spots on the inside of the mouth. Since measles is a highly contagious viral disease, parents should keep the affected child away from other children, especially those who are less than one year old,” said Dr Saleem.
“Remember, the best prevention is two doses of measles vaccine, the first at 9 months and the second between 12 and 24 months,” he added.
Commenting on the outbreak, Dr Anita Zaidi, Chair, Department of Paediatrics and Child Health, AKU, said, “It is shameful that in this day and age, children in Pakistan are dying of measles, a disease easily prevented by vaccines. Investing in improving routine immunisations with two doses of measles vaccine for every child, in addition to high quality measles vaccine campaigns every two year with appropriate monitoring are needed to prevent this disaster from ever happening again.”
According to WHO, there is no specific treatment for measles and most people recover within two-three weeks. However, particularly in malnourished children and people with reduced immunity, measles can cause serious complications, including blindness, encephalitis, severe diarrhoea, ear infection and pneumonia.
The AKU team has emphasised the need for nutritional rehabilitation programmes at the hospitals in the affected areas.
Frequently Asked Questions
What has caused a sudden outbreak of measles in Pakistan?
Unfortunately in Pakistan, a large proportion of children have not even received a single dose of the measles vaccine. If a large proportion of children in a country are not vaccinated, epidemics like the current measles outbreak are almost guaranteed to occur every two to three years.
What can be done to protect children during the current outbreak?
It is recommended that children between six months and ten years of age, who have not received two doses of measles vaccine, should get vaccinated now. However, giving vaccine to a child who already has a fever and/or rash would not help in quick resolution of symptoms.
Can children die of measles?
In developing countries, five to ten per cent of children can die from complications caused by measles, such as pneumonia and encephalitis. However, it should be noted that most children do not develop any serious complications and recover completely.
Who is at highest risk of complications and death due to measles?
Children under five years of age; children with weak immune systems; children who are malnourished as well as children living in over-crowded conditions are at highest risk.
How many doses of the measles vaccine should be given to children?
Two doses of measles vaccine should be given to all children in Pakistan; the first at 9 months and the second between 12-24 months. However, it is best if the second dose is given at 12 months.
Is there a difference in efficacy or side effects between the measles vaccine and the combination Measles-Mumps-Rubella (MMR) vaccine?
No. These two vaccines can be used interchangeably. However, both are in short supply these days due to increased demand throughout the country.
What should I do if my child develops fever with rash or suspected measles?
Visit the doctor immediately. Children with measles need to be evaluated for any complication that requires hospitalisation. All children with measles should get two doses of vitamin A, prescribed by the doctor according to age. You should also try to keep the affected child away from other children, especially those who are less than one year old.
Fabeha Pervez, Media Executive, Department of Public Affairs, Aga Khan University, Stadium Road, Karachi, on +92 21 3486 2925 or firstname.lastname@example.org