Measles remains one of the leading causes of death among children —Experts

Nigeria has every reason to be concerned as measles return with vengeance in northern Nigeria and other parts of the world especially in Europe.

Little wonder that, measles vaccination was stepped up to ensure that this highly contagious and potentially deadly virus that almost quadrupled in Europe in 2017 compared to other years in the past is controlled in Nigeria.

A report published last year by the World Health Organisation (WHO) indicated that 20.8 million children worldwide are still missing their first MeaslesVaccine dose and more than half of these unvaccinated children live in six countries.

Nigeria tops the list of countries with unvaccinated children from measles with 3.3 million children, followed by India – 2.9 million, Pakistan – 2.0 million, Indonesia – 1.2 million, Ethiopia – 0.9 million and Democratic Republic of Congo, DRC, with 0.7 million.

According to the Executive Director, National Primary Health Care Development Agency (NPHCDA), Dr. Faisal Shuaib, a surveillance data shows that measles incidence among children under five years increased in the northern part of Nigeria from 190 million in 2014 to 527 million in 2016.

“Measlesremains one of the leading causes of death among young children globally, despite the availability of a safe and effective vaccine,” said Dr Rafiu Isamotu, a paediatrician and Osun State Commissioner for Health.

Dr Isamotu said the deadly nature of measles made the federal government, alongside some other partners, to ensure all children between nine months and five years would be immunised against measles.

“Like in other countries, it is part of the immunisation schedule for children and it is supposed to be given at 9 months,” he added.

Measles is normally passed through direct contact and through the air. The virus infects the respiratory tract, and then spreads throughout the body. It is a human disease and is not known to occur in animals.

Dr Isamotu declared that the treatment for measles, which is commonly referred to among the Yoruba as Igbona, is more of a supportive one to ease the uncomfortable symptoms of the infection adding “this is a viral infection that is serious for small children but is easily preventable by a vaccine.”

He added, “There is no treatment to get rid of an established measles infection, but over-the-counter fever reducers, anti itchy-lotion or Vitamin A may help with symptoms.

“Also, intake of plenty of fluid and lots of rest is important. We know that the effect of it could be deadly when it is not properly handled. It could be quite devastating.

“Measles immunisation is very safe and effective, but a few children may develop some mild vaccine reactions such as a fever, rash, soreness or swelling where the injection was given or temporary pain. These are minor reactions that mothers should not panic about.”

Measles symptoms do not appear until 10 to 14 days after exposure. They include cough, runny nose, inflamed eyes, sore throat, fever and a red, blotchy skin rash.

The measles rash breaks out between three and five days after symptoms start, and can coincide with high body temperature. The rash usually starts to shows up as flat red spots on the forehead. It spreads to the rest of the face, then down the neck and also to the arms, legs, and feet.

Unfortunately, Dr Isamotu said 90 per cent of people who haven’t been vaccinated for measles and come in contact with an infected person, may contract the virus from droplets sprayed into the air when someone with measles sneezes or coughs.

People with measles can spread the disease from four days before the rash appears until about four days after it does, and are most contagious while they have a fever, runny nose, and cough. Those with weakened immune systems due to other conditions like HIV/AIDS may be contagious until they recover from measles.

Severe complications can occur, including diarrhoea, brain swelling,  meningitis and the risk of death from pneumonia as well as ear infections, which may lead to hearing loss.

However, Dr Jerome Elusiyan, a consultant paediatrician, Obafemi Awolowo University Teaching Hospital Complex, Ile Ife, Osun State, said children not well fed stand a higher risk of having poor weight and immunity, making them more prone to developing measles.

According to him, children that are malnourished lack enough antibodies to mount up enough response to fight the infection, so making its outcome worse in such children.

He added, “even when children that are moderately nourished have measles, the disease can trip them to have severe malnutrition.”

Dr Elusiyan assured that although MeaslesVaccination was safe and effective, some children still develop the disease in some rare cases.

“Our immunisation efforts are working against measles.  In the last five years in Ife and Ilesa, we have not seen a case of measles. It is unlike in the past that almost all our wards may be filled with measles cases,” he added.

Dr Elusiyan said often what many people referred to as measles is not the disease, adding, “MeaslesVaccine protects against this infection when it is given. Many at times, it is not measles that they have. Sometimes, they have measles-like illnesses”

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The expert stated that booster dose of MeaslesVaccine are also important to boost immunity against the disease in the community, adding that the current MeaslesVaccine campaign will also ensure that those that probably had been missed by routine immunisation also get vaccinated.

He added, “There are many things that can cause the rash on the body that may not be measles but it is also possible that somebody that was vaccinated can develop measles if the vaccine that was given has lost its potency.

“But if somebody had received a potent MeaslesVaccine and then has measles, it will be a mild form of it. So immunisation is still very important.”

Such things mothers apply to the skin such as calamine when children have measles, he said help to soothe the discomfort of the rash.

He explained: “the calamine lotion that is given is not treating the measles per say. You are treating the symptom of the disease. It helps to soothe the discomfort that the rash causes.”

Dr Elusiyan declared that mothers should also ensure their children also take Vitamin A to boost their defence against measles.

According to him, “vitamin A is one of the things used in the management of the disease. Measles affects the eye and vitamin A is important to protect the eye in a child that has measles as well as in boosting the body’s immunity.”

Meanwhile, experts’ assessment of MeaslesVaccine in Nigeria and four other countries have found out that the vaccine also helps the body to fight off diarrhoea and pneumonia, two killer illnesses in children.

In the study, the experts found that MeaslesVaccination works as a preventive measure against pneumonia and diarrhoea, when these diseases occur either as a measles complication or secondary infection.

The countries included in the 2017 study in the journal, PLoS ONE, are Democratic Republic of Congo, Ethiopia, India, Nigeria, and Pakistan.

The study found that the vaccine was associated with a reduction of ARI in vaccinated children by 15 per cent in India and 30 per cent in Pakistan.

In addition, MeaslesVaccination also provided a protective effect against diarrhoea in four out of the five countries considered in the analysis—the Democratic Republic of Congo, India, Nigeria and Pakistan.

Compared to unvaccinated children, MeaslesVaccination was associated in reducing diarrhoea in vaccinated children by 22 per cent in the Democratic Republic of Congo, 12 per cent in India, 21 per cent in Nigeria and 19 per cent in Pakistan.

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