With the measles outbreak count in Ahmedabad now at 420 cases and the number of suspect cases at 949, doctors in public sector hospitals in the eastern part of the city are seeing former measles patients now coming back with post-measles complications like pneumonia, some of who are having to be admitted to the Paediatric Intensive Care Units (PICUs).Two and a half year old Adnan* (name changed) has been admitted to three different hospitals at different times and been shown to four doctors in just one month for several complications after he was treated for measles. After his measles infection, the child got fever and swelling all over his body. His abdomen swelled due to the swelling in the liver, whose function had become impaired. With the parents having poor understanding of the child’s condition, coupled with the dismal condition of medical records, Post-Measles Pneumonia was diagnosed only by doctors at Shardaben Hospital after an X-ray a week ago. But his condition ultimately turned out to be much worse.Adnan’s father, a casual labourer, told Mirror, “He first got rashes on the skin which turned black in some places. Then the stomach swelled so much that he began crying all the time. He suffered from constant vomiting and diarrhoea. He is better now.”Pneumonia 15 daysafter measelsDr Hetal Vora, HoD of Paediatrics and Superintendent of the hospital, said, “The child suffered from multiple conditions coupled with Severe Acute Malnutrition, together indicative of Kwashiorkor. The child suffered sudden nutritional loss and the synthetic functions of the liver were impaired. While we have seen several children coming in with pneumonia within 15 days of measles treatment, we have seen this much more complicated case of Kwashiorkor for the first time.”At Shardaben Hospital, which has seen more than 300 measles patients, the highest in the city, doctors said that at least 7-10% of their former measles patients returned to the hospital within a fortnight with pneumonia infection. While the numbers may appear low, doctors said the rate of Pneumonia infection in children who are in post-measles remission is higher than that seen in the community, thanks to lowered immunity and malnutrition, exacerbated by the measles infection.Pneumonia is a well-known complication of measles, which, according to the US CDC, affects 1 in 20 measles-affected children and is the most common cause of death.At LG Hospital, which has seen about 140 measles patients in just the last 2 months, doctors said that the incidence rate of Post Measles Pneumonia would be at about 5-10%. However, further analysis and collation of data is pending due to the load of measles patients which, Superintendent Dr Leena Dabhi said, has required an expansion of the isolation ward. While doctors at the centre of the measles outbreak in eastern Ahmedabad are still attempting to gauge the scale of the problem, the Ahmedabad Municipal Corporation (AMC) seems not to have yet taken note of the issue as there is no central data regarding Measles Associated Pneumonia. However, Dr Bhavin Solanki, Medical Officer of Health (MoH) for AMC said, “There have been no serious cases of pneumonia or of deaths due to measles inthe city.”
Vaccine hesitancy or complacency to the second dose of the Measles Rubella (MR) vaccine, coupled with children not give their periodic dose during the Covid-19 pandemic, is being blamed by officials as the major reason for the drastic rise in the number of measles cases in children in Ahmedabad.The city has reported a total of 367 confirmed measles cases in 2022, with more than three quarters (75%) of these cases being reported in the last three months. It started in the second half of September when the number of cases crossed 60, and in October when the case count touched 111, and November when another 111 confirmed cases have already been reported to the civic body till date. Officials told Mirror that they are expecting more cases of measles in December, even as the number of suspect cases in Ahmedabad has reached 907 so far.Health officials have identified 20 outbreak centres in Ahmedabad centered around three zones of the city - South, North and East. Major areas reporting confirmed cases of measles are Behrampura, Sankalitnagar, Sarkhej, Gomtinagar, Vejalpur, Danilimda, Asarwa, Narol, Rahial, Kalupur, Amraiwadi and Piplaj.Speaking to Mirror, DyMC for Health, Praveen Chaudhary said, “Two major reasons for the measles outbreak affecting these areas of the city — with 80% of cases being reported from these 20 centres — is that many families had been left out of MR immunization during Covid-19 pandemic, and also the vaccine hesitancy seen for the second dose of this vaccine. The first dose is given at 9 months, and second at 1.5 years.”Mirror also learnt that AMC Commissioner M Thennarasan on Friday conducted a detailed review of MR vaccination at the 2,100 Anganwadis under the city jurisdiction, asking ANMs and the ICDS teams to concentrate on areas seeing resistance against vaccination.
A measles outbreak in Mumbai has raised concerns amongst the country’s public health authorities. The city has reported more than 200 cases in the past two months and at least 13 children have lost their lives. This is a big jump from the last few years — 10 cases and one death in 2021; 29 cases and no death in 2020; and 37 cases and three deaths in 2019. Other areas in Maharashtra, including Nashik and Yavatmal, have also been affected. By all accounts, the outbreak seems to have been precipitated by a backslide in the universal immunisation programme during the pandemic. According to the state government data, only 41 per cent of the eligible children have been inoculated against measles in Mumbai. Overworked public health professionals, including ASHA workers, have also had to combat vaccine hesitancy. Parents, reportedly, are showing a disinclination to continue the inoculation regime for their children after they developed fever on being administered the first jab. Such after-effects are par for the course. In the past, health departments in most parts of the country would anticipate the worries of parents and find ways to reassure them. The Mumbai outbreak indicates that the pandemic may have disrupted such efforts.In recent years, the Centre’s Mission Indradhanush project has improved vaccine coverage and reduced delays between shots. But WHO and UNICEF studies have shown that immunisation programmes — especially those focusing on DPT (diphtheria, pertussis and tetanus) and measles — have taken a hit in low and mid-income countries, including India, in the past two years. Early in the pandemic, the National Health Mission’s information system reported that at least 100,000 children missed their shots because of the restrictions on movement. Anecdotal reports do indicate that India’s universal inoculation programme picked up during the later part of the pandemic. But measles is a highly contagious disease. Experts had cautioned that even a 5 per cent fall in the vaccination rate can disrupt herd immunity and precipitate an outbreak. The surge of the disease in Mumbai indicates that their fears are coming true.In the past week, a rise in measles cases has also been reported from Ranchi, Ahmedabad and Malappuram. The Centre has reportedly sent teams to help state health authorities frame control and containment measures. It has also rightly asked states to consider administering an extra dose of vaccines to children, aged five to nine, in vulnerable areas. But the time has also come to look beyond emergency measures and provide the country’s public health services its long-overdue boost. The gains of the Universal Immunisation Programme should not be overturned by health emergencies.
