Measles-free Philippines

The Department of Health (DOH) has declared a measles outbreak with more than 1,700 confirmed cases of the potentially serious viral infection since last year, and 21 confirmed deaths due to complications.

The worse may yet to come, as measles usually peak during summer.

In other countries, a public health warning is already raised when more than one confirmed case a month is reported.

Measles is caused by a virus that attacks the respiratory tract. Its clinical presentation is very similar to the ordinary flu and is characterized by fever, runny nose and coughing. The skin rashes may appear after several days after the onset of fever. It is highly contagious, something like five to six times more  than the ordinary virus;  it can rapidly spread through the cough or sneeze of the infected person.

Infect other people

Unlike other viruses which die immediately when outside the body of its host, the measles virus can survive for some time; hence it can still infect others up to two hours outside its host body. So even if the infected person is no longer there, the measles virus from the droplets he/she has sneezed or coughed out can still infect other people it comes in contact with. The incubation period is  seven to 10 days.

It is unfortunate that measles outbreaks still happen when there is already a known effective vaccine that can prevent and even possibly eradicate the disease if only we’re able to achieve a 100-percent vaccination among children. The DOH has been constantly encouraging parents to bring their children to the nearest health center for free vaccination. But apparently, the response from the public has been relatively lukewarm, especially in certain areas.

Important role

The local government units (LGUs) also play an important role in ensuring full compliance of the government’s immunization programs in their respective areas. In some areas, a concerted effort by the LGUs and the DOH actively seek out the children with door-to-door vaccinations. Indeed, if Mohammad cannot go to the mountain, let the mountain come to Mohammad.

The children in mass evacuation sites after natural calamities, such as the “Yolanda” evacuees, may be good targets for mass vaccinations since the risk of spreading the infection is much higher in the crowded evacuation centers. Ideally the vaccination should be done before an outbreak, because it needs some time for the protective effect of the vaccine to develop. Anyway, doing such mass vaccination now should be as good a time as anytime.

Preventive and proactive

Perhaps with this outbreak, the LGUs and the public will now realize that it pays to be preventive and proactive, rather than frantically treating children who are suffering from the complications of the disease. Measles can lead to severe pneumonia, and some may even go blind.

It also needs to be emphasized that measles vaccination needs two shots—one given at nine months of age and the other, the booster shot, given at 12 to 15 months of age. Having only the initial immunization shot does not ensure full protection. The second dose is the “insurance shot” that helps stimulate sufficient antibody production in the child to effectively ward off the measles virus.

100% protection

This is likely the reason some children who were supposedly immunized already still got the disease. Most probably, they failed to have the second dose. The vaccine is 80-90 percent effective after the first dose; and an almost 100-percent protection against the measles virus can be achieved with the second dose. Of course, there can be isolated cases of vaccination failures despite having the two shots.

Although measles infection is more common in children, adults are not immune to the disease. One who already had the disease has a lifelong immunity, but those who have not had it yet should consult their family physician if they need a booster shot. The antibodies produced by their immunization when they were children may no longer be sufficient to protect them from being infected.

Despite this outbreak, there’s good reason to be confident that with a multisectoral effort to ensure the 100-percent success of the government’s immunization program against measles—with the program consistently and effectively implanted year after year—we can join many countries in the world in declaring the eradication of measles in our country in three years.