AHMEDABAD: Three-member teams will be deployed in Ahmedabad, Ranchi in Jharkhand and Malappuram in Kerala to assess the upsurge in cases of measles, according to a release by the Union government on Wednesday. 'The teams will assist the state health authorities in instituting public health measures and facilitate operationalization of requisite control and containment measures,' mentioned the release. While the state health department remained in denial mode about the surge, city-based pediatricians confirmed that they have been witnessing steady stream of cases involving toddlers and slightly older kids in age group 3-7 years. Experts from PHO, Mumbai, Kalawati Saran Children's Hospital (KSCH), New Delhi and Regional Office of Health and Family Welfare (RoHFW), Ahmedabad will comprise the central team to Ahmedabad. The teams will also undertake field visits to investigate the outbreak and assist the state health departments in terms of public health measures, management guidelines and protocols to manage the increasing cases of measles being reported in the three cities. Dr Chetan Trivedi, a city-based pediatrician and member of the executive board of Indian Academy of Pediatrics, said that he sees 5-7 cases daily. "I believe that one of the reasons could be skipping the vaccines during the Covid period. These children were also not exposed naturally to the virus due to closure of schools and outside activities and did not develop resistance," he said. Dr Nirav Benani, a city-based paediatrician, agreed with the observation, and said that majority of the kids with the symptoms are non-vaccinated. Measles is acute viral respiratory illness characterized by fever, cough and conjunctivitis. Rashes appear in some of the children's bodies, said experts.
AHMEDABAD: Three-member teams will be deployed in Ahmedabad, Ranchi in Jharkhand and Malappuram in Kerala to assess the upsurge in cases of measles, according to a release by the Union government on Wednesday. 'The teams will assist the state health authorities in instituting public health measures and facilitate operationalization of requisite control and containment measures,' mentioned the release. While the state health department remained in denial mode about the surge, city-based pediatricians confirmed that they have been witnessing steady stream of cases involving toddlers and slightly older kids in age group 3-7 years. Experts from PHO, Mumbai, Kalawati Saran Children's Hospital (KSCH), New Delhi and Regional Office of Health and Family Welfare (RoHFW), Ahmedabad will comprise the central team to Ahmedabad. The teams will also undertake field visits to investigate the outbreak and assist the state health departments in terms of public health measures, management guidelines and protocols to manage the increasing cases of measles being reported in the three cities. Dr Chetan Trivedi, a city-based pediatrician and member of the executive board of Indian Academy of Pediatrics, said that he sees 5-7 cases daily. "I believe that one of the reasons could be skipping the vaccines during the Covid period. These children were also not exposed naturally to the virus due to closure of schools and outside activities and did not develop resistance," he said. Dr Nirav Benani, a city-based paediatrician, agreed with the observation, and said that majority of the kids with the symptoms are non-vaccinated. Measles is acute viral respiratory illness characterized by fever, cough and conjunctivitis. Rashes appear in some of the children's bodies, said experts.
AHMEDABAD: According to the Ahmedabad Municipal Corporation (AMC) health department, city hospitals registered 107 new cases of dengue in the first five days of November. A statement from the health department said there were also 10 cases of malaria, seven of falciparum and nine of chikungunya in this period. Some 118 cases of diarrhoea, 98 cases of jaundice and 98 cases of typhoid were also reported in these five days. AMC data shows from January 1 to November 5, the city has registered 1,135 cases of malaria, 128 cases of falciparum, 2,079 cases of dengue and 244 cases of chikungunya. Sources said the number of dengue cases in this period is slightly lower than during the same period last year. Three people have died of dengue this year. Waterborne diseases also increased this year. In the January 1 to November 5 period, the city has registered 5,786 cases of diarrhoea against 3,610 cases in all of 2021. Similarly, there have been 1,930 cases of jaundice this year against 1,439 cases in all of last year.
AHMEDABAD: According to the Ahmedabad Municipal Corporation (AMC) health department, city hospitals registered 107 new cases of dengue in the first five days of November. A statement from the health department said there were also 10 cases of malaria, seven of falciparum and nine of chikungunya in this period. Some 118 cases of diarrhoea, 98 cases of jaundice and 98 cases of typhoid were also reported in these five days. AMC data shows from January 1 to November 5, the city has registered 1,135 cases of malaria, 128 cases of falciparum, 2,079 cases of dengue and 244 cases of chikungunya. Sources said the number of dengue cases in this period is slightly lower than during the same period last year. Three people have died of dengue this year. Waterborne diseases also increased this year. In the January 1 to November 5 period, the city has registered 5,786 cases of diarrhoea against 3,610 cases in all of 2021. Similarly, there have been 1,930 cases of jaundice this year against 1,439 cases in all of last year.
